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Physiotherapy

Physiotherapy is a treatment that aims to improve the way your joints and muscles work. It can help to maximise your movement, flexibility, coordination and strength.

Physiotherapy is carried out by a physiotherapist – a health professional who specialises in maintaining and improving movement and mobility. Your physiotherapist will discuss your care with you before carrying out any treatment. It may be different from what’s described here as it will be designed to meet your personal needs.

 

Physiotherapy is not only used to treat injuries and musculoskeletal problems. It can help people to recover from a stroke or surgery. It’s also very useful in the treatment of some health conditions, such as multiple sclerosis (MS), osteoarthritis and cystic fibrosis.

Physiotherapy tends to be a combination of ‘hands-on’ care, exercise prescription and self-management techniques. Your physiotherapist may coach you through exercises that you can then do yourself at home, or with some support.

Emily Partridge, Regional Lead Therapist, Bupa, says: “Sometimes, one or two sessions of physiotherapy will be enough, but sometimes more will be needed. This will depend on your condition and the cause of it, as well as your lifestyle and how well you keep up the exercises you’re prescribed.”


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Lee learns to manage his back pain

Details

  • When is physiotherapy used? When is physiotherapy used?

    Physiotherapy can help to treat a wide range of conditions including:

    • acute injuries or pain (pain that starts suddenly, for example, because of a fall) in your muscles, bones and joints, such as back pain, neck pain or knee injuries
    • chronic (long-term) musculoskeletal conditions such as osteoarthritis or osteoporosis
    • conditions that cause fluid to build up on your lungs, such as cystic fibrosis
    • conditions such as Parkinson’s disease, stroke or multiple sclerosis (MS), which affect your nervous system
    • women’s health conditions, such as incontinence
    • recovery after stroke, bed rest or surgery
  • Finding a physiotherapist Finding a physiotherapist

    Your GP may refer you to an NHS physiotherapist or you may be able to refer yourself directly (self-referral) – ask for information about this at your surgery. Alternatively, you may wish to book to see a private one. If you have private health insurance, contact your insurer as they should be able to refer you quickly to a physiotherapist in your area. To find a registered physiotherapist in your area, contact the Chartered Society of Physiotherapy or search their website.

    Make sure your physiotherapist is registered with the Health and Care Professions Council (HCPC). This means they have completed approved standards of training and follow the HCPC rules of professional conduct.

    GP self referral

    Bupa health insurance customers can get fast and direct access to advice and treatment with an experienced physiotherapist usually without the need for a GP referral.

    Please note that direct access is subject to a member’s underwriting terms. Pre-existing conditions are normally excluded.

  • Types of physiotherapy Types of physiotherapy

    Your physiotherapist will ask about your symptoms and examine you. Working with you, they’ll create a treatment programme that will be most helpful for you. They will aim to treat your symptoms and help to strengthen your body, so you’re more protected from injury or stiffness in the future.

    The exercises or techniques your physiotherapist suggests will depend on why you're having physiotherapy. There are a number of different techniques they may use. The ones explained below are commonly used at clinic appointments (out-patient physiotherapy).

    As with every procedure, there are some risks associated with physiotherapy. We have not included the chance of these happening as they are specific to you and the treatment you’re having. Ask your physiotherapist to explain the risks that apply to you.

    Range of motion exercises

    If you have stiff joints, these exercises can help to increase your flexibility. Range of motion exercises may help you to get your movement back after a stroke or a long period of bed rest, for example. Your physiotherapy sessions might involve you performing exercises and stretches yourself or with the physical support of your physiotherapist.

    Muscle-strengthening exercises

    These exercises are used to increase the strength of your muscles and for how long you can exercise for (your stamina). They’re also used to improve ‘core stability’ – the strength of the muscles in your abdomen (tummy). This is important for maintaining good posture and balance. These exercises are likely to include resistance training (moving your muscles against some kind of force). For example, your physiotherapist may ask you to use stretchy bands, weights or your own body weight.

    To get a feel for the types of exercises and stretches that a physiotherapist might suggest, watch the Bupa videos linked to below. Your physiotherapist may be able to suggest appropriate exercises for you.

    • Strength-training exercises can help to support and protect your joints and ligaments.
    • Core stability exercises can help align the muscles in your neck, shoulders, trunk, pelvis, hips and knees.
    • Stretches for your calf, quadriceps, hamstrings, chest, shoulder and triceps reduce stiffness and risk of injury.

    Massage (manual therapy)

    Massage can help to loosen muscles and tissue that have become tight (‘knots’), and can also reduce pain and swelling.

    Massage may also be used to complement other types of physiotherapy you’re having.

    Your physiotherapist may use massage to drain excess fluid from your limbs into your lymph system. This is useful if you have lymphoedema, which is a condition that causes too much fluid to collect in your arm or leg.

    Massage can also help if you have cystic fibrosis. A physiotherapist can help to clear mucus from your airways using a special massage technique called percussion.

    Manipulation

    During manipulation, your physiotherapist moves or puts pressure on a precise area of your body, such as your back, to loosen it. They may use increasing pressure or a sudden, controlled push for this. There were some concerns over whether back manipulation is safe, but it’s now thought to work as well as other treatments for long-term back pain. If you’re having manipulation, make sure it’s performed by a qualified practitioner, to reduce the risk of any injury.

    Hydrotherapy

    Hydrotherapy is a set of exercises carried out in a water pool. Warm water helps to loosen and support your joints and muscles. It can also provide useful resistance, which can help you to get stronger. Hydrotherapy can help treat pain and arthritis, for example.

    Emily Partridge, Regional Lead Therapist, Bupa, says: “You may have found that having a bath can ease your pain. This is because the water takes some of the weight off your body. The warmth can also relax your muscles and ease joint pain. Hydrotherapy makes use of these benefits to allow you to exercise more than you might be able to usually.”

    Electrotherapy

    Electrotherapy is a general term for therapies that use low-level electrical energy to reduce your pain and encourage healing. It can be used in combination with other types of physiotherapy. An example is transcutaneous electrical nerve stimulation (TENS), which uses a low-level electric pulse to relieve your pain. This usually feels like a tingle.

    Acupuncture

    Acupuncture is a complementary therapy that typically involves inserting fine needles into your skin at defined points. Your physiotherapist may use it with other types of physiotherapy to help relieve pain.

  • The Bupa knee clinic The Bupa knee clinic

    Bupa's online knee clinic
  • Does physiotherapy hurt? Does physiotherapy hurt?

    Answer

    Some people find that physiotherapy helps to ease their pain straight away. Others may feel a bit sore at first, but this will usually settle after a couple of days.

    More information

    Your physiotherapist will discuss with you any pain you may have during or after your treatment session. Physiotherapy shouldn't cause you any long-term pain, but you may feel a bit sore after your appointment and for the first couple of days. This may be because:

    • you’re using muscles more than you have for a while
    • stiff joints have been loosened
    • tissues have been stretched

    Any pain should settle, but if it doesn't get any better, talk to your physiotherapist about changing your treatment.

    You can take over-the-counter painkillers to help manage any pain at home. Keep a note of how long your pain lasts, as it's useful for your physiotherapist to know.

  • Getting undressed for your appointment Will I need to get undressed during my physiotherapy appointment?

    Answer

    Your physiotherapist will explain what will happen during your treatment, including whether you need to remove any clothing. Let your physiotherapist know if you feel uncomfortable at any time, and ask to have a chaperone if you’d like.

    More information

    At your first appointment, your physiotherapist ideally needs to look at the area of your body that is causing your problems. He or she may also want to see the muscles or joints working. For example, if you're having problems with your lower back, your physiotherapist may want to examine your back or hips. Or, if you have problems with your knees, your physiotherapist may want to look at them while you walk.

    You won’t be asked to remove more clothes than is necessary, but you may need to undress to your underwear. You may wish to wear a similar alternative such as a sports bra and shorts.

    You can choose not to undress. This may influence how well your treatment works because it could be more difficult for your physiotherapist to see the problem.

    You can ask for a chaperone to be present at your appointment, if you’d like. Your physiotherapist may also suggest a chaperone for some procedures.

  • Physiotherapy

    At our Bupa Health Centres, we offer self-pay health services for a wide range of conditions, including physiotherapy.

  • Other helpful websites Other helpful websites

    Sources

    • Physical therapy (PT). MSD Manual. www.msdmanuals.com, reviewed August 2013
    • Rehabilitation. Oxford Handbook of Geriatric Medicine – 2nd ed. (online). Oxford Medicine Online. www.oxfordmedicine.com, published July 2012
    • Musculoskeletal problems. Oxford Handbook of General Practice – 4th ed. (online). Oxford Medicine Online. www.oxfordmedicine.com, published April 2014
    • Nursing patients with respiratory problems. Oxford Handbook of Adult Nursing (online). Oxford Medicine Online. www.oxfordmedicine.com, published August 2010
    • Multiple sclerosis. The Chartered Institute of Physiotherapy. www.csp.org.uk, published June 2014
    • Rehabilitative measures for treatment of pain and inflammation. MSD Manual. www.msdmanuals.com, published August 2013
    • A career in physiotherapy. The Chartered Institute of Physiotherapy. www.csp.org.uk, accessed 30 July 2015
    • Osteoporosis. The Chartered Institute of Physiotherapy. www.csp.org.uk, published June 2014
    • Parkinson’s. The Chartered Institute of Physiotherapy. www.csp.org.uk, published January 2014
    • Incontinence. The Chartered Institute of Physiotherapy. www.csp.org.uk, published June 2014
    • Standards of proficiency. Health and Care Professions Council (HCPC). www.hpc-uk.org, published August 2013
    • Chronic pain. The Chartered Institute of Physiotherapy. www.csp.org.uk, published July 2014
    • Principles of symptom control in palliative care. Oxford Handbook of Oncology – 3rd ed. (online). Oxford Medicine Online. www.oxfordmedicine.com, published June 2013
    • Lymphedema. Medscape. www.emedicine.medscape.com, published January 2015
    • Cystic fibrosis. MSD Manual. www.msdmanuals.com, published January 2014
    • Rubinstein SM, van Middelkoop M, Assendelft WJJ, de Boer MR, van Tulder MW. Spinal manipulative therapy for chronic low-back pain. Cochrane Database of Systematic Reviews 2011, Issue 2. doi:10.1002/14651858.CD008112.pub2
    • Nursing patients with pain. Oxford Handbook of Adult Nursing (online). Oxford Medicine Online. www.oxfordmedicine.com, published August 2010
    • How does hydrotherapy help? Arthritis UK. www.arthritisresearchuk.org, accessed 3 August 2015
    • Chaperoning and related issues. The Chartered Institute of Physiotherapy. www.csp.org.uk, accessed August 2015

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    Reviewed by Alice Rossiter, Bupa Health Content Team, October 2015.

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