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Physiotherapy


Expert reviewer, Emmanuel Udomhiaye, Senior MSK Physiotherapist at Bupa
Next review due October 2023

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, and to optimise your body’s normal functioning and physical ability. Physiotherapy is used to help people recover from illnesses and injuries, and to help treat long-term health conditions and disabilities.

Your care may be different from what we describe here as it will be designed to meet your personal needs. This information explains what physiotherapists do, some of the techniques they use and answers some frequently asked questions about physiotherapy.

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What does a physiotherapist do?

A physiotherapist (physio) is a health professional who specialises in maintaining and improving movement and mobility. Your physiotherapist will discuss your care with you before they start any treatment, and do a thorough examination to understand how best to help you. Sessions can last from 15 minutes to an hour, depending on what you’re having treated. The number of sessions you need will depend on your condition, how long it takes to treat and how well you recover.

What is physiotherapy used to treat?

Physiotherapy is also sometimes called physical therapy. It can help to treat a wide range of conditions including:

  • acute injuries or pain (pain that starts suddenly) in your muscles, bones and joints – for example, 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 – for example, 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 bed rest or surgery

Physiotherapy tends to be a combination of hands-on care, exercises, advice and education. Your physiotherapist may coach you through exercises that you can then do at home by yourself or with some support.

How can I find a physiotherapist?

Your GP may refer you to an NHS physiotherapist or you may be able to refer yourself directly (self-referral). Ask your GP surgery for information. Alternatively, you may wish to book to see a private physiotherapist. Contact the Chartered Society of Physiotherapy or search their website (see our section: Other helpful websites below) to find a registered physiotherapist in your area. If you have private health insurance, contact your insurer because they should be able to refer you to a physiotherapist in your area.

It's important to check that 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.

Physiotherapists work from a wide range of places to provide physiotherapy. They may deliver outpatient therapy in the community – for example in homes, gyms, or clinics in health centres. Or you may have inpatient therapy in hospitals and hospices.

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What treatment techniques do physiotherapists use?

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. This may include advice and information, exercises for you to do and manual therapy. They’ll aim to treat and ease your symptoms, and to look at and solve anything that may have contributed to the problem. This will also help prevent the problem from happening again. The exercises or techniques your physiotherapist suggests will depend on why you're having physiotherapy. There are a number of different techniques, which are explained below.

Mobility exercises

If you have stiff joints, these exercises (also called range of motion exercises) can help to increase your flexibility. Mobility 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 doing exercises and stretches by yourself or with the physical support of your physiotherapist.

Muscle-strengthening exercises

Strength exercises are important in treating any area of your body that is weak and has lost strength because of pain, injury or lack of use. These exercises may help prevent your injury from happening again by supporting and protecting your bone, joints, ligaments and tendons. For example, you might do strength exercises after an ankle sprain or if you dislocate your shoulder. Or you might do core stability exercises to strengthen your abdominal (tummy) and back muscles to help protect your spine from injury. Strength exercises might 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.

Massage

Massage can help to improve your mobility by loosening muscles and tissue that have become tight (have ‘knots’). It can also reduce pain and swelling.

Your physiotherapist may use massage alongside other types of physiotherapy. For example, they may massage you to loosen your muscles and tissue before they do exercises with you.

Massage can be useful if you have lymphoedema (a build-up of fluid) in a part of your body, usually your arm or leg. Your physiotherapist may use massage to move excess fluid from your limbs into your lymph system.

Massage can also help if you have cystic fibrosis, a condition that affects your lungs and digestive system. A physiotherapist can help to clear mucus from your airways using a special massage technique called percussion.

Manipulation

During manipulation, your physiotherapist will move or put pressure on a precise area of your body (for example, your back) to loosen it. They may use short, sharp movements to push your joint beyond its normal range of movement. Manipulation is safe and can help to reduce back pain and improve mobility but it’s important that your physiotherapist is trained to use this therapy.

Joint mobilisation

Joint mobilisation is a technique in which your physiotherapist will slowly move your joint within its normal range of movement. Your physiotherapist will take the weight and move your joint for you.

Joint mobilisation can help to restore the movement of your joint and also to reduce pain and muscle spasms.

Acupuncture

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

Dry needling

Dry needling (often called western or medical acupuncture) is another technique that involves needles but is different from acupuncture. Acupuncture and dry needling differ in their philosophy, where the needles are placed, and how the treatments are practised.

In dry needling, your physiotherapist will place needles into specific points of your muscles in order to treat pain and tightness and to improve movement.

Taping

Taping is often used to support injuries to your joints. It’s also sometimes used to help improve posture and movement during sport and exercise. Different types of tape can be used depending on what type of injury you have. Some tapes are rigid whereas others are more flexible.

The more rigid tape is usually used to prevent an injury. It supports part of your body and can also help prevent an injury from getting worse by limiting the amount of movement.

The more flexible tape is thought to support weak muscles, help inflammation and provide (short-term) pain relief by increasing lymph and blood flow.

Hydrotherapy

Hydrotherapy is a set of exercises that you do in a pool. Warm water helps to loosen and support your joints and muscles, and can provide useful resistance, which can help you to get stronger. This may allow you to exercise more than you might usually be able to. For example, hydrotherapy can help to treat pain and arthritis.

Electrotherapy

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

Frequently asked questions

  • Some people find that physiotherapy helps to ease their pain straight away. But you may feel a bit sore at first, and this is common after having physiotherapy. Many of the techniques physiotherapists use work at or close to the area that’s injured or painful. This will naturally be painful for a little while during or after your treatment but physiotherapy shouldn't cause you any long-term pain.

    If you feel a bit sore after your treatment 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. To help manage any pain at home, you can take over-the-counter painkillers provided these are suitable for you. Always read the patient information leaflet that comes with your medicine and if you have any questions, you can ask a pharmacist. Keep a note of how long your pain lasts because this is useful for your physiotherapist to know.

  • Your physiotherapist will explain what will happen during your treatment, including whether or not 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 one (your physiotherapist may suggest a chaperone for some procedures).

    At your first appointment, your physiotherapist ideally needs to look at the area of your body that’s causing your problems. They may want to see your 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.

    Your physiotherapist won’t ask you to remove more clothes than necessary, but you may need to take some clothing off. Some people may feel more comfortable wearing underwear such as shorts or a sports bra, but it’s your choice. Your physiotherapist will respect your wishes and beliefs and will try to keep you covered up as much as possible where they can.

    You can, of course, choose not to undress. But this might affect how well your treatment works because it could make it more difficult for your physiotherapist to see the problem.



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Related information

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  • Reviewed by Rachael Mayfield-Blake, Freelance Health Editor, October 2020
    Expert reviewer, Emmanuel Udomhiaye, Senior MSK Physiotherapist at Bupa
    Next review due October 2023

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