Overview
Physiotherapy helps restore movement and function when someone is
affected by injury, illness or disability. It can also help to reduce your risk of
injury or illness in the future.
It takes a holistic approach that involves the patient directly in their
own care.
When is physiotherapy used?
Physiotherapy can be helpful for people of all ages with a wide range of health
conditions, including problems affecting the:
Physiotherapy can improve your physical activity while helping you to prevent
further injuries.
Physiotherapists
Physiotherapy is provided by specially-trained and regulated practitioners
called physiotherapists.
Physiotherapists often work as part of a multi-disciplinary team in
various areas of medicine and settings, including:
- hospitals
- community health centres or clinics
- some GP surgeries
- some sports teams, clubs, charities and workplaces
Some physiotherapists can also offer home visits.
What do physiotherapists do?
Physiotherapists consider the body as a whole, rather than just focusing on the
individual aspects of an injury or illness.
Some of the main approaches used by physiotherapists include:
- education and advice – physiotherapists can give
general advice about things that can affect your daily lives, such as posture and
correct lifting or carrying techniques to help prevent injuries
- movement, tailored exercise and physical activity advice –
exercises may be recommended to improve your general health and mobility, and to
strengthen specific parts of your body
- manual therapy – where the physiotherapist uses their hands
to help relieve pain and stiffness, and to encourage better movement of the body
There are other techniques that may sometimes be used, such as exercises
carried out in water (hydrotherapy or aquatic therapy) or acupuncture.
Read more about some of the different
techniques that are used in physiotherapy.
Finding a physiotherapist
Physiotherapy is available through the NHS or privately.
You may need a referral from your GP to have physiotherapy on the NHS, although
in some areas it's possible to refer yourself directly.
To find out whether self-referral is available in your area, ask the reception
staff at your GP surgery or contact your
local NHS hospital.
Read more about accessing
physiotherapy.
How does it work?
Physiotherapy techniques and approaches
Physiotherapy can involve a number of different treatment and preventative approaches, depending on the specific problems you're experiencing.
As your first appointment, you will have an assessment to help determine what help you might need.
Three of the main approaches a physiotherapist may use are:
Sometimes other techniques, such as acupuncture or ultrasound treatment, may also be tried.
Education and advice
One of the main aspects of physiotherapy involves looking at the body as a whole, rather than focusing on the individual factors of an injury.
Therefore, giving general advice about ways to improve your wellbeing – for example, by taking regular exercise and maintaining a healthy weight for your height and build – is an important part of treatment.
A physiotherapist can also give you specific advice that you can apply to everyday activities to look after yourself and reduce your risk of pain or injury.
For example, if you have back pain, you may be given advice about good posture, correct lifting or carrying techniques, and avoiding awkward twisting, over-stretching or prolonged standing.
Movement and exercise
Physiotherapists usually recommend movement and exercise to help improve your mobility and function. This may include:
- exercises designed to improve movement and strength in a specific part of the body – these usually need to be repeated regularly for a set length of time
- activities that involve moving your whole body, such as walking or swimming – these can help if you're recovering from an operation or injury that affects your mobility
- exercises carried out in warm, shallow water (hydrotherapy or aquatic therapy) – the water can help relax and support the muscles and joints, while providing resistance to help you gradually strengthen
- advice and exercises to help you increase or maintain your physical activity – advice will be given on the importance of keeping active, and how to do this in a safe, effective way
- providing mobility aids – such as crutches or a walking stick to help you move around
Your physiotherapist may also recommend exercises that you can continue doing to help you manage pain in the long term or reduce your risk of injuring yourself again.
You can find exercise advice leaflets for some common problems, as well as exercises to prevent falls, on the Chartered Society of Physiotherapy (CSP) website.
Manual therapy
Manual therapy is a technique where a physiotherapist uses their hands to manipulate, mobilise and massage the body tissues.
This can help:
- relieve pain and stiffness
- improve blood circulation
- help fluid drain more efficiently from parts of the body
- improve the movement of different parts of the body
- promote relaxation
Manual therapy can be used to treat specific problems, such as back pain, but may also be useful for a range of conditions that don't affect the bones, joints or muscles.
For example, massage may improve quality of life for some people with serious or long-term conditions by reducing levels of anxiety and improving sleep quality. Manual techniques are also used to help certain lung conditions.
Other techniques
Other techniques sometimes used by physiotherapists that may help to ease pain and promote healing include:
- acupuncture – where fine needles are inserted into specific points of the body, with the aim of reducing pain and promoting recovery
- transcutaneous electrical nerve stimulation (TENS) – a small, battery-operated device is used to deliver an electric current to the affected area, with the aim of relieving pain
- ultrasound – where high-frequency sound waves are used to treat deep tissue injuries by stimulating blood circulation and cell activity, with the aim of reducing pain and spasms, as well as speeding up healing
Some people have found these treatments effective, but there isn't much scientific evidence to support them.
There is some positive evidence for acupuncture, but the National Institute for Health and Care Excellence (NICE) only recommends considering it for persistent lower back pain, chronic tension-type headaches and migraines.
Availability
If you need physiotherapy, a number of options are available to you.
You can see a physiotherapist:
- by getting a referral from a doctor
- by contacting a physiotherapist directly
- at your GP surgery
- privately
Physiotherapy can also sometimes be accessed through occupational health services, charities, patient groups and the voluntary sector.
Physiotherapy on the NHS
Physiotherapy is available free of charge on the NHS throughout the UK.
Depending on where you live in Wales, you may be able to self-refer or you may?need to visit your?GP or consultant first. After discussing your symptoms with your doctor, they may then refer you to a physiotherapist.
Self-referral?for NHS physiotherapy
Some areas?in Wales offer a self-referral service, which means you can make an appointment to see an NHS physiotherapist without having to see?a doctor?first.
However, this isn't available everywhere. Staff at your GP surgery or your local hospital trust should be able to tell you whether it's available in your area.
Self-referral?is particularly suitable for people with relatively?simple conditions such as joint pain, strains or other?injuries.
If you have more complex needs?– for example, you have movement problems caused by a?stroke or?multiple sclerosis (MS)?– you may still need a referral from a doctor.
Direct access to physiotherapy
Some physiotherapists also work in GP practices as the first point of contact for patients with musculoskeletal problems, such as neck or back pain, and those with long-term conditions, such as MS or stroke.
When contacting your GP surgery, you may be offered to see the physiotherapist directly, instead of having to see the GP first.
Physiotherapists working in these roles may have advanced skills, such as prescribing and ordering scans.
Private physiotherapy
Waiting lists for NHS physiotherapy can be long and some people choose to have private treatment instead. If you see a physiotherapist privately you'll have to pay for treatment.
You can usually approach a private physiotherapist directly without a referral from a doctor.
When choosing a private physiotherapist, make sure they're:
You can find a chartered private physiotherapist near you using CSP's Physio2u service. You can also use the Find a physio search facility on the Physio First website.
Occupational health services
Physiotherapy may be available through your workplace.
Some companies provide occupational health services, which include physiotherapy treatment. Check with your manager or Human Resources department to see if its available where you work.