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You are here > Home > Treatment - Therapies > Physiotherapy

Physiotherapy - A Guide to Treatment

Physiotherapy, often referred to as physio, uses physical methods, such as massage and manipulation, to promote healing and wellbeing. Physiotherapy treatments are often used to help restore a person’s range of movement after injury or illness.

Introduction
What physiotherapy is used for
How physiotherapy works
Accessing physiotherapy
Self-help

Introduction

Physiotherapists are healthcare professionals who have trained specifically in physiotherapy. They work in a number of different places, including:

  • hospitals
  • GP surgeries
  • private practices
  • workplaces
  • the community


When is physiotherapy used?

Physiotherapists frequently treat problems that affect:

  • muscles
  • joints
  • heart, blood circulation and lungs

Physiotherapists also help people with mental health conditions, neurological conditions (those affecting the brain and nervous system) and chronic (long-term) health conditions.

Physiotherapy techniques

By using a number of different approaches and techniques, a physiotherapist can help a person overcome injury or short-term health problems, or manage long-term disability.

Physiotherapists use a wide range of techniques and approaches, including:

  • massage and manipulation, using the hands to relieve muscle pain and stiffness and encourage blood flow to an injured part of the body to help recovery
  • heat, cold, electric current, light and water
  • remedial exercise (exercise that takes into account a person’s current level of health and any specific requirements they may have)
  • providing support to help patients manage chronic conditions

Physiotherapy techniques and approaches can improve a person’s ability to use parts of their body that are affected by a health condition or injury.

For example, arthritis is a chronic condition that causes painful, stiff joints and is often associated with ageing. Physiotherapists can help keep the joints mobile and strengthen the surrounding muscles.

See How physiotherapy works for more information about the different techniques that are used by physiotherapists.

Who can physiotherapists help?

Physiotherapy can help people of all ages and social backgrounds. In particular, physiotherapy can help rehabilitate (restore to health) people who have:

  • had a stroke, when the blood supply to part of the brain is cut off
  • heart problems and breathing difficulties
  • a sports injury
  • recently had surgery that affects their movement or mobility

Almost all people who have an injury or a physical disability can benefit from physiotherapy, including children and elderly people.

For more information about when physiotherapy is used and how it can benefit children and the elderly, see What physiotherapy is used for.

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What physiotherapy is used for

Physiotherapists use their knowledge and skills to help people overcome a wide range of physical health problems, including:

  • bone and joint conditions
  • heart and lung conditions
  • neurological conditions (those affecting the brain and nervous system)
  • childhood conditions
  • conditions that occur in old age

These are discussed in more detail below.

Bone and joint conditions

One of the main areas that physiotherapy focuses on is the treatment of conditions and injuries that affect the bones and joints. In particular, physiotherapists often help patients who are recovering from orthopaedic surgery (surgery to correct damage to or deformities of the bones or joints).

The physiotherapist may devise a programme that includes the use of strength training and exercises to help improve co-ordination and balance. They may also use electrical stimulation (using small electrical impulses to stimulate the nerves and muscles). See How physiotherapy works for more information about electrotherapy.

Heart and lung conditions

Physiotherapists may treat people who have:

  • had a heart attack
  • chronic obstructive pulmonary disease (COPD), a collection of lung conditions including chronic bronchitis, emphysema and chronic obstructive airways disease
  • cystic fibrosis (see below)

Cystic fibrosis is a genetic (inherited) disorder where mucus inside the body becomes thick and sticky, clogging the lungs and other important organs.

‘Clapping’ on a patient’s back while they are lying down can help loosen the build-up of mucus in the lungs so it can be coughed up.

Physiotherapists also teach people with cystic fibrosis to help clear the mucus themselves and may work with a child’s parents to teach these methods to them.

Neurological conditions

Physiotherapists can help people with conditions that affect the brain and nervous system, such as:

  • stroke: a serious condition where the blood supply to part of the brain is cut off
  • multiple sclerosis: a condition that affects the central nervous system, which controls functions of the body such as movement and balance
  • Parkinson’s disease: a chronic (long-term) condition that affects the way the brain co-ordinates the body’s movements
  • cerebral palsy: a condition where brain damage affects a child’s movement and co-ordination
  • spina bifida: a brain condition that causes a deformity of the spine

As well as affecting a person’s co-ordination, neurological conditions can sometimes cause paralysis (an inability to move) and muscle pain, which can make it difficult to get around independently.

Childhood conditions

Physiotherapists treat children with musculoskeletal conditions (which affect the bones and muscles).

For example, muscular dystrophy is a congenital condition (present from birth) where a person’s muscles gradually become weaker over time, leading to a loss of strength and mobility.

In such cases, a physiotherapist may be able to use a treatment programme that will help the person maintain muscle strength, increase flexibility and prevent stiffening of the joints.

Conditions that occur in old age

Physiotherapists often treat conditions that are common in old age, such as:

  • arthritis, which causes pain and swelling (inflammation) of the joints
  • osteoporosis, where the bones become thin and brittle

Physiotherapists may help patients who are recovering from hip replacement surgery.

Physiotherapists also play an important role in the general care and wellbeing of elderly people by improving their overall health and fitness to help them stay active and independent.

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How physiotherapy works

The aim of physiotherapy is to help restore normal body function. As well as treating a specific injury or illness, the physiotherapist may consider ways to improve your general wellbeing and overall quality of life.

Holistic approach

Physiotherapists usually take a holistic approach, which means they are likely to look at the body as a whole, rather than focusing on individual factors of an injury or illness. For example, back pain can have a number of causes, such as:

  • muscle tension
  • overstretching
  • bending awkwardly
  • standing or bending for long periods
  • lifting or carrying incorrectly

Patient education is an important part of physiotherapy. As well as aiming to improve your strength and mobility, a physiotherapist can also advise you about how to manage your condition more effectively, for example by exercising regularly.

Physiotherapy techniques

Physiotherapists use a range of techniques and approaches, the most common of which are described in more detail below.

Massage and manipulation

Massage involves manipulating the body’s soft tissues using the hands. It is suitable for most people and can be used to:

  • improve circulation (the flow of blood around the body)
  • help fluid drain from parts of the body more efficiently
  • improve movement of different parts of the body
  • relieve pain and help you relax

Conditions that are often treated using massage include neck problems, headaches and stress.

Movement and exercise

Physiotherapists often use an exercise programme, which may incorporate specific exercises to help with particular health problems.

For example, gentle exercise, such as walking or swimming, may be recommended for someone who is recovering from an illness or injury that affects their overall mobility.

For someone who is having problems moving a limb due to a health condition, such as a stroke, a physiotherapist may suggest specific exercises that target the affected area of the body.

These types of exercises are designed to strengthen your body and improve your range of movement. They usually need to be repeated daily for a number of weeks. Your physiotherapist will advise you about the exercises you need to do and will show you how to perform them correctly.

Energy based therapy

Energy based therapy, which is sometimes referred to as electrotherapy in the UK, is a form of treatment that uses different types of energy, such as electric currents or impulses (small electric shocks) to stimulate the nervous system. The electric impulses make your muscles contract (tighten), which can help ease pain and promote healing.

Energy based therapies do not hurt, although with some types, such as TENS, you may feel a slight tingling sensation just below the surface of your skin. Energy based therapies include:

  • TENS - a transcutaneous electrical nerve stimulation (TENS) machine delivers an electric current to stop your nerves sending pain signals to your brain and encourages endorphins (natural painkilling hormones) to be released.
  • Ultrasound - high-frequency sound waves treat deep tissue injuries by stimulating blood circulation and cell activity. It is thought to help reduce pain and muscle spasm and speed up the healing process.
  • Laser therapy - lasers (narrow beams of light) help reduce pain and muscle spasms. Laser therapy is thought to be most effective at treating tendon conditions, although studies have shown that it may not be as effective as other types of energy based therapies.
  • Shortwave diathermy - an electromagnetic field generates heat within your body’s tissues. This is thought to help reduce inflammation (swelling), strengthen tissues and reduce pain.

Hydrotherapy

Hydrotherapy is a form of physiotherapy that is carried out in water, usually a warm, shallow swimming pool or a special hydrotherapy bath.

The resistance (weight) of the water pushes against your body as you do exercises while you are floating. This helps improve your circulation (blood flow), relieves pain and relaxes your muscles.

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Accessing physiotherapy

You can see a physiotherapist through

  • the NHS
  • the private sector
  • the independent sector
  • contacting a physiotherapist directly

Each route is described in more detail below.

The NHS

Your GP may refer you to a physiotherapist. They will discuss your symptoms with you and may decide that you would benefit from physiotherapy. Physiotherapy through the NHS is free of charge.

All physiotherapists who work in the NHS are chartered (qualified as a member of a professional body). Only practitioners who are registered with the Health Professions Council (HPC) are allowed to use the title physiotherapist.

Private sector

In England, many physiotherapists work in the private sector. If you decide to visit a private physiotherapist, you will have to pay for any treatment you receive.

If you decide to see a private physiotherapist, make sure they are fully qualified and are a member of a recognised body, such as the Chartered Society of Physiotherapy (CSP). Physiotherapists who are members of the CSP will follow high standards of professional practice and will have a good level of knowledge and skills.


Find a Physiotherapist in the UK

Local Physio is the leading free search engine to finding local physiotherapists nationwide. From sports injuries to rehabilitation after an accident or injury, Local Physio can help you find the expert help you require.

Independent sector

You may be able to receive physiotherapy through your workplace. Some companies run occupational health schemes that include physiotherapy treatment. Check with your human resources department to see if you are eligible.

Physiotherapy treatment can sometimes be accessed through charities and the voluntary sector.

Direct referral

Self-referral is becoming more widely practiced and has proven particularly popular for people with chronic (long-term) conditions who know what type of treatment they require.

Self-referral has several benefits including:

  • saving time - both for GPs and patients
  • reducing waiting times for patients
  • improved levels of attendance at appointments
  • empowering patients to self-manage their condition

If you have a long-term condition and you have received physiotherapy in the past as part of your treatment programme, you may decide to contact a physiotherapist directly without being referred by your GP.

However, as self-referral is still a relatively new concept within the NHS, you should contact your local primary care trust (PCT) to check whether it is available in your area.

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Self-help

Basic measures may help to ease (or prevent) painful symptoms and improve your overall health and wellbeing.

Below is some general self-help advice. A physiotherapist will be able to give you advice that is specific to your level of health and your condition or injury.

Exercise

In many situations, keeping active can help reduce pain and stiffness in your joints and speed up recovery. Therefore, taking regular exercise is important. However, ask your GP or physiotherapist for advice if you have not exercised for a while due to injury.

Posture

Maintaining good posture will help prevent aches and pains. Make sure your computer workstation and driving position are set up correctly for your height, and change positions regularly.

Your physiotherapist will be able to give you advice about carrying out tasks that are repetitive or strenuous. Activities such as yoga and Pilates (exercises that strengthen your core abdominal muscles) will help you to relax, become more aware of your body and improve your posture.

Weight

By keeping to a healthy weight for your height and build, you will avoid placing excess pressure on your joints. This will help prevent conditions such as osteoporosis (where the bones become thin and weak).

Seek help

Visit your GP or a physiotherapist as soon as possible if you are in severe pain or if you have a severe or persistent injury.



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