Introduction

Physiotherapy
Physiotherapy

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.

Accessing physiotherapy

Physiotherapy is available through the NHS or privately. It can also sometimes be accessed through other routes, such as charities and the voluntary sector.

In some areas, self-referral schemes allow physiotherapy to be accessed directly. To find out whether self-referral is available in your area, speak to the reception staff at your GP surgery or ask at your local NHS hospital.

Read more about accessing physiotherapy.

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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.

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Availability

If you need physiotherapy, a number of options are available to you.

You can see a physiotherapist:

  • through the NHS– either by getting a referral from a doctor, by contacting a physiotherapist directly (self-referral) or at your GP surgery (direct access)
  • privately
  • through occupational health schemes
  • by contacting a physiotherapist directly (self-referral)

Physiotherapy can also sometimes be accessed through charities, patient groups and the voluntary sector.

The NHS

Depending on where you live in Wales, you may need to visit your GP first who, after discussing your symptoms with you, may refer you to an NHS physiotherapist. Physiotherapy through the NHS is free of charge.

Some areas offer a self-referral service which means you can make an appointment to see a physiotherapist without having to see your GP first (see below).

Private sector

Many physiotherapists in Wales work in the private sector. If you see a physiotherapist privately you will have to pay for treatment.

If you decide to see a private physiotherapist, make sure they are a fully qualified member of a recognised professional body, such as the Chartered Society of Physiotherapy (CSP).

To find a chartered private physiotherapist in your local area, you can use the post code search on the CSP's Physio2u service.

Occupational health schemes

Physiotherapy may be available through your workplace. Some companies run occupational health schemes that include physiotherapy treatment. Check with your human resources department.

Direct referral

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

Self-referral has several benefits including:

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

If you would like to know if physiotherapy is available in your area please click on the link to the Health Board which corresponds to your residential area below:

Abertawe Bro Morgannwg - Self referral to physiotherapy

Aneurin Bevan - Physiotherapy

Betsi Cadwaladr - Physiotherapy

Cardiff & Vale - Physiotherapy

Cwm Taf - Physiotherapy

Hywel Dda - Self referral to physiotherapy

Powys Teaching Health Board

Governance

'Physiotherapy' is a protected title and all physiotherapists must be registered with the Health and Care Professions Council (HCPC).

Being registered with the HCPC means that a physiotherapist is legally allowed to work in the UK and is working within defined professional standards.

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The information on this page has been adapted by NHS Wales from original content supplied by NHS Choices.
Last Updated: 25/02/2016 10:09:30