Physiotherapy - How it works 

How physiotherapy works 

The aim of physiotherapy is to help restore movement and normal body function in cases of illness, injury and disability.

As well as treating a specific problem, your physiotherapist may also suggest ways you can improve your general wellbeing  for example, by taking regular exercise and maintaining a healthy weight for your height and build. 

Physiotherapists take a holistic approach, looking at the body as a whole rather than focusing on the individual factors of an injury or illness.

For example, back pain can be caused by a number of different things, including:

  • poor posture
  • inherited spinal deformity
  • bending or twisting awkwardly
  • overstretching
  • standing for long periods
  • lifting or carrying objects incorrectly

A physiotherapist will look at your individual situation. As well as treating the problem, they may also suggest things you can do on a daily basis to help relieve pain and discomfort.

For example, if you have lower back pain, maintaining good posture and doing core stability exercises to strengthen stomach and lower back muscles may help.

Read more about treating back pain.

Physiotherapy approaches

Physiotherapists use a wide range of treatment techniques and approaches. Some of these are described below.

Movement and exercise

Physiotherapists use therapeutic exercises designed to strengthen the affected body area. They need to be repeated regularly, usually daily, for a set number of weeks.

As well as specific exercises, gentle activities such as walking or swimming may be recommended if you are recovering from an operation or sports injury that affects your mobility.

For someone with a mobility problem caused by a condition such as a stroke, a physiotherapist may suggest doing exercise that targets the affected area of the body.

For example, studies have shown that circuit class therapy is an effective method of rehabilitation after a stroke. Compared with other types of exercise, it can help improve a person's ability to walk further, longer and faster, as well as help with their balance.

There is also strong evidence to show physical activity can help manage and prevent more than 20 different health conditions. For example, physically active adults have been shown to have a significantly lower risk (up to 50%) of developing major health conditions such as coronary heart disease, stroke, diabetes and cancer.

Manual therapy techniques

Manual therapy involves using the hands to mobilise joints and soft tissues. It is suitable for most people and can be used to:

  • improve blood circulation
  • help fluid drain from parts of the body more efficiently
  • improve movement of different parts of the body
  • relieve pain and help relaxation

There is evidence to show manual therapy is beneficial in treating some types of musculoskeletal conditions, such as long-term back pain (where the pain lasts for longer than six weeks).

For example, the National Institute for Health and Clinical Excellence (NICE) advises that manual therapy can be used to treat persistent lower back pain.

In appropriate cases, massage may also be used as part of your treatment programme. Evidence suggests massage can be useful for a range of health conditions, including helping to reduce some of the symptoms of cancer and the side effects of cancer treatment.

A three-year-long American study carried out in 2004 looked at the effects of massage therapy on 1,300 people with cancer. Results showed that massage therapy significantly reduced the symptoms of pain, sickness, tiredness, anxiety and depression in all participants.

Other techniques

Other techniques that can help to ease pain and promote healing include:

  • acupuncture  fine needles are inserted into specific points of the body. Acupuncture may be used alongside other physiotherapy techniques to help reduce tissue inflammation and pain, and to promote recovery.
  • transcutaneous electrical nerve stimulation (TENS)  a TENS machine is a small, battery-operated machine that delivers an electric current to the affected area via two electrodes. The tingling sensation produced by the current can help block or suppress pain signals to your brain.
  • ultrasound  high-frequency sound waves can treat deep tissue injuries by stimulating blood circulation and cell activity. It is thought it can help reduce pain and muscle spasm, as well as speed up healing.

Scientific evidence to support the above treatments is limited. For example, there is not enough firm evidence to say for sure whether TENS is a reliable method of pain relief.

Some people have reported that TENS has been effective for them, but it seems to depend on the condition and the individual. TENS is not suitable for people with a pacemaker or other type of electrical implant.

Read more about TENS.

Aquatic therapy (hydrotherapy)

Aquatic therapy is a form of physiotherapy carried out in water  usually a warm, shallow swimming pool or special hydrotherapy pool. It is often used with children and adults who have physical and learning disabilities.

Aquatic therapy can improve blood circulation, relieve pain and relax muscles.

As with other treatment techniques, aquatic therapy may prove beneficial in certain cases, but again there is limited evidence to show that it is an effective method of pain relief in all cases.

Page last reviewed: 14/05/2012

Next review due: 14/05/2014


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The 1 comments posted are personal views. Any information they give has not been checked and may not be accurate.

coopsy88 said on 26 November 2011

Why is there no discussion of the quality/quantity of evidence behind the techniques of physiotherapists? How can one be expected to make informed decisions without this?

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Managing health conditions

Physiotherapy can be used to help manage health conditions that affect many of the body's systems, including the bones, joints and soft tissues (musculoskeletal), and the heart and blood circulation (cardiovascular).