Techniques - Physiotherapy

Physiotherapy can involve a number of different treatment and preventative approaches, depending on the specific problems you're experiencing.

At 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:

• education and advice
• movement and exercise
• manual therapy

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 get stronger
• 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
• advice on using 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.

More exercise advice

Chartered Society of Physiotherapy: exercise advice leaflets

Chartered Society of Physiotherapy: Get up and go - a guide to staying steady

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 is not 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 chronic (long-term) pain, chronic tension headaches and migraines.