Physiotherapy - 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 specific problems, your physiotherapist may also suggest ways to 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. The person being treated is directly involved in their own care.

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. They may also give you advice about how to prevent the injury re-occurring.

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

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 improve mobility and strengthen the affected area of the body. 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're 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 specific exercises which target 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's also strong evidence to show that 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 uses 'hands on' treatment techniques to mobilise joints and soft tissues. It's suitable for most people and can be used to:

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

There's also evidence to show that 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).

The National Institute for Health and Care Excellence (NICE) advises that manual therapy can be used to treat persistent lower back pain.

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

A study carried out in 2009 looked at the effects of therapeutic massage on the quality of life among people being treated for breast cancer.

The results showed that therapeutic massage had potential benefits for improving the effects of breast cancer treatment by reducing the side effects of chemotherapy and radiotherapy. It also had a positive effect on perceived quality of life.

Other techniques

Other techniques that can help to ease pain and promote healing are described below.

Acupuncture – where fine needles are inserted into specific points of the body. It's sometimes used alongside other physiotherapy techniques to help reduce tissue inflammation and pain and promote recovery.
Transcutaneous Electrical Nerve Stimulation (TENS) – a TENS machine is a small, battery-operated device 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 be used treat deep tissue injuries by stimulating blood circulation and cell activity. It's thought it can help reduce pain and muscle spasm, as well as speed up healing.

Scientific evidence to support the above treatments is currently limited. For example, there's 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. It's not suitable for people with a pacemaker or other types of electrical implant.

Aquatic therapy (hydrotherapy)

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

Aquatic therapy can help improve blood circulation, relieve pain and relax muscles. It can also help with mobility because activities that aren't possible to do on dry land can be performed in the water.

Exercises against the resistance of water and dynamic exercises within the water can also improve muscle strength, balance and co-ordination.