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

You can see a physiotherapist: 

• through the NHS
• privately
• through occupational health schemes 
• by contacting a physiotherapist directly (self-referral)

Each of these routes is described below.

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

The NHS

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

Some areas in the UK 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 England work in the private sector. If you see a physiotherapist privately you’ll have to pay for treatment.

If you decide to see a private physiotherapist, make sure they’re 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 postcode search facility on the CSP’s website. You can also find a physio on the Physio First website.

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 practised and it’s particularly popular for people with long-term conditions who know what treatment they need.

The benefits of self-referral include:

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

Self-referral for physiotherapy may not be available in all areas of the UK. Your GP or local NHS Authority or Trust should be able to tell you whether it’s available in your area.

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.

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 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.

Physiotherapy helps restore movement and function when someone is affected by injury, illness or disability.

It takes a holistic approach that involves the patient directly in their own care.

Physiotherapists

Physiotherapists treat people of all ages, helping them manage pain and using a number of methods to aid recovery.

Although they’re often thought of as just dealing with musculoskeletal problems, physiotherapists are trained healthcare professionals who work in many areas, including:

• intensive care 
• mental health
• neurology (including stroke)
• long-term conditions
• breathing problems 
• men’s and women’s health (including incontinence)
• recovery after major surgery
• orthopaedics and trauma
• sports
• workplace health
• paediatrics (children)
• care of the elderly
• education and health promotion

Many physiotherapists work as part of a multi-disciplinary team. They can work from NHS hospitals, community based organisations, private hospitals and clinics, sports clubs, charities and workplaces.

Physiotherapists help treat physical problems linked to a number of the body’s systems, including:

• musculoskeletal – bones, joints and soft tissues
• neuromuscular – the brain and nervous system
• cardiovascular – the heart and blood circulation
• respiratory – the organs that help you breathe, such as the windpipe (trachea), voicebox (larynx) and lungs

What physiotherapists do

Physiotherapists help people who’ve been affected by injury, illness or disability. Some of the approaches they use include:

• movement and exercise – taking into account a person’s current level of health and their specific requirements
• manual therapy techniques – where the physiotherapist helps recovery by using their hands to relieve muscle pain and stiffness, and encourage blood flow to an injured part of the body
• aquatic therapy – a type of physiotherapy carried out in water
• other techniques – such as heat, cold and acupuncture to help ease pain

Read more about some of the different techniques 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.

There are some basic steps you can take to help ease or prevent painful symptoms and improve your overall health.

A physiotherapist will be able to advise you about specific injuries, conditions and your overall level of health. Some general self-help advice is discussed below.

Regular exercise

For most people, keeping mobile and active can help reduce pain and stiffness in joints and speed up recovery. Taking regular exercise is therefore important.

Ask your GP or physiotherapist for advice before starting a new exercise programme if you haven’t exercised for a while due to injury or illness.

Good 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.

Read more about how to sit correctly. The back pain guide also provides advice about how to prevent back pain while driving.

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

Healthy weight

Keeping to a healthy weight for your height and build helps avoid placing excess pressure on your joints. This can prevent conditions such as osteoporosis developing, where the bones become thin, weak and susceptible to fracture.

Use the BMI healthy weight calculator to find out what your body mass index (BMI) is, and read more about how to lose weight if you’re overweight.