Physiotherapists diagnose and provide hands-on treatment and programs for anyone who has problems with movement. They have an expert understanding of physical disability and conditions that affect muscles and bones. Not only are physiotherapists skilled and highly trained treatment providers, they are also exercise specialists. Often, they can help with a variety of painful conditions by designing a home exercise program for busy patients.

A referral from a doctor is not needed to see a physiotherapist. In fact, if you are injured or in pain, you can call and make an appointment for yourself. This health care specialist can help you overcome or learn to manage your specific condition.

What conditions do physiotherapists treat?

Musculoskeletal disorders – This includes issues with muscles, bones, joints, and their surrounding structures.

It can also include some nerve problems, such as sciatica, and nerve injuries, such as those occurring after a laceration (cut) or crush injury. Pain and disability can also come from losing bone density (osteopenia or osteoporosis). The best treatment for these sorts of conditions is weight-bearing exercise.

Arthritis – Musculoskeletal disorders can come from work, motor vehicle collisions, or sports-related injuries. They can also be linked to degenerative arthritis and the effects of aging. Physiotherapists are trained to manage all different types of arthritis, including osteoarthritis and rheumatoid arthritis.

Neurological disorders – Some physiotherapists specialize in treating disability following a stroke or brain injury. Diseases of the nervous system like Parkinson's or multiple sclerosis have a similar effect. Treatment can include exercises to improve motor control, strength and flexibility. A physiotherapist will pay special attention to helping patients regain gait (walking patterns) and balance.

Vestibular disorders – With new awareness of how falls can reduce mobility and independence, physiotherapists have started to research and treat vertigo (dizziness) and other diseases that affect balance.

Women's health – Some physiotherapy clinics specialize in treating disorders that cause chronic pelvic pain or trouble with bladder or bowel control (incontinence). These conditions often occur with musculoskeletal disorders of the pelvic joints following pregnancy and delivery. Managing these health issues includes a wide range of treatments, including pain management, exercise, education and manual treatment.

Your first appointment

The first visit sets the tone for the entire course of treatment. Your physiotherapist should take time to listen carefully to your problems and description of pain or injury, and the effect it has on your life. A thorough assessment will be done. Expect questions about your medical history, the onset of your condition, past and current medical conditions, treatments, and medications. This information helps in developing the course of treatment most likely to result in less pain and greater physical well-being.

The second part of the visit includes a physical assessment of your physical and functional difficulties. Explain the effect these problems have on your work and your ability to do your daily activities and enjoy leisure activities. You may be asked to fill in a questionnaire on how your current condition impacts your life.

After the assessment, your physiotherapist should share the results. You will likely discuss the diagnosis and some possible treatments. A particular plan may be recommended, based on the assessment findings and the goals of treatment.

What treatments are available?

Exercise therapy — Exercise is a key part of physiotherapy. It does not have to be painful or boring. Your physiotherapist can design a program that will work for you. Exercise therapy can help you improve in strength and flexibility.

Most physiotherapists are trained in kinesiology (the study of motion), physical therapy and exercise physiology. Everyone's body is different, so physiotherapists customize plans that take your specific condition into account. An elite athlete might require a complete sport-specific exercise program, while a teenager with cerebral palsy needs a simple home exercise plan.

Moderate amounts of movement and exercise are known to reduce pain and prevent loss of bone density. Aerobic exercise is effective in preventing loss of brain function that can come with aging. Just 30 minutes of aerobic exercise three to five times per week has been proved to be the most effective way to prevent the loss of cognitive ability, such as occurs with Alzheimer's or dementia.

Pain management — Electrophysical agents may be used to control pain and promote healing. These agents include a variety of machines which provide electrical stimuli, light, deep heat or sound to produce a physiological response in the tissues. The following modalities may be used in a physiotherapy clinic:

Transcutaneous nerve stimulation (TENS machine) – A TENS machine provides a gentle type of electrical current to help reduce pain. This works in a similar way to rubbing a painful area on your body to reduce pain. This sends signals into the spinal cord and nervous system to modulate or reduce pain. In addition to using these machines in the clinic they can be purchased for home use.
Interferential current (IFC) – Interferential machines produce a variety of electrical currents which reduce pain and swelling.
Neuromuscular stimulation (NMES) – These machines are specifically designed to produce a muscle contraction. This can help treat pain and weakness in a muscle following surgery or nerve injury.
Ultrasound and short wave diathermy (thermal) – these methods have been used effectively in physical therapy for many years. Ultrasound can be applied as a continuous or interrupted pulse. A continuous pulse produces deep heating, mechanically affecting the tissues. An interrupted pulse is primarily limited to the mechanical effect of sound on the tissues. Short wave diathermy also provides deep heat.
Low-level laser therapy (LLLT) – This machine produces invisible light which is absorbed into the tissues. Like ultrasound; it is proposed that LLLT can accelerate or enhance soft tissue healing.
Temperature treatment – hot packs can provide surface heat, while cold treatments (cryotherapy) may also give relief.
Extracorporeal shock wave therapy – this can be used to treat tendon problems and heel pain caused by plantar fasciitis. The effects are both mechanical and chemical. The therapy temporarily inflames the area, which is thought to break down calcium deposits and promote healing.

Manual therapy — combined with exercise, this can also ease pain. Manual therapy techniques include treatment techniques that include 'hands-on' therapy. Many manual therapy techniques include only a passive component while others include some active exercise with passive stretching or movement applied by the physiotherapist.

Passive joint mobilization is a low speed passive movement applied to a joint by the physiotherapist to improve motion at that joint.
Manipulation or high-velocity low-amplitude (HVLAT) techniques are high speed small movements applied passively towards the end of the available joint range by the physiotherapist. The purpose of a manipulation may include improvement of joint mobility or breaking down of adhesions.
Trigger point release is a technique used to reduce the tension in tight painful muscles.
Deep tissue friction massage breaks down adhesions which may form in ligament, tendon or muscle following injury or periods of immobility.
Active release techniques (HR) and muscle energy techniques combine active muscle contraction produced by the patient with passive movement applied by the physiotherapist.
Passive stretching improves the length in soft tissue and is most often used when the patient cannot produce the movement or provide sufficient force to perform the passive stretch: for example, a child with cerebral palsy.

Traction or decompression therapy — This strategy is often used to treat spinal conditions in the neck (cervical spine) and lower back (lumbar spine). Traction gently mobilizes an injury and improves blood flow. If there is pressure on nerves that exit the spine and supply an arm or lower leg, traction can reduce the pain. It can ease sciatica, a common condition involving irritation of a lower lumbar nerve as it exits the spine. Sciatica causes pain and altered sensation in the leg.

Acupuncture or dry needling — This has become a very common treatment done by physiotherapists. It can treat a variety of illnesses, helping manage both acute (recent onset) and chronic (long duration) pain. Dry needling or intramuscular stimulation is another method. This involves inserting acupuncture needles in soft tissue to relieve chronic pain.

Prescription of orthotics — Many conditions treated by physiotherapists involve the lower back, lower extremities and feet. Some people benefit from custom orthotic inserts in their footwear. Orthotics can address a variety of conditions such as plantar fasciitis, flat feet, Morton's neuroma, or problems with the tendons around the ankle including tendonitis and tendonopathy.

Functional assessments or pre-employment assessments — Some injured workers require full evaluation of their ability to function. A physiotherapist can help you decide what tasks you can do in the workplace without injuring yourself further. Some employers have physiotherapists screen potential employees to assess how suitable they are for certain types of physically demanding work.

Vestibular therapy — This technique uses very specific exercises to reduce symptoms of some inner ear problems that cause dizziness.

If you are in pain or have trouble moving due to an accident, illness, injury, medical condition or disorder, make an appointment with a physiotherapist. You do not need a doctor's referral. These highly educated health care specialists are very accessible. They can help you restore and maintain your best possible physical function. Physiotherapists are also trained to recognize signs of serious health conditions and will recommend a visit to your doctor if necessary.

If pain and discomfort are getting in your way, a physiotherapist may be just what you need to help you take back control of your body and your life.

Your First Physiotherapy Visit What to expect from this health professional

What conditions do physiotherapists treat?

Your first appointment

What treatments are available?

Your First Physiotherapy Visit
What to expect from this health professional