Physical therapy, also known as physiotherapy, may include certain exercises, massages and treatments based on physical stimuli (e.g. heat, cold, electrical currents or ultrasound). The aim of physical therapy is to relieve pain, help you move better or strengthen weakened muscles. Another important goal is to show patients what they can do themselves to improve their own health. The treatment isn’t only done in a practice or hospital: you can and should continue doing it at home yourself.
Physical therapy includes
- exercises to actively do certain movements yourself,
- guided, passive movements that the therapist does for you, as well as applying pressure (massage), and
- treatments based on physical stimuli such as heat, cold, electrical currents or ultrasound.
These approaches are used to treat acute and chronic symptoms, and also to prevent future problems or for rehabilitation after long-term medical problems, surgery or injuries.
The most suitable type of physical therapy treatment will depend on the symptoms and specific medical problem, as well as whether the patient has had the pain for a short time or long time, for instance. His or her personal preferences and overall physical fitness will play a role too.
When is physical therapy considered?
Physical therapy can be used to treat things like:
- Back pain
- Problems caused by wear-and-tear or injuries of the muscles, tendons or joints
- Pelvic floor problems such as incontinence (urine leakage) or pain
- Rheumatoid arthritis
- Cardiovascular (heart and blood vessel) diseases
- Respiratory diseases (affecting the airways)
- Neurological (nerve-related) diseases such as Parkinson’s, stroke or multiple sclerosis
- Developmental problems in children, for instance affecting their muscles or bones
Physical therapy can also be used to help people who need assistance or nursing care – for instance, to practice doing certain movements in a particular order, strengthen muscles and prevent falls.
What does physical therapy involve?
Exercises to actively do certain movements make up a big part of physical therapy. These exercises improve mobility (ability to move), coordination and muscle strength. The physical therapist shows you how to do the exercises and then you can do them yourself. Generally speaking, physical therapy sessions mainly involve learning these exercises. The exercises will only help if you regularly do them at home on your own too. As well as doing special exercises, physical therapy often aims to help you increase the overall amount of physical activity in your everyday life, too.
Sometimes passive exercises are used as well. In other words, the therapist moves parts of the patient's body in a certain way. The aim may be to, for instance, improve the ability to move a stiff or locked joint. These guided movements can also prepare the patient's body for active exercises if, for example, they can't move their leg or arm themselves yet.
Other than exercises, massage and hand movements to relax muscles and connective tissue, there are other types of physical therapy treatments that are based on physical stimuli. They include the following:
- Manual lymphatic drainage (massage to drain fluid from the tissues)
- Electrotherapy: Treatment with a weak electric current
- Heat therapy: e.g. using warm baths, warm (fango) mud packs, heat lamps or ultrasound.
- Cold therapy: e.g. using cold packs or cold air.
A number of these treatments can be combined too.
What is the aim of physical therapy?
Depending on your medical problem and personal circumstances, the treatment can focus on various goals, such as:
- Improving or restoring the functioning of the body or the ability to move normally
- Improving metabolism and the circulation of blood
- Relieving pain
- Improving coordination and strength
- Compensating for physical disabilities: for example, strengthening the left arm if the right arm can’t move due to paralysis
- Preventing chronic problems
Who offers physical therapy?
Physical therapy is carried out by specially trained physical therapists (also known as physiotherapists). Certain elements of physical therapy, such as massages and treatments based on physical stimuli (e.g. heat therapy or electrotherapy) can also be carried out by other professionals. These include masseurs and people who use water to treat medical problems, known as hydrotherapists.
Physical therapy can be done in both outpatient and inpatient settings – for instance, in physical therapy practices, hospitals, rehabilitative care centers and nursing homes.
How can you apply for physical therapy?
Note: The procedures and requirements for applying for and receiving physical therapy may vary between countries. This information describes the current situation in Germany.
Physical therapy is often part of a treatment plan at a hospital. It is then done in the hospital. To have outpatient treatment at a physical therapy practice, you need a prescription from a doctor. An initial prescription will generally include 6 treatments, each typically lasting 15 to 20 minutes. People have about one to three appointments per week, depending on what the doctor prescribes. The treatment has to start no longer than 14 days after the doctor wrote the prescription, otherwise the prescription won’t be valid after that. Unless there’s a good reason, the time between treatment sessions shouldn't be longer than 14 days. Breaks up to 28 days long have to be justified. If the break is even longer, the remaining treatment sessions will be canceled.
Unless you are exempt from copayments, you have to pay 10 euros per prescription plus 10% of the treatment costs yourself. The cost of different treatments varies. If, for instance, one treatment costs 20 euros, you will have to pay 22 euros for six treatments (the basic fee of 10 euros per prescription, plus 6 x 2 euros).
If the treatment is needed because of a work-related accident, it will be covered by the accident insurance and you won’t have to pay any copayment fees. But only if the treatment starts within 7 days.
For the medical conditions listed above, the costs of prescribed physical therapy (apart from the above-mentioned copayment fees) are often covered by statutory health insurers. If physical therapy is needed as a part of rehabilitative care, your accident insurer or pension fund will cover the costs.
Bundesministerium der Justiz und für Verbraucherschutz (BMJV). Gesetz über die Berufe in der Physiotherapie (Masseur- und Physiotherapeutengesetz - MPhG). August 15, 2019.
Deutscher Verband für Physiotherapie (ZVK). Physio Deutschland: Patienteninformationen. 2020.
Gemeinsamer Bundesausschuss (G-BA). Richtlinie über die Verordnung von Heilmitteln in der vertragsärztlichen Versorgung (Heilmittel-Richtlinie/HeilM-RL). July 1, 2020.
Verband der Ersatzkassen (vdek). Rahmenvertrag Physiotherapie vdek, Anlage 1: Leistungsbeschreibung. April 1, 2013.
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