The goal of physical therapy or physiotherapy is to improve mobility, restore function, reduce pain, and prevent further injury. Physical therapy uses methods such as exercises, stretches, traction, electrical stimulation, and massage. Special tools might be also be used, such as hot or cold packs, crutches, braces, treadmills, prosthetics, compression vests, computer-assisted feedback, lasers, and ultrasound. Physical therapists have graduated from accredited programs. In the United States, all states require physical therapists to graduate from an accredited physical therapy program and pass a licensing exam before they practice.
Physical therapy has been used for arthritis, balance disorders, Duchenne muscular dystrophy (DMD), general health maintenance (overall fitness and health), limb lengthening, muscle pain, muscle weakness, nerve compression, disorders of nerves and muscles (neuromuscular disorders), paralysis, pelvic floor dysfunction, muscle tension, flat feet, Peyronie's disease, irritation of the piriformis muscle, flat head syndrome (plagiocephaly), and inherited disorder called Pompe disease, nerve pain following herpes (postherpetic neuralgia), discomfort after giving birth, pain after a polio infection, pain following trauma, to improve posture, joint deformities, promoting flow of breast milk, catatonic syndrome, brain damage leading to balance loss (Pusher syndrome), Achilles or other tendon pain, chronic obstructive pulmonary disease, respiratory disorders (mitochondrial encephalomyopathies, respiratory function after gallbladder removal, problems with oxygen transport, a juvenile skin and muscle disorder (dermatomyositis), scoliosis, sexual dysfunction, shin splints, sleep disorders, a disorder related to spinal cord damage (Brown-Sequard syndrome), sports injuries, stress/stress-related problems, a pain syndrome called Sudeck's dystrophy, teething, a twisted neck condition called torticollis (congenital muscular), trauma, varicose veins, deep venous thrombosis, vulvular pain, and weight loss.
Physical therapy has also been used for lack of bladder control, a blood cancer called acute lymphoblastic leukemia, a type of arthritis called ankylosing spondylitis, asthma, back pain, prematurity, nerve pain and trauma, chronic bronchitis, a heart disease called cardiac syndrome X, carpal tunnel syndrome, cerebral palsy, chronic venous insufficiency (CVI), complex regional pain syndrome, cystic fibrosis, dementia, Down's syndrome, facial palsy, fall prevention, fatigue, fibromyalgia, fractures, frozen shoulder, a nerve disorder called Guillain-Barre syndrome, headache, heart failure, hypertension, fractures, hip pain, joint problems, a bone disease called Kashin-Beck disease, low back pain, lung function, swelling in the lymph vessels (lymphedema), multiple sclerosis (MS), loss of muscle, severe muscle contractions (muscle spasticity), pain in facial muscles (myofascial pain), neck pain, shoulder pain, low blood pressure upon standing (orthostatic hypotension), osteoarthritis, Parkinson's disease, peripheral artery disease, plantar fasciitis, pneumonia, pregnancy-associated complications, sciatica, skin ulcers, sprains, foot drop, stroke, surgical recovery, ringing in the ears (tinnitus), dizziness (vertigo), and low birth weight.
Is It Effective?
Natural Medicines rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
- Fall prevention. Research shows that physical therapy helps reduce falls in community-dwelling older adults, especially those at risk of falling. As a result, some clinical practice guidelines recommend physical therapy and exercise for community-dwelling adults aged 65 years or older who are at high risk of falling. But it is still not known whether in-home physical therapy programs or group classes are more beneficial. Also, it is not clear what frequency and intensity of exercise provides the most benefit. It's too soon to know if physical therapy helps prevent falls in patients who were recently hospitalized or those living in assisted living facilities.
- A cancer called acute lymphoblastic leukemia. Early research suggests that the combined use of physical therapy plus a home exercise program may help improve strength and movement in children with acute lymphoblastic leukemia.
- Asthma. Some early research suggests that chest physical therapy and physiotherapy breathing retraining might improve quality of life and lung function in children and adults with asthma. However, other research shows no benefit.
- Back pain. Some early research suggests that physical therapy techniques might help for back pain. However, other research shows no benefit.
- A type of heart disease called cardiac syndrome X. Early research suggests that physical therapy may help improve chest pain associated with cardiac syndrome X.
- Carpal tunnel syndrome. Early research suggests that physical therapy techniques such as 'carpal bone mobilization' and 'median nerve mobilization' may not be beneficial for carpal tunnel syndrome.
- Cerebral palsy. It is unclear if physical therapy is beneficial for children with cerebral palsy.
- Chronic obstructive pulmonary disease (COPD). Early research suggests that certain physical therapy techniques may help improve tolerance to exercise and quality of life for people with COPD. Techniques used for COPD generally involve an action of the chest to force clearance.
- Complex regional pain syndrome. Early research suggests that physical therapy may have a better effect than occupational therapy or no treatment for the reduction of pain in some people with complex regional pain syndrome.
- Dementia. Some early research suggests that physical therapy may improve balance and mobility in patients with Alzheimer's disease or dementia. However, other research shows no benefit.
- Fibromyalgia. Early research suggests that physical therapy is no better than a treatment called hypnotherapy for symptoms of fibromyalgia.
- Foot drop. Early research shows that physical therapy with biofeedback may improve strength in people with foot drop following a stroke.
- Fractures. Early research suggests that physical therapy might help to shorten the healing time from hip fracture recovery after surgery or as preparation for hip replacement surgery in the elderly. This might improve life quality.
- Frozen shoulder. Early research suggests that intensive physical therapy involving stretching and movement may help with symptoms of frozen shoulder.
- Heart failure. Early research suggests that physical therapy including supervised and home-based exercise training can enhance exercise capacity in people with chronic heart failure.
- Lack of bladder control (incontinence). Early research suggests that physical therapy may improve symptoms of incontinence in children.
- A bone disease called Kashin-Beck disease. Early research suggests that physical therapy may be better than multivitamins for helping with symptoms of Kashin-Beck disease.
- Knee pain. Some research suggests that physical therapy might be helpful for knee pain.
- Low back pain. Early research suggests that physical therapy may improve function, reduce pain, and improve muscle strength and range of motion for patients with low back pain due to a problem with the sacroiliac joint.
- Swelling in the lymph vessels (lymphedema). Early research suggests that physical therapy may not improve symptoms of lymphedema.
- Pain in the muscles of the face (myofascial pain). Early research suggests that physical therapy may be as effective as other treatments for myofascial pain, such as surgery or removing fluid from the joint.
- Neck pain. Early research suggests that some types of physical therapy may be helpful for various conditions involving neck pain.
- Nerve (neurological) trauma. It is not clear if physical therapy is helpful for nerve trauma. Some research suggests that it might help with movement disorders in people with chronic traumatic brain injury. However, other research does not support this.
- Osteoarthritis. Some research suggests that various types of physical therapy might help with symptoms of osteoarthritis of the knee for a short time but the benefit may not last. Some research suggests that manual physical therapy may also help with osteoarthritis of the hand and hip.
- A genetic disorder causing fragile bones (osteogenesis imperfecta). Early research suggests that a supervised physical therapy program may improve fitness and strength in children with osteogenesis imperfecta.
- Parkinson's disease. Some early research suggests that physical therapy in addition to medications may improve balance, posture, and walking, and reduce falls in the short-term in patients with Parkinson's.
- Pneumonia. Early research suggests that chest physiotherapy techniques are not helpful in the treatment of pneumonia.
- Premature infants. Some research suggests that physical therapy may help improve weight gain, growth, and bone growth. However, other research suggests that physical therapy does not help and may increase the risk of broken bones.
- Complications during pregnancy. Early research shows that physical therapy exercises may help to reduce pain around the pelvis and improve function in pregnant women.
- Rheumatoid arthritis (RA). Some research shows that intense exercise programs involving weight may improve bone density in rheumatoid arthritis.
- Shoulder pain. Early research suggests that manual physical therapy may help with shoulder pain. It might be better that general medical care and traditional physiotherapy.
- Sprains. Early research shows that some physical therapy techniques may help acute ankle ligament sprains and acute hamstring sprains heal.
- Stroke. Early research shows that physical therapy may strengthen weak muscles through repetitive motion. This might help to improve gait and walking, as well as cognitive function, in people undergoing stroke rehabilitation.
- Surgical recovery. Early research suggests that physical therapy may speed recovery after some types of surgery, such as various types of knee surgery, as well as cardiopulmonary bypass, breast cancer surgery, and other surgeries. There may be no difference between different types of chest physiotherapy treatments.
- Tendon pain (tendinopathy). Some early research suggests that structured physical therapy exercises might help with some types of tendon pain. However, it does not seem to help with all types. For example, physical therapy may not be effective for reducing symptoms of tennis elbow. However, techniques such as cold pack use, strengthening, or stretching may reduce the recurrence of tennis elbow.
- Tinnitus. Early research suggests that physical therapy is not as effective as acupuncture for reducing symptoms of tinnitus and improving quality of life.
- Vertigo. Early research shows that physical therapy may help reduce some symptoms of vertigo.
- Balance concerns due to an inner ear (vestibular) disorder. Early research shows that physical therapy specifically designed to help with vestibular rehabilitation may reduce dizziness and imbalance in people with this disorder.
- Other conditions.
More evidence is needed to rate physical therapy for these uses.
Is it Safe?
Physical therapy is designed to improve the day to day function of people. There are various kinds of physical therapy. Some types are for the muscles and bones (musculoskeletal physical therapy). This type uses massage and joint movement to increase strength, balance, and flexibility. Some types are for the heart and lungs. This type of physical therapy helps to clear mucus from the lungs so the patient breathes better. It might also involve exercise so the patient can move better. Physical therapy for the brain and nervous system involves repeated exercises and helps with balance, coordination, and muscle function. One kind of physical therapy (integumentary physical therapy) uses wound cleaning, scar prevention, and scar reduction to help patients with wounds, burns, and other skin-related problems.
There is not enough information available to know if physical therapy is safe to take for medical conditions.
Special Precautions & Warnings:
Pregnancy and breast-feeding: There isn't enough information to know whether physical therapy is safe during pregnancy and breast-feeding. If you are pregnant, check with your healthcare provider before starting physical therapy or any other exercise program.
There are no known interactions with medications. Before taking this product, talk with your health professional if you take any medications.
There are no known interactions with herbs and supplements.
There are no known interactions with foods.
The appropriate or safe use of physical therapy depends on several factors such as the condition being treated or the person administering the treatment. Be sure to seek and follow relevant directions from your physician or other healthcare professional before using this treatment.
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