Physical therapies

Physical therapies help with how your body moves and feels: muscles, joints, bones and the way they work together. Osteopaths, physiotherapists and chiropractors are the best known, with acupuncturists, sports therapists and podiatrists alongside them. Osteopath, chiropractor, physiotherapist and podiatrist are all titles protected by law. Every one of them must be registered, and each register has a public search, so checking takes a minute.

Who does what

Osteopaths look at the body as a whole and use their hands to ease tension and improve movement, through stretching, massage and gentle movement of the joints. They often give advice on posture and exercises to do at home.

Chiropractors focus on the spine and joints and how they affect the rest of the body. Many use manipulation, a quick, precise movement of a joint, alongside soft-tissue work, exercise and advice.

Physiotherapists help people move better and recover from injury, illness or surgery. They use exercise, hands-on (manual) therapy and advice, and work everywhere from NHS hospitals to sports clubs and private clinics.

Alongside them:

• Acupuncturists place very fine needles at chosen points on the body. Traditional acupuncturists train in acupuncture as their main profession, and many physiotherapists, doctors and other health professionals also use acupuncture as part of their work.
• Sports therapists and sport rehabilitators specialise in preventing injuries and getting active people back to their sport.
• Podiatrists (also called chiropodists) look after feet, ankles and lower legs, from everyday foot care to the way you walk and run.

What happens at a first appointment

A first appointment starts with a conversation: what's bothering you, when it started, your general health, any medicines you take and what you do day to day. Mention any medical conditions and medicines, such as blood thinners, as this helps your practitioner choose the right approach for you.

They'll usually watch how you move and examine the area that's troubling you. Wear something comfortable that you can move in easily. They'll then explain what they've found, what they suggest and how many sessions it's likely to take.

Treatment often starts on the first visit. Most people leave with a few exercises or simple changes to try at home, which carry the work on between sessions.

What people come for

People most often see a physical therapist for:

• Back pain
• Neck and shoulder pain
• Sports injuries, sprains and strains
• Stiff or aching joints
• Recovery after surgery or an injury
• Posture and desk-work aches
• Aches and pains in pregnancy
• Foot, heel and ankle problems
• Keeping active as you get older

Recognised in NHS guidance. NICE, which advises the NHS, says manual therapy, such as spinal manipulation, mobilisation or soft-tissue techniques like massage, can be considered for low back pain with or without sciatica, as part of a package of care that includes exercise. Your practitioner will talk you through how they can help with what you'd like to work on.

Alongside the rest of your care

Physical therapies sit comfortably alongside the rest of your care. If you have new symptoms that haven't been looked at yet, see your GP as well. Your practitioner will also ask about your health at the first appointment and will suggest seeing your GP if anything needs checking.

Physiotherapy is also available on the NHS. In many areas you can refer yourself to your local NHS musculoskeletal (MSK) service without seeing a GP first, and many GP surgeries have first contact physiotherapists you can book with directly. Some people use the NHS, some choose a private practitioner for quicker or more flexible appointments, and some do both.

How many sessions, and what it costs

It depends on what you're coming for. A recent strain may settle in two or three sessions; a longer-standing problem may take a few more, often spaced out as you improve. Your practitioner will suggest a plan at your first appointment and review it with you as you go.

Most private practices charge somewhere between about £50 and £95 a session, with the first appointment often costing a little more because it includes a full assessment. Price depends on where the practice is, the length of the appointment and the practitioner's specialism. Many offer a package price for a course of sessions.

Registration: protected titles

These titles are protected by law. Everyone using them must be registered with the regulator, and each regulator has a free public search:

• Osteopath: every osteopath must be registered with the General Osteopathic Council (GOsC).
• Chiropractor: every chiropractor must be registered with the General Chiropractic Council (GCC).
• Physiotherapist (and physical therapist): every physiotherapist must be registered with the Health and Care Professions Council (HCPC). Many are also chartered members of the Chartered Society of Physiotherapy, shown by the letters MCSP.
• Podiatrist and chiropodist: registered with the HCPC.

Acupuncture and sports therapy are self-regulated through registers accredited by the Professional Standards Authority, the body that oversees the UK's health regulators:

• Acupuncture: the British Acupuncture Council (BAcC) runs an accredited register for traditional acupuncturists, whose members train to degree level. Health professionals who use acupuncture, such as physiotherapists, are on their own profession's register as well.
• Sports therapy: BASRaT (the British Association of Sport Rehabilitators) runs an accredited register for sport rehabilitators and sports therapists, and CNHC (the Complementary and Natural Healthcare Council) registers sports therapists too.

Choosing your practitioner

Practitioners are happy to talk about how they work. Good things to ask before you book:

1. Which register are you on, and what is your registration number?
2. Have you helped many people with a problem like mine?
3. What will the first appointment involve, and how long is it?
4. How many sessions do you expect I'll need, and what will it cost in total?
5. Will you give me exercises to do at home?
6. Do you offer evening or weekend appointments, or home visits?

Want to look someone up? Check a practitioner's registration → every regulator and register in one place, with links to their public searches.

Common questions