f you have been referred to a physiotherapist and do not know quite what to expect, this information sheet should give some idea of what is involved.
Chartered physiotherapists are expert members of the medical team. Their aim is to help people resume an active and independent life both at home and work.
They will discuss patients’ treatment with consultants and GPs and keep them fully informed. They will also work closely with other health professionals such as nurses and occupational therapists. But essentially, physiotherapists are independent practitioners who are professionally and legally responsible for their own actions.
Your first appointment
You may see the physiotherapist on the hospital ward or in the out-patient clinic. During your first appointment – which could last up to 45 minutes – you will be asked a number of questions relating to your particular condition. The physiotherapist will then examine you in order to find out what causes you particular difficulties. All information you give is held in strict confidence.
After examining you, the physiotherapist will suggest the treatment most appropriate for you. This will probably start the next time you come. You will also discuss type, frequency and likely duration of your treatment.
Perhaps treatment is not called for, in which case you might be given whatever aids are suitable (a walking stick, for example). Alternatively, a self-help programme to be carried out at home may be suggested.
To make it easier to examine and treat you properly, you may be asked to undress down to your underwear. The physiotherapist might also advise you to bring other clothes (such as shorts or jogging pants) on subsequent visits.
Treatment may take place in the hospital ward, the out-patient department, a hydrotherapy pool, day hospital, school, your home or workplace – or in the community through visits to your home or place of work.
Depending on your particular needs, any of the following types of treatment may be used.
Mobilising, stretching, or strengthening exercises
Many people with arthritis find their joints become stiffer than normal. Also, some of your muscles may have become weak with disuse. You might be shown exercises to improve the movement in your joints and others to strengthen the supporting muscles.
Some people with arthritis find it is easier to move in water. Many physiotherapy departments have hydrotherapy pools heated to a comfortable temperature. Here patients can perform exercise programmes and improve their general mobility. Many people find the feeling of warmth and weightlessness allows them to move with less effort and as a result relaxes their joints and muscles.
Different types of machines are used to speed up the healing process and relieve pain; some provide gentle heat to the affected joints.
When an ice pack is placed on a hot and inflamed joint, it can bring considerable relief. Ice packs not only increase the circulation and speed up healing, they also reduce local inflammation and relieve pain.
Stress and muscle tension can make arthritis seem worse. Learning to release this tension helps a great deal. But there is more to relaxation than simply putting your feet up. The physiotherapist will be able to advise you on techniques or even cassette tapes to help you learn to relax. This is a simple skill to master and can relieve mental and physical tension as well as improving your general sense of well-being.
Many physiotherapy departments are now using acupuncture in the treatment of a number of conditions. This treatment may be offered if the physiotherapist considers it appropriate for you.
This may be particularly important if your problems have caused you to walk awkwardly, especially if you now need a shoe raise or a walking aid. The physiotherapist will advise you on the best kind of footwear and make recommendations if any adaptations (like insoles or shoe raises) should be fitted.
Information and advice
The physiotherapist may provide more general information and advice on how to prevent injury and disability and on developing a healthy lifestyle.
If your joints are particularly swollen and painful – for example during the active phase of rheumatoid arthritis – then temporary splints may be made. Splints are also sometimes useful to give support to joints so that you can carry out some specific task necessary to your work or home life.
You may also be asked to join exercise sessions with other people who have similar problems to your own. This is not only valuable in showing you the exercises to continue at home, but also provides you with the opportunity to meet and talk with other people who have similar difficulties.
The details of your individual treatment programme will be discussed with you during the first assessment and subsequent treatment sessions. At first the treatment will aim to improve your immediate problems. In the long term, the intention is for you to develop the skills, techniques and knowledge to help you cope by yourself.
Remember, it is your body, so do not be afraid to ask questions at any time during the course of your examination and treatment. Physiotherapists are usually very happy to explain any aspect of their treatment.