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
• Osteoarthritis
• 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 your 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. Another common aim of physical therapy is to increase the overall amount of physical activity in your everyday life.

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 – for example, if they can't move their leg or arm themselves yet.

Other than exercises, massage and hand movements to loosen 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 focuses 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. A prescription generally includes six treatment sessions, 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 28 days after the doctor wrote the prescription, otherwise the prescription won’t be valid after that. If the treatment is needed urgently, it has to start within 14 days. The doctor must write this on the prescription.The time between treatment sessions shouldn't be longer than 14 days. If there is a longer break between sessions and there is no good reason, the prescription is no longer valid.

Unless you are exempt from copayments, you have to pay 10 euros per prescription plus 10% of the treatment costs yourself. The costs of different treatments vary. If, for instance, one treatment costs 30 euros, you will have to pay a total of 28 euros for six treatments (the basic fee of 10 euros per prescription, plus 6 x 3 euros).

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.

Sources

• Bundesministerium der Justiz und für Verbraucherschutz (BMJV). Gesetz über die Berufe in der Physiotherapie (Masseur- und Physiotherapeutengesetz - MPhG). 2021.
• Deutscher Verband für Physiotherapie (ZVK). Physio Deutschland: Patienteninformationen. 2023.
• Gemeinsamer Bundesausschuss (G-BA). Richtlinie über die Verordnung von Heilmitteln in der vertragsärztlichen Versorgung (Heilmittel-Richtlinie/HeilM-RL). 2023.

• IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

  Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

  Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.