Physiotherapy for freedom from movement and pain

The importance of physiotherapy today is higher than ever, because lack of exercise and poor posture promote pain in the musculoskeletal system of the body. Thus, back pain has become a widespread disease. Physiotherapy is used for therapy and rehabilitation as well as for prophylaxis of physical dysfunctions. And for this purpose, therapists have various treatment methods at their disposal.

The job description of the physiotherapist

Even in ancient times, heat applications, baths and massages were used specifically to alleviate physical complaints. However, the profession of physiotherapy is still relatively young. When injured and physically disabled soldiers returned from the war of 1870/71, the need for treatment increased by leaps and bounds. The doctors practicing at the time could no longer cope with this onslaught on their own, and a new profession emerged, the so-called "physiotherapists". At that time, treatment was mainly of a wound and orthopedic nature.

In the following decades, other medical specialties were added: internal medicine, gynecology and obstetrics, neurology, pediatrics and psychiatry. It was not until 1994, in reunified Germany, that a standardized education was created and the professional title "Krankengymnast" was replaced by the title "Physiotherapeut".

What is physiotherapy?

The word physiotherapy comes from the Greek and is composed of "physis" (nature, body) and therapeia (care, healing). Movement therapy and physiotherapy are the main tasks of physiotherapy. Through active or passive movement, physical dysfunctions are specifically treated or prevented by preventive health care measures. Thus, in many cases, it represents an alternative or supplement to drug or surgical treatment of disease.

Active movement means that the patient performs the movements independently according to instructions. Passive movement is when external forces are used, for example by the therapist guiding the movement. In so-called physical therapy, treatment is carried out with mechanical stimuli (massage), thermal stimuli (heat and cold), water (hydrotherapy) or electricity (electrotherapy).

Physiotherapy treats these complaints

The examination and treatment of the physiotherapist is oriented to the individual complaints of the patient. The therapy is intended to improve or restore the body's performance. This may include maintaining strength, improving coordination and mobility, relieving pain or promoting circulation. Physiotherapy can be performed in individual or group therapy in outpatient practices, inpatient or day-care facilities, rehabilitation clinics and hospitals.

For the most part, physiotherapy measures are prescribed in Germany in relation to diseases of the spine and joints (for example, back pain or knee pain). However, physiotherapy can also be used after bone fractures or joint operations, torn ligaments or tendons, strokes, multiple sclerosis, cardiovascular problems and other diseases. In the case of chronic diseases, lifelong therapy can even be useful.

What can I understand by "manual therapy"?

The term refers to physiotherapeutic treatment methods that serve to treat functional disorders of the musculoskeletal system. In contrast to physiotherapy, the therapist uses only his hands. The goals of manual therapy are, for example, the loosening of muscle tension, the removal of blockages (especially in the spine) or the stretching of certain areas of the body. A treatment usually lasts 20 minutes.

Healing with electrotherapy

Electrotherapy is the direct or indirect application of electrical energy to the painful part of the body. In direct application, a weak current flows through the body, which is felt as a tingling sensation on the skin. In indirect application, the electrical energy is delivered to the body in converted form as heat, light or radiation energy.

Another possibility for electrotherapy are so-called TENS devices. These are small battery-operated devices, which the patient can use at home after instruction by the therapist (for example, for knee pain). A prescription is required for TENS units.

Pelvic floor training for incontinence

Training the pelvic floor muscles can help patients who are unable to hold urine during physical exertion such as coughing, lifting or jogging. Physical therapy involves learning techniques to tighten and train the hidden muscles. Sometimes posture is additionally corrected to put less strain on the pelvic floor. Exercising the abdominal and back muscles can also help correct or alleviate incontinence.

The Functional Movement Theory (FBL)

Poor posture and incorrect movements can lead to pain in the musculoskeletal system. This is where "Functional Movement Theory" comes in. Its goal is to analyze the cause of the pain and optimize movement behavior. Together with the patient, the therapist develops solutions for improving movement patterns and posture at work or in everyday life. The patient also receives instructions for independent training options to take home.

Physiotherapy in the field of geriatrics

Geriatrics deals with the physical, mental, functional and social aspects in the care of acute and chronic diseases of the elderly (such as osteoporosis, Parkinson's disease, osteoarthritis or circulatory disorders). Physiotherapeutic treatment aims to maintain or restore the independence, mobility and quality of life of the elderly. This requires special treatment techniques. For example, targeted strength training can improve mobility, which reduces the risk of serious falls in old age. Parkinson's disease is also manifested by a loss of general mobility, a forward-leaning posture and a small-stepped gait. Here, stretching exercises, walking exercises and massages, among other things, are part of the physiotherapeutic treatment.

What is the Bobath Concept?

The Bobath concept can be used to treat symptoms of neurological diseases, for example, craniocerebral injuries, strokes, spinal cord injuries, Parkinson's disease or multiple sclerosis. These diseases are often accompanied by disturbances in sensation as well as difficulties in coordination, muscle control and muscle tension. The concept is based on the assumption of the brain's "reorganization capacity." This means that healthy brain regions can learn and take over tasks previously performed by the diseased regions.

In the Bobath concept, the remaining abilities of the affected person and their potential are assessed. It is then determined in which activities and movements he or she needs help. The treatment requires active cooperation from the patient. Initially, the therapist assists with body movements. However, this assistance is progressively reduced so that the patient gradually controls them on his own. Afterwards, what has been learned must be transferred to everyday life. Treatment goals are set and activities are worked out that the patient can perform on his or her own.

The medical necessity of physiotherapy is determined by Ädoctors and prescribed on prescription, for example as „General Physiotherapy (KG)“, „Neurophysiological Physiotherapy (KGN)“, „Skeletal Physiotherapy (KGG)“ or „Manual Therapy (MT)“.

Physiotherapy belongs to the so-called remedies. Many services are covered by private and statutory health insurance. These include physiotherapy, electrotherapy, manual lymphatic drainage, manual therapy and thermotherapy. For patients 18 years and older, a co-payment is due at the start of treatment (except in the case of fee exemption).

Sporty, comfortable clothing is an advantage. However, many treatments take place in underwear. Also a großes towel should be brought.

On average, a treatment lasts between 15 and 25 minutes. For special clinical pictures, for example lymphatic drainage, longer treatment times may be necessary.

Depending on the diagnosis and symptoms, the doctor determines the number of treatments. Usually, there are 6 to 18 treatments. However, physiotherapy should be continued until the symptoms or pain are successfully eliminated.

Conclusion

The aim of physiotherapy is to improve, maintain or prevent the patient's functional, movement and activity limitations. For the treatment, the therapists resort to various manual and physical techniques. Especially for diseases of the spine and joints, good treatment results can be achieved. In some cases, physiotherapy can be an alternative or supplement to surgical or drug treatment.

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