Physiotherapy

Physiotherapy uses a range of treatment methods and concepts. A differentiation is made between exercise therapies and physical therapies.

Physiotherapy aims to help people use their body to the best of their ability so that it is resilient to everyday life. Physiotherapy can be useful in the following situations:

• To prevent illnesses
• To treat both new and long-standing health problems
• As part of rehab following illnesses, surgery or injuries

Physiotherapy treatment can be used as a preventative measure to avoid poor posture or prevent certain illnesses.
Following accidents, injuries, surgery or other illnesses, physiotherapy can help improve mobility, strength and coordination. It aims to help restore the body’s lost functions and resilience. Physiotherapy can also alleviate or even eliminate pain.

What illnesses are treated using physiotherapy?

Physiotherapy is used in many different areas, for example

• to treat muscle and joint disorders, such as back pain or osteoarthritis
• following injuries and surgery
• to treat rheumatism
• to treat internal organ disorders such as cardiovascular disease or respiratory diseases
• to treat lymph drainage disorders, such as lymphoedema or lipedema
• to treat nervous system disorders, for example following a stroke
• to prevent falls in older people
• to promote healthy development in children
• to prevent or better manage stress

What aims can be achieved with physiotherapy?

The most important aims of physiotherapy treatment are

• to improve mobility, coordination, strength and endurance
• to alleviate pain
• to promote metabolic activity and circulation
• to compensate for physical disabilities

Physiotherapy should help people integrate more forms of exercise that promote good health into their lives. In many cases, physiotherapy is used to teach people certain exercises. For these exercises to help, patients must continue to perform them at home once the treatment has finished.

When it comes to physiotherapy treatment methods, a basic differentiation is made between different types of exercise therapy and physical therapies.

Exercise therapies are an important part of physiotherapy. Examples of exercise therapies include:

• Active exercises where patients independently perform certain movements. In some cases, these involve the use of training equipment. These kinds of active exercises are intended, for example, to improve mobility, muscle strength and coordination.
• Passive treatments, where the therapist moves the patient’s body. These can be used to treat impaired mobility or pain, for example.
• Breathing therapy for support in the case of respiratory diseases
• Manual therapy, where specially trained therapists perform certain actions and techniques. Manual therapy aims to improve the function of the joints and interactions between the muscles, nerves and joints.

In addition to exercise therapy, several physical therapies also fall within the field of physiotherapy.
Examples of physical therapies include:

• massage therapy
• manual lymph drainage
• electrotherapy
• thermotherapy
• hydro/balneotherapy

If a patient requires physiotherapy, the doctor can issue a prescription. In most cases, the costs of physiotherapy are then covered by the statutory or private health insurance provider or the statutory accident insurance association (DGUV).

What is the procedure for physiotherapy?

Physiotherapy starts with a consultation and an examination. During these, the symptoms and the progression of the medical condition are discussed, among other factors. A physical examination allows the physiotherapist to more closely assess functional impairments or problems. The treatment aims are then jointly determined. These aims are reviewed over the course of the treatment. A prescription for physiotherapy usually covers 6 to 10 treatment sessions. With certain diagnoses, such as several chronic illnesses, doctors can also issue a prescription for more treatment sessions.

Where is physiotherapy offered?

Physiotherapy can either occur within the scope of a hospital stay or in a physiotherapy practice.

Hospitals and rehab clinics usually have physiotherapists who work in them. They provide physiotherapy as part of the inpatient treatment.

Outpatient physiotherapy is offered in physiotherapy practices. A medical prescription is required to be treated in these. Physical therapies can also be performed by “masseur-hydrotherapists”. These work in clinics, medical centers or massage practices, for example.

If a patient is unable to attend a practice for health reasons, medically required physiotherapy can sometimes also take place in the home.

Physiotherapy can be prescribed in the form of either individual or group therapy. For some treatments, the group dynamic can have a positive effect. In some cases, physiotherapy can also occur within the scope of video therapy.

The cost of medically required physiotherapy is usually covered by the statutory health insurance provider, the private health insurance provider or the statutory accident insurance association (DGUV). This is subject to physiotherapy being needed to cure, alleviate or avoid an illness. The medical conditions for which statutory health insurance providers will cover the cost of physiotherapy are indicated in the therapeutic services directive from the Joint Federal Committee (Gemeinsamer Bundesausschuss, G-BA).

Unless exempt from co-payment, insurance holders must contribute a co-payment of 10 percent of the costs plus 10 euros per prescription.

In the case of private health insurance, the cost coverage depends on the policy-specific agreements.

If the physiotherapy is performed as part of rehabilitation, it is paid for by the accident or pension insurance.

Further information on the precise conditions associated with physiotherapy prescriptions can be found in our “therapeutic services” article.

Several criteria play a role when selecting a suitable physiotherapy practice:

• Location: close proximity to the home and good accessibility are important when it comes to successfully integrating the treatment appointments into everyday life.
• Availability of appointments: practices usually have a very high appointment capacity but with many illnesses, it is important for physiotherapy to start quickly and regular follow-up appointments to be available.
• Treatment quality: the quality of the treatment is a decisive criterion when selecting a practice. Recommendations, for example from acquaintances, can help you make a judgment. Physiotherapy practices that have introduced and can prove the existence of a quality management system (QM system) offer certain quality standards.
• Range of treatments: physiotherapy comprises many types of treatment but not all practices offer all types or specializations.
• Friendliness: last but not least, you should feel well cared for and happy in the practice. After all, a good patient-therapist relationship is important to the treatment’s success.

Professional associations offer search functions on their websites for finding physiotherapists by filtering by qualifications and location:
German Association of Physiotherapy (Deutscher Verband für Physiotherapie (ZVK) e.V.)
National Association of Independent Physiotherapists (Bundesverband selbstständiger Physiotherapeuten – IFK e.V.)
Association of Physiotherapy – Organization for Physiotherapy Professions (Verband für Physiotherapie – Vereinigung für die physiotherapeutischen Berufe (VPT) e.V.) 

The list of therapeutic service providers created by the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) also provides an overview of physiotherapy practices.