Can I really get better with just some advice and exercise?

Online physiotherapy has taken centre stage due to the COVID-19 pandemic. But can a physiotherapist really tell what’s wrong just by talking to you? And can you really make a difference to your pain simply with advice and exercises from the physiotherapist over the internet? You may be surprised, but the answer is absolutely… YES. Here we explain why.

Physiotherapists across the world are having to adapt to the current COVID-19 pandemic and many have set up online consultations to continue providing care for their patients. You may have seen terms such as “telehealth” “physiodirect” “telerehabilitation” or “teleassessment”.

As physiotherapists, one of the first things we do when we meet you is ask questions about your symptoms. This is a structured set of questions allowing us to search for clues to consider different potential diagnoses. 80% or more of the information required for diagnosis can be gained just from these questions (Epstein et al 2008).

So really, when it comes to the physical part of the assessment in clinic, physio’s will likely already have a fairly good idea of what is wrong with you.

There have been lots of studies into “telehealth” as it is already a big business in many parts of the world. It has been found to have excellent reliability in most areas for physiotherapy assessments. A study that compared a telehealth assessment with a face to face assessment for knee pain came to a similar diagnosis in 89% of the cases.

So yes, you can have an assessment over the internet and still be diagnosed correctly.

Don’t I need to be touched to be treated?

There are a lot of conflicting views in the physiotherapy community about manual therapy - in other words “hands on” treatment (massage, spinal mobilisation, manipulation etc - think “back cracking”). Although there is evidence that these techniques can be effective, exercise therapy has been shown to have great outcomes for multiple different conditions.

Explanation, advice and exercise had better outcomes than “hands on” therapy for a group of people with frozen shoulder in this study.

People with neck pain in this study found that “hands on” therapy was not superior to other interventions such as exercise or medication, but there were better improvements in pain when you combined manual therapy with exercise.

There is a load of research behind the benefits of exercise programmes for lower back pain too. Exercise therapy has been found to be a great way to improve pain from knee arthritis.

This study looked at manual therapy vs exercises for hip arthritis and found that manual therapy had better outcomes on pain and movement. But, there was still a significant improvement with exercise alone.

So whilst you may not be able to have manual “hands on” therapy at the moment, and for the foreseeable future, it’s safe to say that online assessment, advice, education and exercise programmes from physiotherapists can certainly be helpful in improving pain, movement and most of all, your happiness and well being.

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