What a physiotherapist is trained to do
Physiotherapy is a degree-level healthcare profession concerned with movement, pain and function. In practice, most physiotherapists working privately in London see musculoskeletal problems: backs, necks, shoulders, hips, knees, feet, tendons and the nerves that run through all of it.
The work breaks into four parts, and only one of them is what most people picture.
Assessment. Taking a history of the problem and examining how the area moves, how much strength it holds and how it behaves under load. This is the largest part of a first appointment and it is what everything else depends on.
Diagnosis. Forming a view on what is producing your symptoms, and being clear about how confident that view is. A physiotherapist should be able to explain their reasoning to you in ordinary language.
Treatment. Hands-on techniques where they help, alongside a progressive exercise programme, advice on what to change day to day, and a realistic timeline.
Screening and onward referral. Recognising the signs that a problem is not musculoskeletal, or needs imaging or a medical opinion, and acting on them.
What actually happens at a first appointment
Expect to talk more than you expected to. A physiotherapist wants to know when it started, what you were doing at the time, what makes it better and worse, how it behaves overnight and first thing in the morning, what you have already tried, and what you need to get back to.
That last question matters more than it sounds. A plan for someone who needs to sit through long meetings without their back seizing is a different plan from one for someone training for a marathon, even where the diagnosis is identical.
The physical examination follows: watching how you move, testing strength and range of movement, and applying specific tests that make a particular structure more or less likely to be the source. You should leave understanding what your physiotherapist thinks is happening, what will change it, and roughly how long that takes.
Most people also start treatment and go home with exercises in that first appointment.
Why you probably do not need a scan
This surprises people, and it is one of the more useful things to understand before you book.
Physiotherapists diagnose musculoskeletal problems primarily through history and physical testing. Imaging is used when there is a specific clinical reason, not as a default first step.
The reason is that scans of people with no pain at all routinely show disc bulges, rotator cuff changes, meniscal tears and joint wear. Finding one of those on your scan does not establish that it is causing your symptoms, and it can make people more fearful and less active, which tends to make recovery slower rather than faster.
There are clear situations where imaging changes what happens next, and a good physiotherapist will tell you plainly when yours is one of them.
Hands-on treatment, and what it does
Manual therapy covers soft-tissue work, joint mobilisation and manipulation. It can reduce pain and improve movement in the short term, and people generally find it helpful.
What it does not do on its own is change the capacity of the tissue that failed. That is what exercise does. This is why current thinking treats hands-on work as part of a package that includes exercise, rather than as a treatment in its own right.
If a course of treatment consists only of passive techniques, with no progressive loading and no plan for what happens after, it is worth asking why.
How to check your physiotherapist is registered
Physiotherapist and physical therapist are protected titles in the UK. Using either without registration is a criminal offence.
The register is public, free and quick to search. You can look up any individual by name on the HCPC register and see their registration status and number before you book.
Many physiotherapists are also members of the Chartered Society of Physiotherapy, the professional body. Chartered status sits alongside HCPC registration rather than replacing it. Registration is the one that is a legal requirement.
When physiotherapy is not the answer
A physiotherapist should be as willing to tell you that you do not need them as to book you in again.
Some problems need a GP or a consultant instead. Some need imaging first. Some settle perfectly well on their own with a bit of reassurance and a sensible plan, and do not need a course of appointments at all.
The honest version of this profession involves saying so.
Getting seen in Canary Wharf
We match you with a physiotherapist practising at UNTIL Canary Wharf, 30 South Colonnade, E14. Treatment rooms run from 6am on weekdays through to 8pm, and Saturday mornings from 7am to 2pm.
Every physiotherapist is HCPC registered. Fees are set by the individual clinician, and we confirm the exact figure with you before anything is booked.
Frequently asked questions
What does a physiotherapist do?
A physiotherapist assesses and treats problems with movement, pain and function affecting muscles, joints, tendons and nerves. The work covers diagnosis through history and physical examination, hands-on treatment, prescribing progressive exercise, and screening for problems that need a medical opinion instead.
Is physiotherapist a protected title in the UK?
Yes. Physiotherapist and physical therapist are both protected titles under UK law. Anyone using them must be registered with the Health and Care Professions Council. You can check any individual for free on the HCPC public register before you book an appointment.
Do physiotherapists diagnose?
Yes, within their scope. Physiotherapists diagnose musculoskeletal problems mainly through history and physical testing rather than scans. They also screen for signs that a problem is not musculoskeletal, and refer on to a GP or consultant when the picture calls for it.
Do I need a GP referral to see a physiotherapist?
No, not to book privately. You can arrange an appointment directly. If private medical insurance is paying, your insurer may require a referral or an authorisation code first, so it is worth checking your policy before your first appointment.