What the evidence shows
Physiotherapy is a core recommendation in UK and international guidelines for low back pain, neck pain, knee and hip osteoarthritis, shoulder pain, tendon conditions, ankle sprains and rehabilitation after fractures and surgery. Trials consistently show that structured exercise reduces pain and improves function, and that combining exercise with hands-on treatment and advice works better than either alone. For osteoarthritis, exercise-based physiotherapy is as effective as many medications with fewer side effects, and for some knee problems it matches surgery.
How it works
Pain and injury usually have a cause: weakness, stiffness, a movement pattern that overloads a tissue, or a load that was more than the tissue could handle. Physiotherapy identifies that cause, reduces pain and irritation in the short term with hands-on treatment, and then changes the cause with exercise, so the tissue can tolerate more and the problem does not return.
Why it sometimes does not
The most common reason is the exercises not being done. The second is the wrong diagnosis, which is why the first assessment matters. The third is expecting hands-on treatment alone to fix a problem that needs strength or a change in activity. A physiotherapist who only treats the sore bit without a plan is not delivering physiotherapy as the evidence describes it.
How long it takes
Pain often eases within the first few sessions. Real change in strength and movement takes six to twelve weeks, because that is how long tissue takes to adapt. Most people need three to eight sessions, with the work between appointments doing much of the job.
At Omnia
Our physiotherapists in Chiswick are HCPC registered and work from a 70-minute first assessment, so you get a clear diagnosis, treatment on the day and a plan you understand. Where acupuncture, red light therapy or manual therapy would add something, they are in the same building.