Three people (not forumites) are urging me to do physiotherapy.

Is physiotherapy a quack treatment?

One guide to whether a treatment is quack is how many visits are required for a complete cure. Physiotherapy fails that test.

Part 1. History.

Looking up the history of physiotherapy on wikipedia, I find that it didn’t really exist before the polio epidemic, but exploded in use at that time. It was only one of five or so methods tried on polio. An early paper of the use of physiotherapy for polio is not promising.

“An evaluation of physiotherapy in the early treatment of anterior poliomyelitis”, McCARROLL, H. R.; CREGO, C. H. JR., Journal of Bone and Joint Surgery: October 1941 – Volume 23 – Issue 4 – p 851-861

“The results in this series of 160 cases of recent anterior poliomyelitis extending over a four-year period seem to indicate that the type of early treatment has little or no effect on the course of the disease and alters little, if any, the degree of residual paralysis which is seen.” Instead of physiotherapy, the authors recommend “Immobilization and protection for three reasons: (1) the comfort of the patient during the acute stage, (2) the prevention of deformities, and (3) the prevention of stretch paralysis in the involved muscles.”

A later paper comes to the same conclusion, but from a different point of view. Cases of polio claimed to have been cured by physiotherapy were not actually polio.

https://journals.sagepub.com/doi/pdf/10.1177/003591574804100628

The Role of Physiotherapy in the Treatment of Poliomyelitis
By F.S.COOKSEY,O.B.E.,M.D.
Proceedings of the Royal Society of Medicine Vol. 56, p. 395

“Physiotherapy plays a large part in the treatment of poliomyelitis and it is expedient to review the subject after the epidemic of 1947. New methods of treatment (ie. physiotherapy) are tried sometimes with the haste which leads to exaggerated claims. (By 1948) no one has ever cured a case of poliomyelitis (and) the process of recovery is quite outside our control.”

Claims of earlier use of physiotherapy going back to the ancient Greeks are also exaggerated, being expanded to include hot baths, massage and traction (eg. for broken bones). Even in the 1950s, poultices to apply heat are being called “physiotherapy”.

The 1950s was a period of physiotherapy machines, such as the “rapidly rocking bed”.

So it’s quite clear that up until at least the 1950s, physiotherapy as we know it now did nothing other than damage patients and earn a lot of money for practitioners.

When did that change? If it did at all.

I had physio for my pinched nerve 3rd vertebrae in spine, I couldn’t sleep for 2 weeks due to pain.

Doctor gave me advice to see a physiotherapist an a script for an anti-inflammatory and a pain killer that works with it, which helped me get some sleep.

2 weeks of physio of stretching the neck eventually cleared it.

mollwollfumble said:

Three people (not forumites) are urging me to do physiotherapy.

Is physiotherapy a quack treatment?

One guide to whether a treatment is quack is how many visits are required for a complete cure. Physiotherapy fails that test.

Part 1. History.

Looking up the history of physiotherapy on wikipedia, I find that it didn’t really exist before the polio epidemic, but exploded in use at that time. It was only one of five or so methods tried on polio. An early paper of the use of physiotherapy for polio is not promising.

“An evaluation of physiotherapy in the early treatment of anterior poliomyelitis”, McCARROLL, H. R.; CREGO, C. H. JR., Journal of Bone and Joint Surgery: October 1941 – Volume 23 – Issue 4 – p 851-861

“The results in this series of 160 cases of recent anterior poliomyelitis extending over a four-year period seem to indicate that the type of early treatment has little or no effect on the course of the disease and alters little, if any, the degree of residual paralysis which is seen.” Instead of physiotherapy, the authors recommend “Immobilization and protection for three reasons: (1) the comfort of the patient during the acute stage, (2) the prevention of deformities, and (3) the prevention of stretch paralysis in the involved muscles.”

A later paper comes to the same conclusion, but from a different point of view. Cases of polio claimed to have been cured by physiotherapy were not actually polio.

https://journals.sagepub.com/doi/pdf/10.1177/003591574804100628

The Role of Physiotherapy in the Treatment of Poliomyelitis
By F.S.COOKSEY,O.B.E.,M.D.
Proceedings of the Royal Society of Medicine Vol. 56, p. 395

“Physiotherapy plays a large part in the treatment of poliomyelitis and it is expedient to review the subject after the epidemic of 1947. New methods of treatment (ie. physiotherapy) are tried sometimes with the haste which leads to exaggerated claims. (By 1948) no one has ever cured a case of poliomyelitis (and) the process of recovery is quite outside our control.”

Claims of earlier use of physiotherapy going back to the ancient Greeks are also exaggerated, being expanded to include hot baths, massage and traction (eg. for broken bones). Even in the 1950s, poultices to apply heat are being called “physiotherapy”.

The 1950s was a period of physiotherapy machines, such as the “rapidly rocking bed”.

So it’s quite clear that up until at least the 1950s, physiotherapy as we know it now did nothing other than damage patients and earn a lot of money for practitioners.

When did that change? If it did at all.

Well, good advice was what I found physio’s best at. Also that they never made false claims. If they could not help a problem they told me. Thre is no limit on the number of visits to effect a curre because no physio ever told me that I could be cured by visiting. Similarly, no Doctor has ever told me that they could cure me either.

One case where I think physio would be invaluable is intramuscular bleeding. The gentle exercise would help to break up the blood clot which would otherwise greatly impair muscle movement.

mollwollfumble said:

One case where I think physio would be invaluable is intramuscular bleeding. The gentle exercise would help to break up the blood clot which would otherwise greatly impair muscle movement.

Recuperation after having bone repair.
Reduction and repair of muscle spasm.

roughbarked said:

mollwollfumble said:

One case where I think physio would be invaluable is intramuscular bleeding. The gentle exercise would help to break up the blood clot which would otherwise greatly impair muscle movement.

Recuperation after having bone repair.
Reduction and repair of muscle spasm.

“Bone repair” would be intramuscular bleeding. Yes.
Muscle spasm might respond to heat treatment, relaxation (ie. hypnotherapy), massage perhaps?
I wonder about physiotherapy and tendon stretching. Perhaps.
I wonder about physiotherapy and repatterning eg. motor neuron damage within the brain. Perhaps.

Note, my friend with a PhD in physiotherapy, as used for recovery from stroke, hasn’t got back to me yet.

There are literally 4,000 papers on the topic of “effectiveness of physiotherapy”. I’ll see if I can read them all (just kidding). There’s something funny about the timescale of them though. Only 21 papers older than 1980. Let me peel them off by decades.

1913 – For attention deficit disorder
1938 – For vision
1950-1959 – 1 paper – After shoulder joint surgery
1960-1969 – 2 papers – For knee damage. Helped by bronchodilator
1970-9 – 10 papers – Child brain dysfunction. Leukemia. Geriatric. Menstrual irregularity, Ambulation, Health resorts.
1980-9 – 49 papers
1990-9 – 171 papers
2000-9 – 899 papers
2010-9 – 2870 papers

Exponential growth !
The damn things breed.

Not all conditions can be “cured”. Physio is designed to treat and manage after injury or illness. Citing failure of physio as a treatment of polio doesn’t mean physio is a quack treatment. As far as I’m aware, you’re not suffering polio or the after effects of polio.

Have you researched the efficacy of physio on your affliction? You’re always going to have people saying physio didn’t work for them and it can usually be boiled down to one of three factors:

1. They had a shit physiotherapist
2. The patient was in the mindset of “it’s not going to work”, or the patient won’t do the exercises required
3. Physio was never going to give results equal to the patient’s expectations.

In my experience, physio treatment focuses on heat, massage and stretching. All these treatments are proven to assist in healing for musculoskeletal afflictions… but of course it depends on the condition you’re trying to treat. Spondylitis isn’t going to be cured by physio, for example.

Divine Angel said:

Not all conditions can be “cured”. Physio is designed to treat and manage after injury or illness. Citing failure of physio as a treatment of polio doesn’t mean physio is a quack treatment. As far as I’m aware, you’re not suffering polio or the after effects of polio.

Have you researched the efficacy of physio on your affliction? You’re always going to have people saying physio didn’t work for them and it can usually be boiled down to one of three factors:

1. They had a shit physiotherapist
2. The patient was in the mindset of “it’s not going to work”, or the patient won’t do the exercises required
3. Physio was never going to give results equal to the patient’s expectations.

In my experience, physio treatment focuses on heat, massage and stretching. All these treatments are proven to assist in healing for musculoskeletal afflictions… but of course it depends on the condition you’re trying to treat. Spondylitis isn’t going to be cured by physio, for example.

Spondylitis and others would come under ‘permanent’.
ie; you’re stuck with it.

Spondylitis, don’t know it, thankfully. But prior to fusing of vertebra, inflamation of the spine can sometimes be cured in less than 1 hour with a steroidal anti-inflamatary such we prednisolone, it did for me after 2 months of steadily increasing lumbar pain. A total of 8 tablets over 10 days made the cure permanent.

> 2. The patient was in the mindset of “it’s not going to work”, or the patient won’t do the exercises required

There’s a problem of cause and effect reversal here. If a patient’s mindset affects the treatment then the treatment was a placebo in the first place. I, personally, found the exercise regime to be so onerous for tendonitis that you have to be completely well in order to do the exercises required. If everyone who completes the exercise routine is cured, it only implies that you have to be cured first in order to complete the exercise routine, it does not imply that the exercise routine is a cure.

My tendonitis ended up by being completely cured by not exercising, bed rest and use of crutches.

mollwollfumble said:

Spondylitis, don’t know it, thankfully. But prior to fusing of vertebra, inflamation of the spine can sometimes be cured in less than 1 hour with a steroidal anti-inflamatary such we prednisolone, it did for me after 2 months of steadily increasing lumbar pain. A total of 8 tablets over 10 days made the cure permanent.

> 2. The patient was in the mindset of “it’s not going to work”, or the patient won’t do the exercises required

There’s a problem of cause and effect reversal here. If a patient’s mindset affects the treatment then the treatment was a placebo in the first place. I, personally, found the exercise regime to be so onerous for tendonitis that you have to be completely well in order to do the exercises required. If everyone who completes the exercise routine is cured, it only implies that you have to be cured first in order to complete the exercise routine, it does not imply that the exercise routine is a cure.

My tendonitis ended up by being completely cured by not exercising, bed rest and use of crutches.

You can’t continually take prednisolone. Unfortunately.

I found physio didn’t really help my problem of it hurting to walk any distance.
Even strongish type painkillers and anti inflammatorys barely helped took the edge of it maybe
I only feel better since I lost some weight and stopped eating lots of sugar.
I can walk reasonable distance since then which is good as I’ve never minded walking far to get places

Tau.Neutrino said:

I had physio for my pinched nerve 3rd vertebrae in spine, I couldn’t sleep for 2 weeks due to pain.

Doctor gave me advice to see a physiotherapist an a script for an anti-inflammatory and a pain killer that works with it, which helped me get some sleep.

2 weeks of physio of stretching the neck eventually cleared it.

And without physio it could have taken up to a fortnight to clear up.

roughbarked said:

mollwollfumble said:

Spondylitis, don’t know it, thankfully. But prior to fusing of vertebra, inflamation of the spine can sometimes be cured in less than 1 hour with a steroidal anti-inflamatary such we prednisolone, it did for me after 2 months of steadily increasing lumbar pain. A total of 8 tablets over 10 days made the cure permanent.

> 2. The patient was in the mindset of “it’s not going to work”, or the patient won’t do the exercises required

There’s a problem of cause and effect reversal here. If a patient’s mindset affects the treatment then the treatment was a placebo in the first place. I, personally, found the exercise regime to be so onerous for tendonitis that you have to be completely well in order to do the exercises required. If everyone who completes the exercise routine is cured, it only implies that you have to be cured first in order to complete the exercise routine, it does not imply that the exercise routine is a cure.

My tendonitis ended up by being completely cured by not exercising, bed rest and use of crutches.

You can’t continually take prednisolone. Unfortunately.

Yes you can.

poikilotherm said:

roughbarked said:

mollwollfumble said:

Spondylitis, don’t know it, thankfully. But prior to fusing of vertebra, inflamation of the spine can sometimes be cured in less than 1 hour with a steroidal anti-inflamatary such we prednisolone, it did for me after 2 months of steadily increasing lumbar pain. A total of 8 tablets over 10 days made the cure permanent.

> 2. The patient was in the mindset of “it’s not going to work”, or the patient won’t do the exercises required

There’s a problem of cause and effect reversal here. If a patient’s mindset affects the treatment then the treatment was a placebo in the first place. I, personally, found the exercise regime to be so onerous for tendonitis that you have to be completely well in order to do the exercises required. If everyone who completes the exercise routine is cured, it only implies that you have to be cured first in order to complete the exercise routine, it does not imply that the exercise routine is a cure.

My tendonitis ended up by being completely cured by not exercising, bed rest and use of crutches.

You can’t continually take prednisolone. Unfortunately.

Yes you can.

Mr poik a question, something I never put much thought into but do prescription prices vary from chemist to chemist, I pretty much go to where ever is closest and assumed the cost is pre determined.

Cymek said:

poikilotherm said:

roughbarked said:

You can’t continually take prednisolone. Unfortunately.

Yes you can.

Mr poik a question, something I never put much thought into but do prescription prices vary from chemist to chemist, I pretty much go to where ever is closest and assumed the cost is pre determined.

Depends.

If you’re on a concession or pension card they’ll generally be the same, if you’re not, they’ll vary.

poikilotherm said:

Cymek said:

poikilotherm said:

Yes you can.

Mr poik a question, something I never put much thought into but do prescription prices vary from chemist to chemist, I pretty much go to where ever is closest and assumed the cost is pre determined.

Depends.

If you’re on a concession or pension card they’ll generally be the same, if you’re not, they’ll vary.

Ok thanks

Peak Warming Man said:

Tau.Neutrino said:

I had physio for my pinched nerve 3rd vertebrae in spine, I couldn’t sleep for 2 weeks due to pain.

Doctor gave me advice to see a physiotherapist an a script for an anti-inflammatory and a pain killer that works with it, which helped me get some sleep.

2 weeks of physio of stretching the neck eventually cleared it.

And without physio it could have taken up to a fortnight to clear up.

The pinched nerve finally must have realized it was no longer being pinched and then realised it no longer had to send pain signals.

This was a good decision on its part.

Tau.Neutrino said:

Peak Warming Man said:

Tau.Neutrino said:

I had physio for my pinched nerve 3rd vertebrae in spine, I couldn’t sleep for 2 weeks due to pain.

Doctor gave me advice to see a physiotherapist an a script for an anti-inflammatory and a pain killer that works with it, which helped me get some sleep.

2 weeks of physio of stretching the neck eventually cleared it.

And without physio it could have taken up to a fortnight to clear up.

The pinched nerve finally must have realized it was no longer being pinched and then realised it no longer had to send pain signals.

This was a good decision on its part.

The physio neck stretching definitely cleared the pinched nerve in the third vertebrae.

I felt it begin to relax.

I could not get to sleep for nearly two weeks, and was beginning to feel like I had been hit by a truck

The only way to get sleep was after the combination of the two drugs had done their thing.

I watched the below recently, really interesting and a possible way to combat pain at the ground level

When pain persist

Is this any help?

https://www.cochrane.org/search/site/physiotherapy%20back%20pain

poikilotherm said:

roughbarked said:

mollwollfumble said:

Spondylitis, don’t know it, thankfully. But prior to fusing of vertebra, inflamation of the spine can sometimes be cured in less than 1 hour with a steroidal anti-inflamatary such we prednisolone, it did for me after 2 months of steadily increasing lumbar pain. A total of 8 tablets over 10 days made the cure permanent.

> 2. The patient was in the mindset of “it’s not going to work”, or the patient won’t do the exercises required

There’s a problem of cause and effect reversal here. If a patient’s mindset affects the treatment then the treatment was a placebo in the first place. I, personally, found the exercise regime to be so onerous for tendonitis that you have to be completely well in order to do the exercises required. If everyone who completes the exercise routine is cured, it only implies that you have to be cured first in order to complete the exercise routine, it does not imply that the exercise routine is a cure.

My tendonitis ended up by being completely cured by not exercising, bed rest and use of crutches.

You can’t continually take prednisolone. Unfortunately.

Yes you can.

Well that’s news.

> You can’t continually take prednisolone. Unfortunately.

Supposed to be addictive.

Didn’t work at all for sciatica, unfortunately.

But streroidal anti-inflammataries can work hugely better than non-steroidal anti-inflammatories for lower back pain.

mollwollfumble said:

> You can’t continually take prednisolone. Unfortunately.

Supposed to be addictive.

But streroidal anti-inflammataries can work hugely better than non-steroidal anti-inflammatories for lower back pain.

No

No/depends

mollwollfumble said:

> You can’t continually take prednisolone. Unfortunately.

Supposed to be addictive.

Didn’t work at all for sciatica, unfortunately.

But streroidal anti-inflammataries can work hugely better than non-steroidal anti-inflammatories for lower back pain.

I found prednisolone to be fantastic but my doctor hasn’t given it to me full time yet.

roughbarked said:

mollwollfumble said:

> You can’t continually take prednisolone. Unfortunately.

Supposed to be addictive.

Didn’t work at all for sciatica, unfortunately.

But streroidal anti-inflammataries can work hugely better than non-steroidal anti-inflammatories for lower back pain.

I found prednisolone to be fantastic but my doctor hasn’t given it to me full time yet.

Moon face buffalo hump among other reasons…

Cushing’s syndrome is a collection of signs and symptoms due to prolonged exposure to glucocorticoids such as cortisol. Signs and symptoms may include high blood pressure, abdominal obesity but with thin arms and legs, reddish stretch marks, a round red face, a fat lump between the shoulders, weak muscles, weak bones, acne, and fragile skin that heals poorly. Women may have more hair and irregular menstruation. Occasionally there may be changes in mood, headaches, and a chronic feeling of tiredness.

https://en.wikipedia.org/wiki/Cushing%27s_syndrome

poikilotherm said:

roughbarked said:

mollwollfumble said:

> You can’t continually take prednisolone. Unfortunately.

Supposed to be addictive.

Didn’t work at all for sciatica, unfortunately.

But streroidal anti-inflammataries can work hugely better than non-steroidal anti-inflammatories for lower back pain.

I found prednisolone to be fantastic but my doctor hasn’t given it to me full time yet.

Moon face buffalo hump among other reasons…

Probably.

Only time I had anything to do with a phisios was to mobilize my shoulder after a nasty fractured humerus reduction. They got me doing a lot of stretching followed up with exercises.

Seems to be their SOP –

• Pain in spine.. prescribe stretching and exersise.
• Pain in knee or elbow.. prescribe stretching and exersise.
• Pain in hand or foot.. prescribe stretching and exersise.
• Muscle/tendon pain.. prescribe stretching and exersise.
• Abdominal pain.. prescribe stretching and exersise.
• Tumour/cancer.. prescribe stretching and exersise.
• Etc, etc

*This according to my (not even slighty cynical) speech path daughter

I’ve been to physios for two issues:

When I was pregnant, I had bad sciatica. I saw a student physio at the hospital. Stretches for that (which quickly became useless because I couldn’t bring my legs up with a growing bump in the way)

Couple years ago, I woke with a stiff neck and shoulder. They call it a wry neck. Heat, massage, stretches. Gave me a massive headache after the first treatment and I had to go home sick from work that afternoon.

only time i saw a physio was after i had the op for my vikings disease. 4 days after the op she bent my fingers to see how much movement i had. reckoned i had full movement and she had never seen that so soon after the op. didn’t need to see me again.

ChrispenEvan said:

only time i saw a physio was after i had the op for my vikings disease. 4 days after the op she bent my fingers to see how much movement i had. reckoned i had full movement and she had never seen that so soon after the op. didn’t need to see me again.

Physio-: Morning Boris.
Boris-: Have I told you the one about…..yarder…………… yarder……….and then the dog said that’s not my bone……hahahahahahaha
Physio-: Your fingers are fine………….we don’t ever need to see you again.

Peak Warming Man said:

ChrispenEvan said:

only time i saw a physio was after i had the op for my vikings disease. 4 days after the op she bent my fingers to see how much movement i had. reckoned i had full movement and she had never seen that so soon after the op. didn’t need to see me again.

Physio-: Morning Boris.
Boris-: Have I told you the one about…..yarder…………… yarder……….and then the dog said that’s not my bone……hahahahahahaha
Physio-: Your fingers are fine………….we don’t ever need to see you again.

“…..yarder…………… yarder……….”

Que?

Does you means “yadda……..yadda”?

Peak Warming Man said:

ChrispenEvan said:

only time i saw a physio was after i had the op for my vikings disease. 4 days after the op she bent my fingers to see how much movement i had. reckoned i had full movement and she had never seen that so soon after the op. didn’t need to see me again.

Physio-: Morning Boris.
Boris-: Have I told you the one about…..yarder…………… yarder……….and then the dog said that’s not my bone……hahahahahahaha
Physio-: Your fingers are fine………….we don’t ever need to see you again.

that is sooooo close to what happened.

ChrispenEvan said:

Peak Warming Man said:

ChrispenEvan said:

only time i saw a physio was after i had the op for my vikings disease. 4 days after the op she bent my fingers to see how much movement i had. reckoned i had full movement and she had never seen that so soon after the op. didn’t need to see me again.

Physio-: Morning Boris.
Boris-: Have I told you the one about…..yarder…………… yarder……….and then the dog said that’s not my bone……hahahahahahaha
Physio-: Your fingers are fine………….we don’t ever need to see you again.

that is sooooo close to what happened.

And then the bear said ‘You ain’t here for the hunting, are ya mate.’

mollwollfumble said:

Three people (not forumites) are urging me to do physiotherapy.

Is physiotherapy a quack treatment?

One guide to whether a treatment is quack is how many visits are required for a complete cure. Physiotherapy fails that test.

Part 1. History.

Looking up the history of physiotherapy on wikipedia, I find that it didn’t really exist before the polio epidemic, but exploded in use at that time. It was only one of five or so methods tried on polio. An early paper of the use of physiotherapy for polio is not promising.

“An evaluation of physiotherapy in the early treatment of anterior poliomyelitis”, McCARROLL, H. R.; CREGO, C. H. JR., Journal of Bone and Joint Surgery: October 1941 – Volume 23 – Issue 4 – p 851-861

“The results in this series of 160 cases of recent anterior poliomyelitis extending over a four-year period seem to indicate that the type of early treatment has little or no effect on the course of the disease and alters little, if any, the degree of residual paralysis which is seen.” Instead of physiotherapy, the authors recommend “Immobilization and protection for three reasons: (1) the comfort of the patient during the acute stage, (2) the prevention of deformities, and (3) the prevention of stretch paralysis in the involved muscles.”

A later paper comes to the same conclusion, but from a different point of view. Cases of polio claimed to have been cured by physiotherapy were not actually polio.

https://journals.sagepub.com/doi/pdf/10.1177/003591574804100628

The Role of Physiotherapy in the Treatment of Poliomyelitis
By F.S.COOKSEY,O.B.E.,M.D.
Proceedings of the Royal Society of Medicine Vol. 56, p. 395

“Physiotherapy plays a large part in the treatment of poliomyelitis and it is expedient to review the subject after the epidemic of 1947. New methods of treatment (ie. physiotherapy) are tried sometimes with the haste which leads to exaggerated claims. (By 1948) no one has ever cured a case of poliomyelitis (and) the process of recovery is quite outside our control.”

Claims of earlier use of physiotherapy going back to the ancient Greeks are also exaggerated, being expanded to include hot baths, massage and traction (eg. for broken bones). Even in the 1950s, poultices to apply heat are being called “physiotherapy”.

The 1950s was a period of physiotherapy machines, such as the “rapidly rocking bed”.

So it’s quite clear that up until at least the 1950s, physiotherapy as we know it now did nothing other than damage patients and earn a lot of money for practitioners.

When did that change? If it did at all.

After months lying prone in hospital my muscles had atrophied & physio (painfully) got me moving again.