Physiotherapy: Yesterday, Today and Tomorrow

Inés Llamas Ramos^*
*Correspondence: Inés Llamas Ramos, Department of Nursing and Physiotherapy, University of Salamanca, Spain, Tel: (+34) 923 294 418, Email:

Editorial

In this special section on “Physiotherapy” I would like to dedicate a few words to this profession that offers so many joys as little recognition it receives.

The word physiotherapy comes from the Greek physis "nature" and therapéia "treatment" also known as physical therapy. It belongs to the health sciences and its techniques are aimed at diagnosing, preventing, treating multiple acute or chronic injuries through physical agents such as electricity, ultrasound, laser, cold, heat or different manual therapy techniques, among which we find mobilizations, stretches, tractions or massages. The fundamental objective is the maintenance and recovery of function and mobility, and of course, the most important, the objective will always be to improve the quality of life.

The World Health Organization (WHO) defined physiotherapy in 1958 as: “The Science of Treatment through: physical means, therapeutic exercise, massage therapy and electrotherapy. In addition, physiotherapy includes the execution of electrical and manual tests to determine muscle involvement and strength, tests to determine functional capacities, range of joint movement and measures of vital capacity, as well as diagnostic aids for the control of the evolution".

Although there are people who do not know the existence of this discipline, it is not something new. If we go back to prehistory, massages were used to alleviate pain. In ancient China, massage and breathing were used routinely, and drawings were found in Egypt showing body exercises and massage. In Greece there was the friction on the joints and the application of cold; in Rome, with the appearance of the hot springs, hydrotherapy, cold baths, massage therapists began to develop. Physiotherapy became more important in the 18th and 19th centuries due to the treatments applied to war mutilated. So we could continue until we get to today. This sector has grown thanks to sports and the importance of injury prevention in society and nowadays it is a profession that requires university studies.

It is a discipline that covers many areas such as trauma, neurology, paediatrics, cardio-respiratory, sports or even oncology. Despite this, physiotherapy continues to be the great unknown in many countries; physiotherapists are considered simple masseurs and in some cases even healers. The physiotherapist is sometimes the professional of choice for muscle or ligament injuries; however, on other occasions access to this service depends on the criteria of a physician who refers the patient or not to that treatment. But do we know when we need the services of a physical therapist? People who do not know this work come with fear and mistrust until they see the benefit they can get. Let's see an example.

A forgotten field is occupational medicine. When someone suffers a work accident, they are referring to the rehabilitation service where physiotherapist recovers the injury, the post-surgery situation. Work sick leave is a very frequent cause of absenteeism. The reasons are varied, from an accident at work to stress, anxiety, and depression. One of the most common is mechanical low back pain. 70-80% of individuals may have at least one episode of low back pain throughout their lives. It is one of the most frequent reasons for medical consultation and the second cause of sick leave. Among the causes we can find structural alterations, functional or postural overload. Mechanical low back pain affects a large part of the population causing symptoms that prevent them from going to their job. A person suffering from low back pain may suffer pain, limited mobility... from physiotherapy we have many tools to combat this pathology, as well as favouring muscle strengthening or postural correction, achieving patient recovery.

It should be noted that one of the most recommended "treatments" is rest, which is not always the most appropriate. Another recommendation would be transcutaneous electrical nerve stimulation or the application of local heat. Prevention would be a factor to take into account, the realization of a constant way of exercises prescribed and adapted to each type of patient prevents back injuries in many cases. It is important to mention the role of the physiotherapist in these cases, if we go to a qualified professional we will be able to avoid or shorten situations such as sick leave and we will be able to control the symptoms that arise day by day. Therefore, put yourself in good hands and let yourself be advised. We can approach this example from the point of view of health, as we said before, the fundamental objective is the recovery of the patient and their quality of life, but one aspect to highlight is the economic impact on society. If patients recover sooner, they can return to their jobs sooner so the economic cost derived from that sick leave will be less. This is a good example to show why we must consider physiotherapists as one more professional in the health system.

Another field that we must promote is Research. Studies are needed to demonstrate the reliability and validity of our treatments because some techniques have little or no evidence or they need to change. Research studies must have the necessary rigor in order to show the scientific community the benefit of our techniques or methods, the great benefit that we can provide to the general population.

Finally, I would like to emphasize that the best treatment is not indicated only by a physiotherapist, a physician or by a nurse. The best treatment derives from teamwork in which we must work together to achieve the best results. All members of a team are equally important. Each of them contribute their knowledge within their competences and the coupling of all makes us reach the goal that must always be: “The Health of Our Patients”.