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Physiotherapy: an active approach to bone and joint health


Dr. Caitriona Cunningham

Irish Society of Chartered Physiotherapists

A physiotherapist can work with a patient to decide on the most appropriate management for acute and long-term bone and joint pain — or help people who simply want advice about getting active.

When the body’s movement and function is threatened by factors including age, injury, disease,  joint and muscle  conditions , your GP may refer you to a physiotherapist. This can be a misunderstood profession, with some patients believing that a physiotherapist will simply offer manual  therapy  or manipulation of affected areas and they may: yet physiotherapy is a much broader healthcare specialty than that.

“A physiotherapist takes a holistic view,” says Dr. Caitriona Cunningham of the Irish Society of Chartered Physiotherapists, the professional body representing over 3,000 Chartered Physiotherapists in Ireland. “Their role is to assess the individual, come to a clinical diagnosis and then work with the patient to decide on the most appropriate management for them. They may ask:  is  exercise the  most appropriate  approach in this particular case,  at this point in time? Will this patient benefit from manual therapy or a joint injection?  Does this person need further investigations, and/or medications? They’ll be able to offer  treatment  and advice  for acute bone and joint pain based on current best evidence, and provide guidance on  long-term bone and joint pain management which will usually involve exercise.They also have knowledge of the appropriate referral pathways in the health system”


Some people presenting to a physiotherapist with joint aches and pains may be diagnosed with arthritis or degenerative changes of their joints, says Cunningham. But, she stresses, if arthritis is diagnosed, a physiotherapist will be able to help the patient self-manage the condition, even if it becomes chronic. “Some people need to see a professional to be empowered to manage their chronic conditions,” she says. “Physiotherapy can help do that, and so maximise function and quality of life.”

Yet physiotherapists don’t only offer treatment to those with acute or chronic pain. “They can also advise people who are feeling well to get active,” says Cunningham. “Increasing numbers of physiotherapists are focussing on health promotion and primary prevention. For example, if you want to take up exercise but are concerned about keeping your joints healthy, a physiotherapist can assess you and advise which exercises to do and which ones to avoid.”

Keeping active

In terms of bone health and osteoporosis, one role of the physiotherapist is to encourage young people to be active so that they can build bone strength and to advise people to engage in impact and strengthening  exercise  throughout their lives  to maintain  bone strength and muscle health.  “Some people avoid exercise, either on the basis that it might be bad for their joints, or that they have osteoporosis,” actually, we all experience muscle loss as we age and joint aches and pains are common  but it can create more problems if you don’t stay active. Yet you may need guidance from a physiotherapist to get you started.”

If you have any concerns about bone or joint aches or pains, you can contact a private physiotherapy  practitioner directly — but the advice is to always see your GP first. And when you choose a physiotherapist, make sure that they are a  Chartered practitioner. As state registration  of Physiotherapists is on the way , this will provide greater transparency  for  members of the the public,  enabling them  to make more informed choices.

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