What is a Physiotherapist?
A Physiotherapist is a health care professional who treats individuals of all ages with health conditions that limit their ability to move or perform functional daily activities.
Physiotherapists work based on diagnoses from Doctors in form of prescription presented by patients upon arrival. They examine each patient and develop a treatment plan using various techniques to promote movement, reduce pain, restore function and prevent disability.
Physiotherapists are qualified graduates from universities offering accredited physiotherapy degree programs after which they are eligible to obtain a license to practice in Luxembourg upon fulfilment of the requirements. They may also obtain a Masters' or Doctorate degree to specialise in specific sub-domains.
Why do people go to a Physiotherapist?
While physiotherapists are known for helping with painful and limiting conditions, they also assist with injury prevention, preparation for surgery, management of chronic conditions as well as general health and wellness services.
Can I go directly to physical therapy?
Yes you can go to a physiotherapist directly without a prescription. This happens mostly in cases that do not require medical diagnosis such a consultations for injury prevention, health and wellness etc.
How to go for physical therapy or send a friend/family member?
To visit a physiotherapist in Luxembourg, you need a prescription from referring a doctor (either a specialist or general practitioner) which indicates your medical diagnosis.
The National Health Fund (la Caisse Nationale de Santé - CNS) pays for 70 percent of the cost of physical therapy treatments while the patient pays the remaining 30 percent. Many patients have a supplementary insurance from whom they may be able to request reimbursement of the payment they made. There are cases when the CNS covers 100 percent of the cost e.g. in case of a patient under the age of 18, in case of work-related accidents with an open file at AAA (L' Association d'assurances accident).
Yes self-payment patients are accepted provided that they present a valid prescription from a doctor or are coming for a consultation on something that does not require a pre-screening/diagnosis from a physician such as injury prevention, general health and wellness services.
For most patients who present a valid prescription, two invoices are generated - one for CNS (70% of the cost) and the other for the patient (30%). The exceptions are in case of conditions that are fully covered by CNS or in case the patient is under the age of 18.
The settlement of the 70 percent is sorted out directly with CNS, while the patient will be required to pay the remaining 30 percent at the end of the treatment.
Upon arrival on the first day, you will be required to provide your personal information (name, address, telephone number and social security number) so that a file can be opened for you. The physiotherapists then proceeds to take a full history of your condition, perform several tests so as to rule in or out competing diagnoses and finally determining the causes and contributing factors. With your involvement, the physiotherapists sets goals and develops an appropriate treatment plan based on the evaluation already performed. This plan may be readjusted after reassessments as the treatment progresses.
You should bring your social security card, valid prescription from a doctor and any other tests results you may have (previous diagnosis not older than 6 months, discharge report from a previous physiotherapist visit for the same condition, X-ray, MRI, EMG, etc.).
You should dress comfortably while coming to physiotherapy or bring comfortable clothes that you can change into before treatment begins. We recommend dressing or bringing along running/yoga gear, shorts, T-shirt (short sleeve or sleeveless).
This varies depending on the condition being treated, the outcome of the evaluation and the current state of the patient. Most treatments are hands-on, meaning that the physiotherapist will perform one or more techniques depending on the goal of the treatment.
Here are some treatment goals that can be set in a physiotherapy setting:
- Decrease in pain
- Increase in mobility (both at joint segment and at soft tissue level)
- Correction of dysfunction in biomechanics
- Managing neurological pain and weakness
- Improving strength and conditioning
- prescription of supportive devices
- Improving function, independence with activities of daily living
- Educating patient on self conditioning and management, injury prevention etc.
Initial evaluation lasts 45 to 60 minutes while each treatment will last about 20 - 45 minutes depending on the condition being treated and how the patient is reacts.
The length of a treatment period is determined by the prescribing doctor. Typically, doctors prescribe 8 treatment sessions for common musculoskeletal conditions, 32 sessions for post-operative rehabilitation and 64 occasions for more severe conditions. In case of common musculoskeletal conditions, the doctor can issue a new prescription to continue treatment where/when necessary.
You can be referred back to your doctor if there is a need for you to continue treatment beyond what the prescription stipulates.
All physiotherapy treatments are built around 2 principles;
- to improve function
- to reduce pain
Physiotherapy treatments work on achieving the these goals to the best possible extent. Achieves such results depend on the condition being treatment and the patient's willingness to take active part in the treatment in the form of following all home exercises as prescribed.
Following the prescribed home exercise regimen correctly helps achieve a long lasting result.
In such a case, you can return to your referring doctor to discuss the pain that has returned. The doctor will decide whether to send you back right away to Physiotherapy or to request for a report on your previous treatment before deciding on the next course of action.
The goal of physical therapy is to reduce pain and improve function but there are exceptional cases/techniques that may elicit more pain. Examples of these exceptional cases include treatment of frozen shoulder, post-operative rehabilitation of the knee. The resulting pain during these treatments occurs as the physiotherapist tries to restore full range of motion in these joints. In some other cases, provocation tests are required to rule-in/out some conditions such as peripheral sensitisation, complex regional pain syndrome, nerve entrapment tests, tests for lower back pain etc. For this reason, physiotherapy treatment is adapted as it progressed based on each individual's response to ensure that there is rarely pain save for the exceptional cases.
There is a wide variety of treatment methods used in physiotherapy but we are listing a few of those here:
- manual therapy
- range of motion exercises (active, active assisted and passive)
- proprioceptive neuromuscular facilitation
- suspension therapy
- gait training
- soft tissues mobilization (including all forms of massage)
- electrical stimulation (TENS, interferential current etc.)
- Balneotherapy and much more
Massage therapy as the name implies is purely focused on soft tissue mobilisation mostly aimed at relaxation (but in certain cases therapeutic) whereas physiotherapy is a much more holistic approach to solving musculoskeletal problems. Physiotherapist use massage as one of many treatment approaches when necessary to treating musculoskeletal conditions but that does not mean that they are massage therapists.
Chiropractic care focuses mostly on solving joint and soft tissue limitations. They approach these using joint manipulation, traction, and massage. Some patients may see both a chiropractor and a physiotherapist at the same time, and the overlap in their approaches may yield better for these patients.
There are many Physiotherapists with chiropractor degree and vice versa, thus depending on the condition your doctor might make some recommendations.
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