What online physiotherapy cannot do
Online physiotherapy cannot give hands-on treatment, handle emergencies, or replace in-person assessment when a problem needs it. Our video appointments cover the UK. We also offer home visits in the Glasgow area, which can include hands-on treatment (manual therapy) where appropriate. We do not offer acupuncture or needles. If you need urgent help, we say so and tell you where to go instead.
Why we publish this page
Most of what we do is by video, and video care is not right for everyone. The Chartered Society of Physiotherapy backs a flexible blend of remote and in-person care, which means in-person care is the right answer for some people. We would rather say that plainly than keep you in a plan that does not fit.
Below are the main things we cannot do, and what we suggest instead.
Hands-on treatment
Video sessions cannot include hands-on treatment, so we cannot give manual therapy, such as hands-on joint mobilisation, over video. At a home visit in the Glasgow area, hands-on treatment (manual therapy) is available where appropriate, alongside exercise and advice. We do not offer acupuncture or needles, and we have no clinic or premises. Home visits use the same booking flow as video calls, at the video price plus a travel fee per visit (see pricing).
Our service guidance says that if hands-on treatment is the main thing a problem needs, you will be told at triage and offered a home visit if you are in the Glasgow area, or pointed towards an in-person clinician or your GP. If you want hands-on care and you are outside the Glasgow area, look for a registered in-person physiotherapist near you. Check that they are on the HCPC Register, because physiotherapist is a protected title.
It is worth knowing that national guidance is cautious about some hands-on approaches. NICE says manual therapy for low back pain should only be part of a package that includes exercise, and it advises against acupuncture for low back pain and for osteoarthritis.
Sudden injury or a suspected fracture
If you have had a recent fall or accident and think you may have broken a bone, you need to be seen in person. We cannot examine a limb or order an X-ray over video.
What to do instead: go to A&E now, or call NHS 111 straight away if you are not sure where to go. Do not drive yourself if you feel very unwell. For back pain after a serious accident, the NHS says to call 999 or go to A&E. Once you have been assessed and cleared, we can help with the exercise-based rehab that follows.
Red-flag symptoms
Some symptoms are warning signs that need urgent medical care. For back pain and sciatica, the NHS says to call 999 or go to A&E if you have weakness or numbness in both legs, numbness around your genitals or anus, changes in your bladder or bowels, or if it started after a serious accident. The NHS also says not to drive yourself to A&E.
A video appointment is not the right route for any of these. Our service guidance also lists unexplained weight loss, night pain that does not ease and progressive weakness as reasons to be pointed towards in-person care or your GP.
Sudden neurological symptoms and complex presentations
Our neurological service guidance treats sudden new symptoms such as facial drooping, sudden weakness, slurred speech or a fall with injury as a medical emergency. Call 999 or go to A&E. It is not a physiotherapy appointment.
In our neurological rehabilitation guidance, online sessions are for ongoing guided practice once you are medically stable and urgent hospital care is arranged. They do not replace your NHS or specialist team. Before you start, your GP or specialist team must confirm it is safe for you to begin physiotherapy. If we think you need hands-on assessment, we will tell you at triage. See our neurological rehabilitation service for more.
Babies and very young children
In our paediatric service guidance, we explain that very young infants and complex conditions affecting several body systems are often better seen by an in-person paediatric specialist team, and we talk this through before booking.
If a child has a new or worsening symptom, loss of a skill they had gained, unexplained pain or signs of injury, they need a GP or A&E assessment, not an online appointment. Read more about our paediatric physiotherapy service.
After surgery and with falls or mobility problems
Our post-surgical guidance sends wound checks, removal of stitches or staples, and any complication back to your surgical team for in-person review. Rehab with us starts once your surgical team has said you are ready for outpatient or community physiotherapy, and we follow any restrictions or precautions they give you. See post-surgical rehabilitation.
For gait and mobility, our service guidance says a recent fall with injury, sudden weakness or acute pain affecting walking needs urgent in-person medical assessment first. It also says falls-risk tools that need hands-on testing, or a home hazard check, are better done in person. See our gait and mobility assessment.
How to decide what to do next
If you think it might be an emergency, call 999 or go to A&E. If you are not sure, call 111 or speak to your GP. If your problem is not urgent but may need hands-on care, a home visit (Glasgow area) or an in-person physiotherapist near you is the right choice.
If it is a problem where exercise, advice and guided movement are the main treatment, video may well suit you. Read the evidence in our guide on whether online physiotherapy works, and book an appointment if you want to go ahead.
Common questions
Do you offer manual therapy or acupuncture?
We do not offer acupuncture or needles. Video sessions cannot include hands-on treatment, but at a home visit in the Glasgow area hands-on treatment (manual therapy) is available where appropriate, and your physiotherapist will tell you what suits you. Elsewhere, we point you to an in-person clinician near you.
What if I think I have broken a bone?
Go to A&E now, or call NHS 111 straight away if you are not sure where to go. Do not drive yourself if you feel very unwell. We cannot examine a suspected fracture over video.
What symptoms mean I should not book a video appointment?
For back pain or sciatica, the NHS says to call 999 or go to A&E for weakness or numbness in both legs, numbness around the genitals or anus, bladder or bowel changes, or back pain after a serious accident. Our neurological service guidance also treats sudden facial drooping, sudden weakness or slurred speech as an emergency: call 999.
Will you tell me if online physio is not right for me?
Yes. If triage shows that you need hands-on care, we offer a home visit if you are in the Glasgow area, or point you to an in-person clinician. If you need urgent help, we tell you plainly and point you to your GP or urgent care.
This information is general and not a substitute for an assessment. Don't start a new exercise programme without advice from a physiotherapist or doctor who knows your condition. If an exercise causes pain that doesn't settle, stop and seek advice.
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