Most people book a physiotherapist when something hurts. That is a good reason, but it covers only part of the job. World Physiotherapy describes physiotherapy as services that “develop, maintain and restore maximum movement and functional ability throughout the lifespan”, in situations where movement is threatened by ageing, injury, pain, disease or the environment [1].
This guide explains what a physiotherapist does, how the profession is regulated in Thailand, what happens at a first appointment and which treatments have good evidence.
- Physios assess and treat movement problems, mostly through exercise, hands-on treatment and advice.
- In Thailand, physiotherapy is a licensed profession. With limited exceptions, only people licensed by the Physical Therapy Council can practise.
- You don’t need a doctor’s referral to see a physiotherapist in Thailand.
- Exercise therapy has the best evidence of the treatments physios use for back pain and knee osteoarthritis.
- For some knee problems, physiotherapy has matched surgery in randomised trials.
What a physiotherapist does
A physiotherapist works out why you are in pain or moving badly, then treats it. That usually means three things: an assessment of how you move, a diagnosis of the movement problem, and a plan that combines exercise, hands-on treatment and advice. World Physiotherapy notes that physiotherapists can act as first contact practitioners, so patients can see them directly without a referral from another health professional [1].
Physios work across a wide range of problems: back and neck pain, sports injuries, rehab after surgery, joint pain, posture and desk-related pain, and recovery from conditions that affect movement.
How physiotherapy is regulated in Thailand
Physiotherapy in Thailand is governed by the Physical Therapy Act B.E. 2547 (2004). A practitioner of physical therapy is defined as a person who is registered and holds a licence from the Physical Therapy Council. To be licensed, applicants must become members of the Council and pass its exam. Practising physiotherapy without a licence is an offence, punishable by up to three years in prison, a fine of up to 60,000 baht, or both [2].
According to the Physical Therapy Association of Thailand, licences are granted by national examination, applicants must hold a physiotherapy bachelor’s degree from an accredited programme, and there are an estimated 16,850 practising physiotherapists in the country [3].
In practice, this means you can ask to see a physiotherapist’s licence. Our physiotherapists and their qualifications are listed on our team page.
Do you need a referral?
No. In Thailand, people can refer themselves to a physiotherapist in private practice, and in the public system with some limits [3]. Some insurers ask for a doctor’s referral before paying for physiotherapy, so check your policy first if you plan to claim. Our insurance page explains how claims work with us.
Going direct appears to be safe. A systematic review of 8 studies found that people who saw a physiotherapist directly had equal or better outcomes and satisfaction, with fewer physiotherapy visits, scans, prescriptions and extra appointments than people who were referred. It found no evidence of harm [4]. A later review of 18 studies, of weak to moderate quality, compared direct access physiotherapy with usual care led by a doctor. It concluded that direct access may give better results for disability, quality of life and costs, though not for pain [5].
What happens at your first appointment
At Aspire Physio Bangkok, the first consultation is free. It starts with questions about your pain or injury, your work, your training and what you want to get back to. Then the physiotherapist looks at how you move, how you sit and work, and which movements bring on your symptoms.
By the end you should know what the physio thinks is going on, what the plan is, roughly how long it should take and what you can do at home. If something needs a doctor or a scan first, we will tell you.
The main treatments, and how good the evidence is
Exercise therapy
Exercise is the core of modern physiotherapy because it has the best evidence. In chronic low back pain, a Cochrane review of 249 trials found that exercise reduced pain by about 15 points on a 100-point scale compared with no treatment, usual care or placebo [6]. For knee osteoarthritis, a Cochrane review of 139 trials with 12,468 people found improvements in pain and function of around 13 points on 100-point scales compared with no exercise or usual care, though the reviewers judged their clinical importance uncertain [7].
Hands-on treatment
Manual therapy covers mobilisation, manipulation and soft tissue work. For low back pain, NICE recommends it only as part of a treatment package that includes exercise [8]. That is how we use it: to ease pain and stiffness so you can do the exercise that builds lasting change. See manual therapy, dry needling and sports massage.
Physiotherapy instead of surgery, in some cases
In a trial of 351 people aged 45 and over with a meniscal tear and knee osteoarthritis, those who had physiotherapy improved about as much at 6 months as those who had keyhole surgery. About 30% of the physiotherapy group went on to have surgery within 6 months [9]. In another trial, 140 middle-aged adults with degenerative meniscal tears did either 12 weeks of supervised exercise or surgery. Results were similar at two years, and the exercise group was stronger at 3 months [10].
These trials were in middle-aged and older adults with wear-related tears. Acute injuries in young athletes are a different question, and some, like many ACL ruptures, are often treated with surgery followed by rehab. See post-surgery rehab and ACL rehab.
Machines
TENS and therapeutic ultrasound were once standard in physiotherapy clinics. For chronic low back pain, a Cochrane review found the evidence does not support routine use of TENS [11], and another found little to no difference between ultrasound and placebo [12]. We don’t use ultrasound, TENS or other electrotherapy at Aspire Physio Bangkok. Session time goes into the treatments with stronger evidence.
What we treat
At Aspire Physio Bangkok, we treat back pain, neck and shoulder pain, office syndrome, knee pain and sports injuries. We also offer a full posture assessment. Our gym is in the same building, so rehab carries straight through to strength training.
Book a free first consultation through our contact page or call 082-281-8009. We’re at Jasmine Building, 2nd Floor, Sukhumvit Soi 23, near Asok BTS.
Common questions
Do I need a doctor’s referral to see a physiotherapist in Thailand?
No. People in Thailand can refer themselves to a physiotherapist. Some insurers ask for a doctor’s referral before they pay for physiotherapy, so check your policy if you plan to claim.
Are physiotherapists in Thailand licensed?
Yes. Under the Physical Therapy Act of 2004, only people registered and licensed by the Physical Therapy Council can practise physiotherapy, with limited exceptions such as supervised students. Applicants need a physiotherapy degree from an accredited programme and must pass the national licensing exam.
Can physiotherapy replace surgery?
For some problems it can. In two trials of middle-aged and older adults with degenerative meniscal tears, exercise-based physiotherapy gave results similar to keyhole surgery. Other injuries, such as many complete ligament ruptures in young athletes, often do need surgery, followed by rehab.
How is physiotherapy different from massage?
Massage is one hands-on technique. Physiotherapy starts with an assessment of how you move and what is causing the problem, and treatment is built mainly around exercise, with hands-on work as support. In Thailand it must be delivered by a licensed physiotherapist.
References
- World Physiotherapy. Policy statement: Description of physiotherapy. London: World Physiotherapy; 2023. world.physio/sites/default/files/2024-01/PS-2023-Description.pdf
- Physical Therapy Council of Thailand. Practice of the Physical Therapy Act B.E. 2547 (2004). Unofficial English translation. www.pt.or.th/ptcouncil/law/1-2/eng.pdf
- World Physiotherapy. Member organisation profile: Thailand. Data reported by the Physical Therapy Association of Thailand, 2024. world.physio/membership/thailand
- Ojha HA, Snyder RS, Davenport TE. Direct access compared with referred physical therapy episodes of care: a systematic review. Phys Ther. 2014;94(1):14-30. doi.org/10.2522/ptj.20130096
- Demont A, Bourmaud A, Kechichian A, Desmeules F. The impact of direct access physiotherapy compared to primary care physician led usual care for patients with musculoskeletal disorders: a systematic review of the literature. Disabil Rehabil. 2021;43(12):1637-1648. doi.org/10.1080/09638288.2019.1674388
- Hayden JA, Ellis J, Ogilvie R, Malmivaara A, van Tulder MW. Exercise therapy for chronic low back pain. Cochrane Database Syst Rev. 2021;9(9):CD009790. doi.org/10.1002/14651858.CD009790.pub2
- Lawford BJ, Hall M, Hinman RS, et al. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev. 2024;12(12):CD004376. doi.org/10.1002/14651858.CD004376.pub4
- National Institute for Health and Care Excellence. Low back pain and sciatica in over 16s: assessment and management. NICE guideline NG59. 2016, updated 2026. www.nice.org.uk/guidance/ng59/chapter/Recommendations
- Katz JN, Brophy RH, Chaisson CE, et al. Surgery versus physical therapy for a meniscal tear and osteoarthritis. N Engl J Med. 2013;368(18):1675-1684. doi.org/10.1056/NEJMoa1301408
- Kise NJ, Risberg MA, Stensrud S, et al. Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two year follow-up. BMJ. 2016;354:i3740. doi.org/10.1136/bmj.i3740
- Khadilkar A, Odebiyi DO, Brosseau L, Wells GA. Transcutaneous electrical nerve stimulation (TENS) versus placebo for chronic low-back pain. Cochrane Database Syst Rev. 2008;(4):CD003008. doi.org/10.1002/14651858.CD003008.pub3
- Ebadi S, Henschke N, Forogh B, et al. Therapeutic ultrasound for chronic low back pain. Cochrane Database Syst Rev. 2020;7(7):CD009169. doi.org/10.1002/14651858.CD009169.pub3
