28. November 2016
Written by Bryan Kelly, Chartered Physiotherapist (MCSP), HCPC-registered, at CK Physio in Hanwell.
Clinically reviewed by CK Physio Team
Published 26 Oct 2026. Last reviewed 26 Oct 2026. Next review due Oct 2027.
In short
Your first physiotherapy appointment is mainly an assessment. Your Chartered Physiotherapist will ask about your symptoms, medical history and goals, examine how you move, explain what they think is going on, and agree a plan with you — often including some first treatment and exercises to start at home.
Your First Physiotherapy Appointment: What to Expect and How to Get the Most From It
If you have never seen a physiotherapist before, it is normal to feel a bit unsure about what will happen, what to wear, and whether you will need to undress. This is CK Physio's canonical guide to physiotherapy at our Hanwell clinic, written by one of our Chartered Physiotherapists. It covers what happens at the first session, how to prepare, your rights during the appointment, and the things you can do between visits that make the biggest difference to how you recover.
Key takeaways
- Your first appointment is mostly a conversation and a movement assessment, not a long treatment session.
- Allow around 45 to 60 minutes for an initial assessment at CK Physio, and around 30 minutes for most follow-ups.
- You do not usually need a GP referral for private physiotherapy, though your insurer may ask for one.
- Writing down your symptom story and goals before you arrive makes the session more useful for you.
- Doing a small number of home exercises consistently matters more for recovery than any single appointment.
What happens at a first physiotherapy appointment?
A first physiotherapy appointment is mainly an assessment. According to the NHS, "at your first appointment, the physiotherapist will ask about your symptoms, medical history and lifestyle" and may examine the affected area and check things like your strength and balance, before discussing treatment options and how many sessions you may need.1 At CK Physio, that usually breaks down into five stages.
1. Talking it through — your history
Your physiotherapist will ask when your symptoms started, what makes them better or worse, how they affect your sleep, work and daily life, and what you have already tried. They will also ask about your general health, medications and any past injuries or surgery. This conversation often takes the biggest share of the first appointment, because it shapes everything that follows.
2. The physical examination
Your physiotherapist will watch how you move, test your strength and flexibility, and gently feel the affected area. They may ask you to walk, bend, lift or balance in specific ways. Some of these tests may briefly reproduce your symptoms — that is intentional, and helps your physiotherapist understand what is causing them.
3. Your working diagnosis and plan
Your physiotherapist will explain what they think is going on and talk through the options with you. A good plan is one you have shaped — your preferences, your schedule and your goals all matter. You should leave with a clear idea of what to do next and why.
4. First treatment and exercises
In most cases, you will have some first treatment at the same appointment — perhaps hands-on techniques, movement advice, or a short tailored exercise programme. You can read more about the main treatment approaches physios use. If you are in a lot of pain, your physiotherapist may do less on day one and focus on settling symptoms first.
5. Screening for anything that needs a doctor
Part of your Chartered Physiotherapist's job is to spot symptoms that need medical review rather than physiotherapy. If anything you describe suggests a different cause, they will tell you clearly and help you get to the right person — usually your GP or, where appropriate, urgent care. This happens quietly in the background; it is not something to worry about.
How long is a first physio appointment at CK Physio?
Your first appointment at CK Physio usually lasts around 45 to 60 minutes. Follow-up sessions are typically shorter, at around 30 minutes. The exact length depends on what you are coming in for and how much ground your Chartered Physiotherapist needs to cover.
| Appointment type | Typical length | What it covers |
|---|---|---|
| Initial assessment | 45–60 minutes | History, examination, working diagnosis, plan, first treatment where appropriate |
| Follow-up session | Around 30 minutes | Progress review, hands-on treatment and exercise progression |
| Home visit (West London) | Confirmed when you book | Assessment and treatment at home, often used for mobility, post-surgical or older patients |
How should I prepare for my physio appointment?
A little preparation can genuinely change how much you get out of your first session. West London NHS Trust puts it well: "the more you are involved in making decisions on your treatment plan, the more likely you will achieve a better outcome."1 Before you come in, try to work through the five steps below.
- Write down your symptom story. Use the table below as a prompt. You will not need to recite it word for word, but having it in front of you means nothing important gets left out.
- List your medications, conditions and previous treatment. Include anything you take regularly, past injuries or surgery, and any physiotherapy, osteopathy or chiropractic care you have had before.
- Bring scans, letters and insurance details. Any recent GP letters, discharge summaries, X-ray or MRI reports are useful. If you are claiming through private medical insurance, bring your membership number and authorisation code.
- Decide what you want to get back to. Think about the specific things your symptoms are stopping you doing — running your usual loop, lifting your grandchild, sleeping through the night, finishing a work day without flaring up. These goals matter more than a pain score.
- Prepare your top three questions. Three is enough. Writing them down means you will not forget them when the session gets busy.
A simple symptom diary to fill in
| Question | Your notes |
|---|---|
| When did it start, and was there a trigger? | |
| What makes it worse? | |
| What eases it? | |
| Worst time of day or week? | |
| Pain score right now, out of 10? | |
| One thing you want to get back to doing? |
What should I wear to physio, and will I need to undress?
Wear something you can move in, and that gives your physiotherapist a clear view of the area that is bothering you. You should not need to undress to your underwear if you choose clothing that gives easy access to the right body area. If you would rather stay in your usual clothes, let us know when you book and we can have shorts or a gown ready for you.
| Area being assessed | Suggested clothing |
|---|---|
| Lower back, hip, knee or ankle | Loose shorts or soft trousers that roll up, and a comfortable top |
| Shoulder, elbow or wrist | A vest or sleeveless top, or a t-shirt you can comfortably remove |
| Neck or upper back | Something you can take off at the top, or a loose, wide-necked top |
| Running, gait or balance | Your usual trainers, plus kit you would actually train in |
You can bring a friend, partner, relative or interpreter with you if that helps you feel more comfortable, and you can ask for a chaperone at any point — we will not ask why.
How do I describe my pain to a physiotherapist?
Describe where it is, what it feels like, when it happens and how much it limits you. You do not need medical vocabulary — your own words are usually clearer. If you can, give your pain a score out of 10 at its best and at its worst over the past week. The small shifts below are more useful to your physiotherapist than a general "it hurts a lot".
| Instead of… | Try saying… |
|---|---|
| "My back is killing me." | "A dull ache low on the right side, 7 out of 10 after sitting an hour, 3 out of 10 after a walk." |
| "My shoulder hurts all the time." | "A sharp catch on the outside of my shoulder when I reach overhead, and a deep ache that wakes me at night." |
| "My knee is bad after running." | "A grinding sensation under the kneecap during downhill sections, worse the next morning on stairs." |
Your rights during the appointment: consent, chaperones and stopping
You stay in control of your appointment. The Chartered Society of Physiotherapy's consent guidance is clear that "before any assessment or treatment, you must get consent from the person", that consent "must be given voluntarily, without pressure", and that patients can withdraw consent at any time.2 In plain English, that means:
- You can ask questions at any point — before, during or after a test or technique.
- You can say no to any part of the assessment or treatment, and change your mind later.
- You can ask for a chaperone, a relative, friend or interpreter to be present.
- You can ask to pause or stop the session if you need a break.
- Any photos or video of you (for exercise reminders, for example) are only taken with your written consent, and you can withdraw it later.
What should I do after my first physio appointment?
What happens between appointments usually matters more than what happens inside them. Do your home exercises, keep moving within sensible limits, and pay attention to how your symptoms respond.
Do your home exercises — a few, done well
The NHS reminds people that "it is important you do them regularly to help with your recovery."1 That advice is backed up by evidence: a 2024 overview of systematic reviews in Systematic Reviews concluded that non-adherence to physiotherapy "can be as high as 70%, particularly in unsupervised home exercise programmes."3 That is why our Chartered Physiotherapists favour active exercise alongside hands-on treatment and give you a small number of exercises you can actually fit into your week, rather than a long sheet you will not finish.
Soreness vs warning signs: what is normal?
It is reasonably common to feel mildly sore or tired after your first session, in the way you might after an unfamiliar workout. That usually settles within a day or so. New or rapidly worsening pain, numbness, pins and needles, weakness, or any symptom that worries you is a reason to get in touch with us before your next appointment, rather than waiting it out.
Track your progress
Keep a very short note each day — a pain score out of 10, a tick when you did your exercises, and one line about anything that changed. It takes a minute, and it gives both you and your physiotherapist something concrete to work from at the next session.
When to contact us before your next session
You are welcome to get in touch if you are unsure about an exercise, if your symptoms change meaningfully, or if you have had to stop your plan for any reason. A short conversation often avoids a lost week.
How many sessions will I need, and how will we know it is working?
Honestly, it depends. Different problems respond at different speeds, and we would rather talk you through a realistic plan than quote a tidy number that may not apply to you. The NHS makes the same point: your physiotherapist "will discuss the treatment options with you and advise you about the number of sessions you may need."1
What matters more than the number is whether things are moving. At each appointment, your Chartered Physiotherapist will look at measurable signs — your range of movement, strength, how long you can sit, stand or walk comfortably, how much your symptoms are interrupting your sleep, and progress toward the specific goals you set at the start. If progress stalls, we review the plan together. You can see the conditions we commonly treat for examples of how care is tailored.
NHS or private physiotherapy in West London: what is the difference?
You can access physiotherapy on the NHS without usually needing a GP referral — the NHS confirms that "in many areas, you may be able to get physiotherapy from NHS community musculoskeletal (MSK) services without needing a referral from a GP", though "there may be a long waiting list."1
Private physiotherapy usually gives you a quicker initial appointment, longer sessions, and continuity of care with the same clinician. For a side-by-side comparison relevant to our area, see our dedicated article on NHS vs private physiotherapy in Ealing. If you are choosing a private physiotherapist, the NHS advises making sure "they're chartered (they'll have MCSP after their name) and registered with the Health and Care Professions Council (HCPC)."1 You can verify any clinician on the HCPC public register, and read about our Chartered Physiotherapists here.
Preparing for a home visit in West London
If a home visit suits you better — because of mobility, post-surgical recovery, or because you look after someone at home — a little setup helps the session go well. See our full home visit physiotherapy guide for the full picture, and the quick list below for a first appointment.
- Choose a room with space to walk a few steps and lie down comfortably — a living room is usually ideal.
- Have any walking aids, splints or braces to hand, along with the shoes you most often wear.
- A relative or carer is welcome to sit in, especially if that helps with memory of advice or follow-up.
- For older adults, physiotherapy for ageing well explains how we tailor the plan.
When to seek urgent medical advice
This guide is general information, not a diagnosis. If you have a sudden loss of bladder or bowel control, numbness around the saddle area, severe or rapidly worsening weakness, chest pain, shortness of breath, or symptoms following a significant fall or accident, do not wait for a physiotherapy appointment. Contact NHS 111 or call 999 straight away.
Frequently asked questions
Do I need a GP referral to see a physio?
For private physiotherapy at CK Physio you do not usually need a GP referral — you can book directly. Some private medical insurance policies ask for a GP referral or a case number first, so check with your insurer before you book.
Does CK Physio work with insurers?
Yes. We are recognised by major UK private medical insurers. If you plan to claim, bring your membership number and authorisation code to your first appointment, and we will handle the rest.
What does a first physiotherapy appointment cost?
Current rates for assessment and follow-up appointments are listed on our bookings page — see our current fees.
Can I book an evening or Saturday appointment?
We offer evening appointments during the week and limited Saturday-morning slots. Please confirm current opening hours when you book, as availability varies by clinician.
Can I bring someone with me?
Yes. A friend, partner, relative or interpreter is welcome. If you would like a chaperone from our team, just ask.
Will physiotherapy hurt?
Parts of the assessment may briefly reproduce your symptoms, because that information helps your physiotherapist work out what is going on. Treatment itself should feel acceptable to you — tell us straight away if anything is too uncomfortable, and we will change what we are doing.
How do I check my physiotherapist is qualified?
In the UK, "physiotherapist" is a protected title, regulated by law.4 Only clinicians registered with the HCPC may use it. All our clinicians are Chartered Physiotherapists (MCSP), HCPC-registered, and you can verify them on the HCPC register.
Ready to book your first appointment?
Our Chartered Physiotherapists see new patients at our Hanwell clinic (57 Elthorne Avenue, W7 2JY) and across West London. You can book online, or speak to our team.
About the author
Bryan Kelly is a Chartered Physiotherapist (MCSP), HCPC-registered , and sees patients at CK Physio in Hanwell, West London. Connect on LinkedIn.
Clinically reviewed by CK Physio Team on 26 Oct 2026. Next scheduled review: Oct 2027.
References
- NHS. Physiotherapy. Page last reviewed 3 April 2025. nhs.uk/tests-and-treatments/physiotherapy/
- Chartered Society of Physiotherapy. Consent and physiotherapy practice. csp.org.uk/professional-clinical/professional-guidance/consent-physiotherapy-practice
- Ley C, Putz P. Efficacy of interventions and techniques on adherence to physiotherapy in adults: an overview of systematic reviews and panoramic meta-analysis. Systematic Reviews, 2024. doi:10.1186/s13643-024-02538-9
- Health and Care Professions Council. The professions we regulate — protected titles including Physiotherapist. hcpc-uk.org/about-us/who-we-regulate/the-professions/
- Advertising Standards Authority. Health: Physiotherapy — AdviceOnline. asa.org.uk/advice-online/health-physiotherapy.html
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