Contraindications to physical therapy modalities are conditions in which a treatment could do harm. The most common general contraindications are cancer, pregnancy (treatments around the abdomen and pelvis), a pacemaker, fever and acute infections, thrombosis, a tendency to bleed, sensory disorders and damaged skin at the treatment site. Each of the 5 main types of treatment also has its own additional contraindications.
Below we have collected the general contraindications and the specific ones for currents, ultrasound, laser, magnetic therapy and the Sollux lamp. The list is for information only: whether you qualify for a treatment is decided by the physiotherapist after taking a medical history, and in case of doubt by a doctor.
In brief
- 8 general contraindications: cancer, pregnancy (abdomen and pelvis), pacemaker, fever and infections, thrombosis, bleeding, sensory disorders, damaged skin.
- Contraindications are divided into absolute (the treatment is not performed) and relative (an individual decision).
- Metal in the body mainly rules out direct current in the treatment area; magnetic therapy and laser over metal may be acceptable after assessment.
- Physical therapy treatments at the clinic in Rydułtowy cost PLN 15–20, a consultation PLN 180.
- The clinic offers private visits only (not covered by NFZ, the Polish public health fund), Mon–Fri 7:00–20:00.
Contents
Who cannot have physical therapy treatments?
Physical therapy treatments are usually not performed on people with active cancer in the treatment area, during pregnancy around the abdomen, pelvis and lower back, with a pacemaker or another implanted electronic device, with a fever or acute infection, thrombosis, a tendency to bleed, active tuberculosis, severe heart failure or sensory disorders, or on damaged skin.
This list also includes situations in which the patient cannot cooperate and report sensations, e.g. with impaired consciousness or severe cognitive impairment. Epilepsy, uncontrolled high blood pressure and recent injuries also call for caution.
What is the difference between absolute and relative contraindications?
An absolute contraindication means that the treatment is not performed at all in the given situation, e.g. currents in a person with a pacemaker within the area the current acts on. A relative contraindication means that the treatment is possible after weighing up the benefits and risks, often with a change of site, parameters or type of treatment, sometimes after consulting the doctor in charge of your care.
An example of a relative contraindication is a metal implant: for some treatments it does not matter, for others it rules out treatment only in that area. The same condition can therefore be a contraindication for one treatment but not for another.
What are the contraindications to individual treatments?
Apart from the general contraindications, each treatment has its own. For currents these include metal in the treatment area and the front of the neck; for ultrasound – the eyes, gonads and growth plates; for laser – the eyes and photosensitising medicines; for magnetic therapy – among others an overactive thyroid; and for the Sollux lamp – acute inflammation and recent injuries.
| Treatment | Specific contraindications (in addition to the general ones) | Price |
|---|---|---|
| TENS and other currents | metal in the treatment area (especially direct current and diadynamic currents), front of the neck, eyes, epilepsy (head and neck area), allergy to the medicine used in iontophoresis | PLN 15 |
| Ultrasound, phonophoresis | eyes, testes and ovaries, heart area, growth plates in children, area after removal of a vertebral arch, joint replacements with cement or plastic components, allergy to the medicine | PLN 20 |
| Laser therapy | eyes (without protective glasses), photosensitising medicines and conditions, thyroid area, tattoos and moles in the treatment field | PLN 20 (spot laser) |
| Magnetic therapy | overactive thyroid, gastrointestinal bleeding, severe heart disease, acute viral, bacterial and fungal infections | PLN 15 |
| Sollux lamp | acute inflammation, recent injuries, hypersensitivity to light, advanced peripheral circulation disorders | PLN 15 |
An indicative table. Prices valid from 08.2026. We describe the details in our posts on TENS currents, laser therapy and magnetic therapy.
Can I have physical therapy treatments during pregnancy?
During pregnancy, physical therapy treatments are not performed around the abdomen, pelvis and lower back, and magnetic therapy and heat treatments covering a large area of the body are usually not used at all. Some treatments on distant sites, e.g. the hand, may be possible after assessment by a physiotherapist, ideally after consulting the doctor looking after the pregnancy.
The exception is TENS used for labour pain under the care of a midwife. During pregnancy, exercise and manual therapy are usually a safer and better-researched form of help with pain – more in our post back pain in pregnancy.
Does a pacemaker or metal in the body rule out physical therapy?
A pacemaker, a cardioverter-defibrillator and other implanted electronic devices rule out treatment with currents and magnetic therapy, and call for great caution with other treatments. Metal in the body, e.g. a joint replacement or fracture fixation, mainly rules out direct current in the treatment area. Laser, and often magnetic therapy too, may be acceptable over metal after assessment by a physiotherapist.
For any implant, it is worth bringing information from your hospital records: what was implanted, where and when. Non-metal implants, e.g. hernia mesh, usually do not interfere, but they should also be reported.
Can I have physical therapy after cancer?
Active cancer is a contraindication to most physical therapy treatments, especially around the tumour. After treatment has finished, the decision is made individually, ideally after consulting an oncologist, who will assess the risk of recurrence. Movement-based physiotherapy, exercise and lymphatic drainage, with the doctor’s approval, are often recommended for cancer patients and are safer than physical therapy modalities.
Before the treatment, it is worth having up-to-date information from the doctor in charge of your care with you. With new, unexplained pain, especially at night, with weight loss or fever, medical tests are needed first, not a treatment.
Good to know: before your first treatment, tell the physiotherapist about pregnancy, implants, a pacemaker, cancer, thrombosis, epilepsy, the medicines you take (especially anticoagulants and photosensitising medicines) and allergies.
Summary
General contraindications to physical therapy modalities include cancer, pregnancy (around the abdomen), a pacemaker, fever, thrombosis, bleeding and sensory disorders, and each treatment also has its own list. Treatments at the clinic in Rydułtowy cost PLN 15–20, and the physiotherapist checks whether you qualify before the first treatment.
Frequently asked questions
Can I have physical therapy treatment when I have a cold?
With a fever or an acute infection, physical therapy treatments are postponed until you have recovered, as they may worsen the symptoms and put a strain on the body. With a mild runny nose and no fever, the physiotherapist decides. It is worth cancelling the visit in advance, also so as not to infect other patients. Information about cancelling visits is on the clinic’s website.
Is physical therapy possible during a period?
During a period, treatments around the abdomen, pelvis and lower back are avoided, especially magnetic therapy and heat treatments, as they may increase bleeding. Treatments on other parts of the body, e.g. the shoulder or knee, are usually possible. If your periods are very heavy, it is worth telling the physiotherapist before the treatment.
Can I have physical therapy if I have diabetes?
With diabetes, physical therapy is usually possible, but it requires caution. Diabetic neuropathy can reduce the ability to feel heat and current, which increases the risk of burns, and circulation problems make it harder for the skin to heal. The physiotherapist checks sensation at the treatment site and adjusts the parameters. Wounds and ulcers on the feet first need a doctor’s care.
Can I have physical therapy if I have high blood pressure?
With well-controlled high blood pressure, most physical therapy treatments are possible. Uncontrolled high blood pressure is a relative contraindication, particularly to heat treatments covering a large area of the body and to some currents. Before the treatment, take your medicines as recommended by your doctor and tell the physiotherapist about your condition and any recent changes in treatment.
Can I have physical therapy if I have varicose veins?
With varicose veins, heat treatments and some currents directly over the affected veins are avoided. Treatments on other areas are usually possible. Deep vein thrombosis or phlebitis is an absolute contraindication. Sudden swelling, pain and redness of the calf need an urgent visit to a doctor, not a treatment at the clinic.
Can children have physical therapy treatments?
In children, some physical therapy treatments are used less often and more cautiously, because growing bones have growth plates and a small child is less able to report unpleasant sensations. Ultrasound is not used over growth plates. In children, physiotherapy is usually based on exercise, and decisions about physical therapy treatments are made individually.
Sources
- Mika T., Kasprzak W. (eds.), Fizykoterapia, Wydawnictwo Lekarskie PZWL, edition.
- Houghton P.E. et al., Electrophysical agents – contraindications and precautions: an evidence-based approach to clinical decision making in physical therapy, Physiotherapy Canada, 2010.
- Watson T., Nussbaum E.L. (eds.), Electro Physical Agents: Evidence-Based Practice, Elsevier, 2020.
About the author: Tatiana Grabowska, MSc – master’s degree in physiotherapy, licence to practise number PWZFz 11646 (Polish physiotherapist licence). Since 2013 she has run the “W zdrowym ciele” physiotherapy and rehabilitation clinic in Rydułtowy; she has about 12 years of professional experience. Physiotherapist’s profile
- Consultation180 PLN
- Referralnot needed
- ReceptionMon–Fri: 7.00–20.00
