A physical therapist can design a tailored rehabilitation program to address the specific causes of the condition. Physical therapy helps reduce pain and prevent recurrence by addressing underlying causes such as muscle imbalances or poor movement mechanics. Techniques include:

• Manual therapy to restore movement in the joints or mobilise the tendons, whilst alleviating pain, reduce muscle tension and stiffness.
• Gait training to identify and correct walking mechanics, faulty movement patterns and reduce joint stress or correct biomechanical issues, such as overpronation or calf weakness, that may contribute to Achilles tendinopathy.
• Strengthening exercises targeting muscles around the affected joints, such as quadriceps strengthening for knee osteoarthritis and foot and ankle muscles to improve support and reduce strain on the plantar fascia.
• Electrotherapy the use of non-invasive modalities to treat pain and healing using electrical currents, acoustic waves or magnetism. TENS (Transcutaneous Electrical Nerve Stimulation) therapy involves applying electrical currents to the skin over painful joints. It can help reduce pain by stimulating nerves and blocking pain signals to the brain. TENS units are often used for short-term pain relief and can be applied at home.

Advanced Modalities such as acupuncture may also be recommended. Acupuncture involves inserting thin needles into specific points on the body to stimulate pain relief and promote healing. It has been shown to be effective for both acute and chronic back pain by reducing inflammation and enhancing the body's natural healing mechanisms.

An occupational therapist can provide strategies and tools to help manage daily activities without worsening joint pain. They may recommend adaptive equipment or joint protection techniques to reduce stress on affected joints during activities like lifting or gripping.

Yoga and Pilates

Yoga and Pilates are effective for strengthening core muscles, improving flexibility, and enhancing posture. Certain poses or exercises specifically target the spine and help relieve tension in the back muscles. These modalities can be particularly useful for chronic, non-specific back pain.

Eccentric Strengthening

Eccentric exercises where the muscle lengthens under load, are beneficial for tendinopathies. In the case of the rotator cuff, controlled lowering of weights or resistance bands can help build tendon resilience.

Aquatic Therapy

Exercising in water reduces the load on joints while allowing for movement and strengthening. Aquatic therapy can be especially beneficial for individuals with severe pain or mobility issues, as the water supports the body and allows for low-impact exercise. This is especially beneficial for individuals with severe osteoarthritis, as the buoyancy of water provides a low-impact environment.

Avoiding activities that exacerbate the pain while staying as active as possible is essential for recovery. Prolonged bed rest is generally not recommended, as gentle movement helps maintain flexibility and prevents muscle weakening. Reducing or modifying activities that strain the plantar fascia, such as running or prolonged standing, allows the tissue to heal. Rest is one of the most effective early interventions.

Cold therapy
Applying ice packs to the affected area for 15–20 minutes several times a day can reduce inflammation and numb acute pain, particularly after an injury.

Heat therapy:
Heat pads or warm baths can relax muscles, increase blood flow, and reduce stiffness, especially for chronic or muscle-related back pain.
Alternating between heat and cold therapies can be effective in managing both acute and chronic symptoms.

Regular stretching and strengthening exercises can help improve flexibility, alleviate tension and reduce pain.

Poor posture is a common contributor to conditions such as back pain. Making postural adjustments while sitting, standing, and moving can help prevent and alleviate discomfort.

Massage can relieve muscle tension, reduce pain, and improve circulation. Deep tissue or myofascial release techniques are often used for muscle-related back pain to target trigger points and improve muscle function or reduce inflammation in the plantar fascia and surrounding tissues.

Taping or Bracing

Lumbar support braces or kinesiology tape can help stabilize the back, reduce strain, and provide temporary relief from pain, especially during physical activity, whilst shoulder braces can provide support and offload stress from the Rotator Cuff. Taping is often used in conjunction with other therapies to improve shoulder mechanics during rehabilitation.

Orthotics and Footwear Modifications

Wearing supportive shoes with proper arch support and cushioning can alleviate pressure in cases of plantar fascia. Custom orthotics or over-the-counter shoe inserts are often used to provide additional support and correct any underlying biomechanical issues.

Canes or Walkers

Reduces the load on the joints and improves mobility.

Night Splints

Night splints hold the foot in a dorsiflexed position (toes pointing upward) while sleeping, keeping the plantar fascia stretched and preventing morning stiffness. These splints are particularly helpful for people with chronic cases.

NSAIDs such as Ibuprofen or Naproxen can be taken to reduce pain and inflammation in the short term. They are typically used in combination with other therapies for relief during the initial stages of treatment.

Various creams, gels, and patches containing NSAIDs, capsaicin, or salicylates can be applied directly to the affected joint. These provide localized pain relief without the systemic side effects of oral medications.

In cases of severe muscle spasms or tension, muscle relaxants such as Cyclobenzaprine or Methocarbamol may be prescribed. These medications help reduce muscle stiffness and improve mobility.

If inflammation and pain are severe and non-responsive to oral medications, corticosteroid injections may be used. These injections are typically administered near the affected nerves or joints to reduce inflammation and provide temporary relief. However, caution is advised, as repeated injections can weaken the tendon and increase the risk of rupture.

Hyaluronic acid injections help lubricate the joint and may provide pain relief, particularly in knee osteoarthritis. The injections can mimic the natural fluid found in healthy joints, though their effectiveness can vary.

PRP therapy involves injecting a concentration of the patient’s platelets into the affected area to promote healing and tissue regeneration. It is considered an emerging treatment and has shown potential in improving joint function in some osteoarthritis patient, degenerative back conditions like disc injuries or ligament damage and treating chronic plantar fasciitis.

Stem cell injections are another emerging treatment designed to regenerate damaged cartilage and reduce pain. While promising, more research is needed to fully understand their long-term efficacy in osteoarthritis treatment.

Surgery is generally reserved for severe cases where patients have not responded to conservative treatments, or where there is significant structural damage, tears, etc. Surgical options include:

• Arthroscopy
• Osteotomy
• Joint replacement (arthroplasty)
• Discectomy
• Laminectomy
• Spinal fusion
• Tendon transfer or repair