Are there any reasons to skip physical therapy?

Reluctance toward medical interventions can affect diagnostics, medications, surgical procedures, life-prolonging measures, and even physical therapy.

The reasons for refusing diagnosis and treatment are complex and should not be criticized. An important prerequisite for opting out of treatment is that doctors provide patients with detailed information about the potential benefits of treatment and, at the same time, about the implications of not undergoing treatment.

However, patients also have the right to waive their right to information in this case: Patients may also choose not to be informed about treatment options and the consequences of forgoing treatment.

Regardless of a general decision not to undergo treatment, patients may choose not to undergo physical therapy specifically. Common reasons for discontinuing treatment or choosing not to undergo therapy in the first place include a desire to avoid the physical strain that physical therapy may entail.

The trip (or transportation) to a therapy practice, having a therapist come to one’s home (home visit), and the time required for therapy can be perceived as burdensome and unacceptable. Added to this is the potential physical exertion resulting from active physical therapy (including movement and gait exercises) and the subsequent exhaustion.

Joint and muscle pain can occur, especially at the beginning of therapy, such as when treating pre-existing spasticity and contractures. Despite the availability of effective pain management options, the onset of therapy-related pain may be considered intolerable, leading to a refusal of physical therapy.

In this situation, patients are informed that passive treatment methods are available within physical therapy that involve minimal physical strain and are aimed at reducing symptoms. This palliative physical therapy may also be omitted if there are no distressing symptoms or if symptom control is to be achieved through medication.

Typical reasons for refusing physical therapy in the advanced stages of a disease include a desire for privacy and a reluctance to spend the time required for physical therapy.