Continuing physiotherapy and chronic pain care in Spain

Key rules

• Prescription: Public physiotherapy needs a doctor's prescription, usually from a hospital rehabilitation specialist after a GP referral.
• Pain units: You cannot book a public pain unit yourself; a GP or specialist must refer you.
• Waits: Expect a wait for the specialist and another for the first session; both vary by region and hospital.
• Private route: For minor problems or to avoid waiting, private physiotherapy is often the practical choice.

What public cover gives you

The public system pays for physiotherapy and rehabilitation only when a doctor prescribes it. Most of it happens in hospital rehabilitation services (rehabilitación), with some physio units in primary care. Cover is mainly for conditions after surgery, neurological problems, injuries and musculoskeletal problems.

How to get public physio

1. See your GP and ask for a referral to the hospital rehabilitation specialist.
2. The specialist assesses you and prescribes the sessions.
3. Sessions start after a further wait.

Expect two waits: one for the specialist, one for the first session. Each can run from a few weeks to several months, depending on your region and hospital. Ask for the expected times at each step. Regional health services publish waiting-list data.

Public pain units

A pain unit (unidad del dolor) treats chronic pain that has not improved with GP care and standard treatment. Examples are nerve pain, back pain and cancer pain. You cannot book directly: your GP or another specialist must refer you.

The unit is usually run by anaesthesiologists. It assesses you and may offer injections, nerve blocks, neuromodulation and medication plans.

Availability is uneven. Major hospitals usually have a unit. Smaller areas may not, so ask your GP which hospital serves you. Waits vary by region.

When private physio is the practical route

Go private if your problem is minor, or if you cannot wait for the public queue. Many people with minor problems do this.

Private session prices depend on session length, treatment type and clinic. They are usually higher in Madrid, Barcelona and tourist areas than in smaller cities and rural areas. Many clinics sell discounted packs of sessions. Home visits and specialised treatments cost more.

Before you commit to a course of sessions, compare several local clinics. You can also ask your regional physiotherapists' college for current price guidance.

The checklist and FAQ below cover the steps and common questions.

Checklist

• Ask your GP for a referral to a hospital rehabilitation specialist (rehabilitación) if you need ongoing physiotherapy.

• Ask the rehabilitation specialist to prescribe your physiotherapy sessions, since public cover needs a doctor's prescription.

• Ask for the expected wait for the specialist appointment and for the first session, as both can take weeks to months depending on your region.

• Ask your GP to refer you to a public pain unit (unidad del dolor) if chronic pain has not responded to standard treatment.

• Check whether a hospital in your area has a pain unit, as smaller areas may lack one.

• Compare prices and session packs at several local private physiotherapy clinics if your problem is minor or the public wait is too long.

• Ask your regional physiotherapists' college for current price guidance before you book a private course of sessions.

Frequently asked questions

Can I book a public pain unit appointment myself?

No, you cannot book a public pain unit (unidad del dolor) appointment yourself, because you need a referral from your GP or another specialist. Referral is usually for chronic pain, such as nerve, back or cancer pain, that has not improved with standard treatment. Ask your GP to refer you.

What can a public pain unit offer me?

A public pain unit can offer injections, nerve blocks, neuromodulation and medication plans after assessing you. These units are usually based in hospitals and run by anaesthesiology doctors. Major hospitals usually have one, but smaller areas may not, so you may need to travel.

Do prices for private physiotherapy vary across Spain?

Yes, private physiotherapy usually costs somewhat more in Madrid, Barcelona and tourist areas than in smaller cities and rural areas.