NZ-specific risk guide

Risks of physiotherapy in New Zealand

Covers musculoskeletal physiotherapy, sports physiotherapy, post-surgical rehabilitation, dry needling and manual therapy performed in NZ by physiotherapists registered with the Physiotherapy Board of NZ.

Last reviewed: 2026-05-27 · how we source risk data

Who is qualified to perform this in NZ

Performed by physiotherapists holding an Annual Practising Certificate from the Physiotherapy Board of New Zealand. Confirm your physiotherapist is registered via the public register.

Risks

Risks are categorised by frequency reported in NZ + Australasian surgical college guidance. None of this is a substitute for an individual clinical assessment by a registered practitioner.

Post-treatment soreness

Common

What: Mild muscle soreness for 24 – 48 hours after manual therapy or exercise prescription. Expected, not a complication.

How risk is reduced: Tell the physio if soreness is severe — treatment intensity can be adjusted.

Bruising from dry needling or cupping

Uncommon

What: Some bruising is expected with these modalities. Resolves within 1 – 2 weeks.

How risk is reduced: Disclose anti-coagulant medication and easy-bruising history pre-treatment.

Transient symptom flare

Uncommon

What: Some conditions temporarily worsen before improving after manual therapy or exercise prescription.

How risk is reduced: Report flares — the program can be modified.

Pneumothorax from dry needling near the chest

Rare

What: Documented in international literature with very low incidence. Needle inserted through chest wall, into pleural space.

How risk is reduced: Practitioner trained specifically in dry needling, using anatomical landmarks and shorter needles around the chest.

Vasovagal episode (faint)

Rare

What: Some patients faint during dry needling or after sudden postural changes.

How risk is reduced: Treatment in lying or supported position for first-time dry needling.

Worsening of underlying serious pathology

Rare

What: Manual therapy applied to undiagnosed serious pathology (fracture, malignancy, infection) can worsen the condition. Physio screening should detect these.

How risk is reduced: Honest disclosure of all symptoms; physio refers back to GP / specialist if red-flag symptoms present.

Pre-procedure checklist

  1. Confirm the physiotherapist is registered with the Physiotherapy Board of NZ and holds a current Annual Practising Certificate.
  2. Disclose all current medications, recent surgeries, anti-coagulant use and pregnancy status.
  3. Ask whether dry needling / acupuncture is being used and whether the physio is specifically trained in the modality.
  4. Confirm ACC funding eligibility upfront — if the condition relates to an accident, treatment can be partially or fully ACC-funded.
  5. Agree a realistic treatment plan length and review point (typically 4 – 6 sessions before re-assessment).

Red flags — stop and get a second opinion if you see these

  • A practitioner promising a specific number of sessions to "cure" a chronic condition.
  • Any practitioner not registered with the Physiotherapy Board.
  • Pressure to purchase packages of 10+ sessions upfront without a clinical review point.
  • Dry needling or manipulation performed without a clear consent discussion first.

Call your clinic if you notice

  • · Pain that is markedly worse than at start of session and does not settle within 48 hours
  • · New numbness, tingling or weakness
  • · Significant bruising spreading beyond treatment site
  • · Fever within 48 hours of dry needling

When to call 111 / go to ED

Chest pain, shortness of breath or sudden severe pain immediately after treatment — call 111. New neurological symptoms (numbness, weakness, loss of bladder/bowel control) — go to ED.

Sources we reference

This page draws on NZ + Australasian surgical college guidance and NZ regulator publications. Full list:

See all sources we cite across the site.

Next steps

Browse physiotherapy clinics →

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Plain-language answers to 200+ NZ medical questions.

This page is general guidance about the kinds of risks documented for physiotherapy in New Zealand and Australia. It is not a substitute for an in-person clinical assessment. Risk profiles depend on the specific procedure, your individual health, the surgeon\'s experience and the facility. Always discuss your specific situation with a registered practitioner before consenting to any procedure.

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