Practice & Scope
Fesera is a physiotherapy practice. Care is delivered in person, in your own home, by a licensed physiotherapist. When you book an assessment, a professional clinical relationship is created between you and your treating physiotherapist, with all the duties of care, confidentiality and record-keeping that this carries.
If you are having a medical emergency, call emergency services or go to your nearest hospital. Do not wait for a reply to a message.
1. Who provides your care
Care is provided by Alao Daniel, a physiotherapist licensed to practise in Nigeria and registered with the Medical Rehabilitation Therapists Board of Nigeria (MRTB), the statutory body that regulates physiotherapists and other rehabilitation professionals under the Medical Rehabilitation Therapists (Registration, etc.) Act.
Practice is subject to the MRTB's professional and ethical standards, including standards on scope of practice, informed consent, confidentiality, record-keeping and continuing professional development. Registration details can be verified with the Board on request. Fesera currently has one physiotherapist, Alao Daniel; if that changes, every physiotherapist working under the Fesera name holds the same registration and is held to the same standards.
Fesera operates as a practitioner-led service, seeing people in person at home and remotely by video. There is no clinic premises, and we are not a registered hospital or health facility.
2. What we do and do not do
Within our scope
- Physiotherapy assessment of musculoskeletal problems
- Working out the most likely drivers of your pain
- Screening for signs that need medical review, and referring you on
- Prescribing and progressing exercise and loading programmes
- Education, pain explanation and self-management coaching
- Measuring function and tracking it over time
- Writing to your doctor, with your consent
Outside our scope
- Prescribing, adjusting or stopping any medication
- Ordering or formally reporting scans and X-rays
- Making a medical diagnosis outside physiotherapy practice
- Treating conditions unrelated to the musculoskeletal system
- Emergency or out-of-hours care
- Advising you to stop treatment prescribed by your doctor
We work with back pain, and with knee and hip osteoarthritis. Problems outside that scope will be recognised and referred rather than treated.
3. Conditions we treat
The practice is built around three problems:
- Non-specific low back pain, particularly where it is persistent or recurrent
- Knee osteoarthritis
- Hip osteoarthritis
Assessment findings sometimes point somewhere else entirely. Where that happens we will tell you plainly and help you find the right person, whether or not that leads to any further work with us.
4. Safety screening and referral
Screening happens at three points: in the questions on this website before any booking is confirmed, again in person at the first visit, and continuously at each visit afterwards.
4.1 Before booking
The questions at the start of booking screen for symptoms that need medical assessment before exercise, including the specific presentations that matter most in Nigeria. Where your answers suggest a doctor should see you first, you are told so and no booking is taken.
4.2 At the first visit
In person, the first visit includes a physical examination, a cardiovascular and general health screen, and blood pressure measurement, because exercise is being prescribed and readiness to load has to be established rather than assumed.
Remotely, the same readiness screen happens by video and self-report: a cardiovascular and general health questionnaire, and guided self-examination and functional movement testing in place of hands-on assessment. Where you have a diagnosis of high blood pressure, diabetes or heart disease, or report symptoms such as chest pain, unusual breathlessness, palpitations or dizziness, we ask for a recent blood pressure reading, taken at a pharmacy, clinic or with a home monitor, before prescribing a loaded programme, or refer you for medical clearance first. Anything that would normally be found on hands-on examination and cannot be established this way is treated as unconfirmed rather than assumed clear, and where that matters, we ask you to move to an in-person assessment.
4.3 We will stop and refer you if
- You have signs of cauda equina syndrome, which is a same-day emergency
- You have progressive weakness or a worsening neurological deficit
- There are signs suggesting fracture, infection, or cancer affecting the spine or joints
- There are signs of inflammatory arthritis needing rheumatology assessment
- Your blood pressure or cardiovascular status makes loading unsafe
- You are not improving on a properly delivered programme
- Your problem is outside physiotherapy scope or beyond our competence
Referral is a normal clinical outcome, not a failure. It is also free: we do not charge you for telling you that you need someone else.
5. When physiotherapy is not appropriate
We will not begin an exercise programme, or will pause one already underway, where any of the following applies until it has been assessed and cleared by the appropriate doctor:
- Cauda equina syndrome or suspected cauda equina syndrome
- Suspected or confirmed spinal fracture, including osteoporotic compression fracture
- Suspected or confirmed spinal or joint infection
- Active cancer affecting the spine or the joint in question, or suspected metastatic disease
- Severe or rapidly progressive neurological deficit
- Untreated inflammatory arthropathy requiring medical management
- Recent surgery without clearance from the operating surgeon
- Exertional chest pain, exertional blackouts, or unexplained breathlessness
- Blood pressure at a level where exercise is unsafe on the day
- For remote care: known high blood pressure, diabetes or heart disease without a recent blood pressure reading
- Under 18 years of age
6. How we decide what to do
Assessment and treatment follow published clinical evidence and validated tools rather than a fixed house protocol:
| Framework | How it is used |
|---|---|
| STarT Back Screening Tool | Risk stratification, which sets how intensive your care needs to be |
| Pain mechanism classification | Distinguishing nociceptive, neuropathic and nociplastic presentations so treatment matches the driver |
| Cognitive Functional Therapy | Making sense of pain, graded exposure to feared movement, and lifestyle change |
| WHO guideline on chronic low back pain (2023) | What to use, and what to avoid, in persistent low back pain |
| Exercise therapy for hip and knee osteoarthritis | Structured education and progressive strengthening as first-line care |
| Validated outcome measures | Recording function at baseline and re-measuring it, so progress is checked rather than assumed |
Fesera is not affiliated with, accredited by, or endorsed by any of the bodies behind these frameworks. They are referenced from published academic literature.
7. Treatments we do not offer, and why
We do not build treatment on therapeutic ultrasound, TENS, traction, or lumbar belts and supports for persistent low back pain. The World Health Organization's 2023 guideline on chronic primary low back pain recommends against their routine use, because the evidence does not show they improve outcomes.
You may still choose to use something like a TENS unit at home for comfort, and that is your decision. We will not bill it as treatment or present it as the thing that will get you better.
8. What we do not promise
Physiotherapy for persistent pain produces real and durable improvement in pain and function for many people. It does not reliably eliminate pain, and no honest practitioner can promise that it will.
We do not guarantee any specific clinical outcome. What we do commit to is measuring where you start, re-measuring at agreed points, and telling you honestly if it is not working, including when that means recommending you stop or see someone else.
9. Consent
Nothing is done to you or with you without your agreement. Before assessment and before treatment begins you will be told what is proposed, what it involves, what the likely benefits and risks are, and what the alternatives are, including doing nothing.
You can decline any part of an assessment or treatment, ask for a chaperone to be present, ask us to stop at any point, or end care entirely, without having to give a reason and without it affecting how you are treated.
Photographs and video are sometimes clinically useful for recording how you move at the start and later on. These are only ever taken with your specific consent, that consent is recorded separately, and it can be withdrawn at any time. Consent to clinical use is never treated as consent to marketing use, which is asked for separately and is always optional.
10. Clinical records
A clinical record is kept for every person assessed and treated. This is a professional obligation, and it is also what makes it possible to tell whether treatment is working.
Records are confidential. They are not shared with anyone, including family members paying for your care, without your consent, other than where the law requires it or where there is a serious risk to someone's life. How your information is stored, used and deleted is set out in the Privacy Policy.
11. The app
Fesera has built an application to support the home exercise programme between visits. It holds the exercises you have been prescribed, lets you record what you have completed and how the pain responded, and lets you see your own progress.
These are the terms it comes on:
- Anyone can create an account, and an account on its own is empty. What a physiotherapist opens for you, after assessing you, is the programme inside it. The app supports care rather than replacing assessment or treatment, and holding an account does not mean you are under anyone's care.
- It is optional. Declining it does not affect your care or your price, and you can stop using it at any point without giving a reason.
- It is not sold separately and no fee you pay includes a charge for it. There is nothing to buy inside it.
- Its regulatory classification, including whether any part of it falls to be treated as a medical device under NAFDAC or any other applicable framework, is kept under review. Nothing on this page should be read as a statement that it has been classified, cleared or registered under any such framework.
- Automated logic in it is limited to progressing a programme a physiotherapist has already prescribed, within limits that physiotherapist has set. It does not diagnose you, and it does not change what you have been prescribed on its own. Where it notices something that may matter, it raises it with your physiotherapist.
- This page, the Privacy Policy and the Terms of Service cover it. If they change materially you will be told what has changed rather than left to notice.
12. Concerns and complaints
If you are unhappy with any part of your care, tell us first. Most things are resolved quickly once they are raised. Write to [email protected] and we will respond within seven days.
If you are not satisfied with our response, you may raise the matter with the Medical Rehabilitation Therapists Board of Nigeria, which handles complaints about the conduct of registered practitioners. Nothing here limits that right.
13. Contact
- General and clinical: [email protected]
- Data protection: [email protected]
- Legal: [email protected]
Fesera is based in Lagos, Nigeria, and sees people in person there and remotely by video anywhere in the country.