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Musculoskeletal (MSK)


Flowers digital art

Services available

Advanced Physiotherapist Practitioners (APP’s) are highly specialised clinicians who work at a higher level of varied advanced practice.

They provide assessment, diagnosis and advice on complex musculoskeletal cases which may involve investigations and/or onward referral to other Specialties e.g. rheumatology or orthopaedics.  

First Contact Physiotherapists (FCP) are based within the Musculoskeletal service and are based in local GP practices

Physiotherapy within musculoskeletal (MSK) service provides a MSK assessment diagnosis and rehabilitation typically if the complaint has not resolved after six weeks. With regards to Orthotics – we can provide a range of equipment such as splints where necessary.   

Flowers digital art

How to access the service

Access to physiotherapy services is via a referral from your GP practice or the hospital team.

Flowers digital art

Treatment options

Including individualized home-based exercises to improve your muscle strength, increase your joint range of movement, and improve balance and general fitness   

We have a gym space to allow you to use more specialised equipment that you may not have at home to help progress your rehabilitation guided by our team of physiotherapists   

Group exercise class to enable long term self-management of hip and Knee Osteoarthritis  

Where appropriate we can consider steroid injection as part of your treatment   

Soft tissue and joint mobilisation may be required in addition to your exercise program if indicated   

Orthopaedic assessment and group triage (OAGT) is a group based rehabilitation approach aiming to covering information surrounding the condition, self management strategies allowing patients to feel empowered and take control of their own care.

Flowers digital art

Your appointment

Once we have received a referral from your GP/consultant, you will be contacted via letter It is your responsibility to organise your first appointment.  If you are unable to make your appointment, please contact the department as soon as possible so we can rearrange and offer it to someone else.

If you do not attend your initial or follow up appointments, you must contact the department within   28 days to reschedule or you will be discharged from this service.  

If you have any specific requirements with regards to interpreter, gender preference or chaperone, please notify the team when booking your appointment  

Flowers digital art

Your Assessment

Your first appointment will be used to identify your goals and expectations.  Information gathered will include details of your current symptoms, medical history, medication, your lifestyle and how your symptoms are affecting you.  This will include a physical examination of the affected area, looking at joints, muscles, nerves and strength.  

From these findings we will discuss with you an appropriate treatment plan to support you in achieving your goals  

You may be booked for a follow appointment to manage your progress as per your condition or referred to alternative service as needed.  If appropriate you may be offered a patient initiated follow up (PIFIU) , where you have a 3-month window to rebook if you needed a review  ( link from DGFT?? )  

Students may be involved in your care but will always be under the supervision of a qualified physiotherapist.    

Flowers digital art

What to wear

Please bring with you appropriate clothing for the body part being treated i.e. shorts for lower limb, vest top for back and upper limb.  If it is your neck, shoulder or back that is affected, you may be asked to remove your shirt.  This will be done in a private space, and your dignity will always be protected.   

Flowers digital art

Self-care guides

It is not uncommon for people to experience muscle and joint ache and pains which can interfere with work or day to day activities Self-care guides offer advice, and tips on how to self-manage and when to seek further advice from your healthcare professionals. See the links below which have been sourced not only from our trust but other hospitals;

Osteoarthritis

Rheumatoid Arthritis  

Exercise videos | NRAS | Physical Health | Getting Started 

 

Osteoporosis  

Exercise for bone health (theros.org.uk) 

 

 

Shoulder

Shoulder pain is the third most common reason why people see their GP for a musculoskeletal problem, behind lower back pain and neck pain. Whilst the natural history of shoulder pain is largely favourable, it is not uncommon for some discomfort to persist beyond 12-months

The educational resources below will provide you with information on common reasons why people develop shoulder pain, what you can do to help yourself recover as well as providing some guidance on things you may wish to discuss with your Physiotherapist.

Frozen Shoulder – St George’s Physiotherapy service

Frozen Shoulder – British Elbow & Shoulder Society

Rotator cuff shoulder related pain – Royal United Hospitals Bath Physiotherapy Service

Shoulder Osteoarthritis

 

Elbow

Elbow Pain can occur with or without an injury which may affect the joint or surrounding tissues.  If the pain doesn’t improve within 6-12 weeks, you may need to seek further advice from a health professional  

 The resources below provide information on the many reasons people develop Elbow problems, and the steps you can take to assist your recovery. It may also help to discuss some of the information in this section with your Physiotherapist.  

Tennis elbow

Tennis elbow exercises – Arthritis Research UK

Golfers elbow

Elbow Osteoarthritis

 

Wrist and Hand

Most cases of hand and wrist pain will not be a sign of a serious or long-term problem and will settle in a few days or weeks with some simple self-care you can do at home.  There are several conditions that can cause pain or other symptoms in the hands and wrists, including types of arthritis.   

The resources below provide information on the many reasons people develop wrist and hand problems, and the steps you can take to assist your recovery. It may also help to discuss some of the information in this section with your therapist.  

Terminal finger joint arthritis

Basal thumb arthritis

Carpal Tunnel Syndrome – The British Society for Surgery of the Hand

Carpal Tunnel Syndrome – Causes, symptoms, treatment

De Quervain’s syndrome

De Quervain’s Tenosynovitis

Trigger finger/thumb – The British Society for Surgery of the Hand

 

Hip

Hip pain is a very common problem which can be due to age-related changes, injuries or repetitive activities.  The location of pain may vary from the thigh, hip joint, groin or buttock dependent on source of symptoms. It can also be referred from other arears of the body such as the back.

Exercises can help keep joints mobiles and strengthening muscles around your hip. If symptoms do not settle in 6-12 weeks, you may need to seek further advice.

The educational resources below will provide you with information on common reasons why people develop hip pain, what you can do to help yourself recover as well as providing some guidance on things you may wish to discuss with your Physiotherapist.

Hip pain exercise information booklet

Hip Osteoarthritis – NHS Lanarkshire

Lateral hip pain

 

Knee

Knee pain can occur  without an accident or injury. It may present with stiffness pain and /swelling This may affect functional activities like getting up from a chair or kneeling,

In most cases the knee problems respond well to exercises however if this does not settle within 6-12 weeks seek advice from a health professional

The educational resources below will provide you with information on common reasons why people develop knee pain, what you can do to help yourself recover as well as providing some guidance on things you may wish to discuss with your Physiotherapist.

Knee pain exercise sheet

Knee Osteoarthritis – NHS Lanarkshire

Osteoarthritis – causes, symptoms, treatments

Anterior knee pain – patellofemoral pain syndrome

Patellar Tendinopathy

 

Ankle and Foot

Foot and Ankle Pain can occur with or without injury. Some of the reasons may include sprains, overuse injuries, biomechanics, and osteoarthritis. Simple over the counter pain relief, modification of your activities, and wearing good supportive footwear may relieve your pain. If your pain does not settle in 6 weeks, you may need to seek further advice from a health professional   

The educational resources below will provide you with information on common reasons why people develop ankle pain, what you can do to help yourself recover as well as providing some guidance on things you may wish to discuss with your Physiotherapist. 

Ankle sprain exercise sheet

Ankle sprain

Achilles tendinopathy

Heel pain – plantar fasciitis

Information regarding MRI

Neck

Neck pain is very common and most of us will have it at some point in our lives. Usually, neck pain is the result of holding your neck in the same position for too long, but many people develop a stiff and painful neck for no obvious reason.  There could be other causes such as a whiplash or spondylosis.

The educational resources below will provide you with information on common reasons why people develop neck pain, what you can do to help yourself recover as well as providing some guidance on things you may wish to discuss with your Physiotherapist.

Versus arthritis – information and exercises

Cervical spondylosis

Low back pain

More than 80% of the population suffer from simple low back pain at some point in their lives.  Most low back pain will improve within the first 2 weeks and 85% will resolve by 3 months.  Staying active and continuing your normal activities should help with recovery.

The educational resources below will provide you with information on common reasons why people develop lower back pain, what you can do to help yourself recover as well as providing some guidance on things you may wish to discuss with your Physiotherapist. 

 

The Dudley Group Acute Low Back Pain – Patient Information Leaflet

Osteoarthritis of the spine – information and exercises 

10 things to know about back pain

901 exercises for back pain

Injured at work, public or private place

Ten sciatica facts – South Tees Hospitals NHS Foundation Trust 

Ten Lumbar Spinal Stenosis Facts – South Tees Hospitals NHS Foundation Trust 

Pain is a vital function of the nervous system in providing the body with a warning the body of potential or actual injury. It is both a sensory and emotional experience, affected by psychological factors such as past experiences, beliefs about pain, fear or anxiety. 

Persistent Pain

 

Flowers digital art

Services available

Advanced Physiotherapist Practitioners (APP’s) are highly specialised clinicians who work at a higher level of varied advanced practice.

They provide assessment, diagnosis and advice on complex musculoskeletal cases which may involve investigations and/or onward referral to other Specialties e.g. rheumatology or orthopaedics.  

First Contact Physiotherapists (FCP) are based within the Musculoskeletal service and are based in local GP practices

Physiotherapy within musculoskeletal (MSK) service provides a MSK assessment diagnosis and rehabilitation typically if the complaint has not resolved after six weeks. With regards to Orthotics – we can provide a range of equipment such as splints where necessary.   

Flowers digital art

How to access the service

Access to physiotherapy services is via a referral from your GP practice or the hospital team.

Flowers digital art

Treatment options

Including individualized home-based exercises to improve your muscle strength, increase your joint range of movement, and improve balance and general fitness   

We have a gym space to allow you to use more specialised equipment that you may not have at home to help progress your rehabilitation guided by our team of physiotherapists   

Group exercise class to enable long term self-management of hip and Knee Osteoarthritis  

Where appropriate we can consider steroid injection as part of your treatment   

Soft tissue and joint mobilisation may be required in addition to your exercise program if indicated   

Orthopaedic assessment and group triage (OAGT) is a group based rehabilitation approach aiming to covering information surrounding the condition, self management strategies allowing patients to feel empowered and take control of their own care.

Flowers digital art

Your appointment

Once we have received a referral from your GP/consultant, you will be contacted via letter It is your responsibility to organise your first appointment.  If you are unable to make your appointment, please contact the department as soon as possible so we can rearrange and offer it to someone else.

If you do not attend your initial or follow up appointments, you must contact the department within   28 days to reschedule or you will be discharged from this service.  

If you have any specific requirements with regards to interpreter, gender preference or chaperone, please notify the team when booking your appointment  

Flowers digital art

Your Assessment

Your first appointment will be used to identify your goals and expectations.  Information gathered will include details of your current symptoms, medical history, medication, your lifestyle and how your symptoms are affecting you.  This will include a physical examination of the affected area, looking at joints, muscles, nerves and strength.  

From these findings we will discuss with you an appropriate treatment plan to support you in achieving your goals  

You may be booked for a follow appointment to manage your progress as per your condition or referred to alternative service as needed.  If appropriate you may be offered a patient initiated follow up (PIFIU) , where you have a 3-month window to rebook if you needed a review  ( link from DGFT?? )  

Students may be involved in your care but will always be under the supervision of a qualified physiotherapist.    

Flowers digital art

What to wear

Please bring with you appropriate clothing for the body part being treated i.e. shorts for lower limb, vest top for back and upper limb.  If it is your neck, shoulder or back that is affected, you may be asked to remove your shirt.  This will be done in a private space, and your dignity will always be protected.   

Flowers digital art

Self-care guides

It is not uncommon for people to experience muscle and joint ache and pains which can interfere with work or day to day activities Self-care guides offer advice, and tips on how to self-manage and when to seek further advice from your healthcare professionals. See the links below which have been sourced not only from our trust but other hospitals;

Osteoarthritis

Rheumatoid Arthritis  

Exercise videos | NRAS | Physical Health | Getting Started 

 

Osteoporosis  

Exercise for bone health (theros.org.uk) 

 

 

Shoulder

Shoulder pain is the third most common reason why people see their GP for a musculoskeletal problem, behind lower back pain and neck pain. Whilst the natural history of shoulder pain is largely favourable, it is not uncommon for some discomfort to persist beyond 12-months

The educational resources below will provide you with information on common reasons why people develop shoulder pain, what you can do to help yourself recover as well as providing some guidance on things you may wish to discuss with your Physiotherapist.

Frozen Shoulder – St George’s Physiotherapy service

Frozen Shoulder – British Elbow & Shoulder Society

Rotator cuff shoulder related pain – Royal United Hospitals Bath Physiotherapy Service

Shoulder Osteoarthritis

 

Elbow

Elbow Pain can occur with or without an injury which may affect the joint or surrounding tissues.  If the pain doesn’t improve within 6-12 weeks, you may need to seek further advice from a health professional  

 The resources below provide information on the many reasons people develop Elbow problems, and the steps you can take to assist your recovery. It may also help to discuss some of the information in this section with your Physiotherapist.  

Tennis elbow

Tennis elbow exercises – Arthritis Research UK

Golfers elbow

Elbow Osteoarthritis

 

Wrist and Hand

Most cases of hand and wrist pain will not be a sign of a serious or long-term problem and will settle in a few days or weeks with some simple self-care you can do at home.  There are several conditions that can cause pain or other symptoms in the hands and wrists, including types of arthritis.   

The resources below provide information on the many reasons people develop wrist and hand problems, and the steps you can take to assist your recovery. It may also help to discuss some of the information in this section with your therapist.  

Terminal finger joint arthritis

Basal thumb arthritis

Carpal Tunnel Syndrome – The British Society for Surgery of the Hand

Carpal Tunnel Syndrome – Causes, symptoms, treatment

De Quervain’s syndrome

De Quervain’s Tenosynovitis

Trigger finger/thumb – The British Society for Surgery of the Hand

 

Hip

Hip pain is a very common problem which can be due to age-related changes, injuries or repetitive activities.  The location of pain may vary from the thigh, hip joint, groin or buttock dependent on source of symptoms. It can also be referred from other arears of the body such as the back.

Exercises can help keep joints mobiles and strengthening muscles around your hip. If symptoms do not settle in 6-12 weeks, you may need to seek further advice.

The educational resources below will provide you with information on common reasons why people develop hip pain, what you can do to help yourself recover as well as providing some guidance on things you may wish to discuss with your Physiotherapist.

Hip pain exercise information booklet

Hip Osteoarthritis – NHS Lanarkshire

Lateral hip pain

 

Knee

Knee pain can occur  without an accident or injury. It may present with stiffness pain and /swelling This may affect functional activities like getting up from a chair or kneeling,

In most cases the knee problems respond well to exercises however if this does not settle within 6-12 weeks seek advice from a health professional

The educational resources below will provide you with information on common reasons why people develop knee pain, what you can do to help yourself recover as well as providing some guidance on things you may wish to discuss with your Physiotherapist.

Knee pain exercise sheet

Knee Osteoarthritis – NHS Lanarkshire

Osteoarthritis – causes, symptoms, treatments

Anterior knee pain – patellofemoral pain syndrome

Patellar Tendinopathy

 

Ankle and Foot

Foot and Ankle Pain can occur with or without injury. Some of the reasons may include sprains, overuse injuries, biomechanics, and osteoarthritis. Simple over the counter pain relief, modification of your activities, and wearing good supportive footwear may relieve your pain. If your pain does not settle in 6 weeks, you may need to seek further advice from a health professional   

The educational resources below will provide you with information on common reasons why people develop ankle pain, what you can do to help yourself recover as well as providing some guidance on things you may wish to discuss with your Physiotherapist. 

Ankle sprain exercise sheet

Ankle sprain

Achilles tendinopathy

Heel pain – plantar fasciitis

Information regarding MRI

Neck

Neck pain is very common and most of us will have it at some point in our lives. Usually, neck pain is the result of holding your neck in the same position for too long, but many people develop a stiff and painful neck for no obvious reason.  There could be other causes such as a whiplash or spondylosis.

The educational resources below will provide you with information on common reasons why people develop neck pain, what you can do to help yourself recover as well as providing some guidance on things you may wish to discuss with your Physiotherapist.

Versus arthritis – information and exercises

Cervical spondylosis

Low back pain

More than 80% of the population suffer from simple low back pain at some point in their lives.  Most low back pain will improve within the first 2 weeks and 85% will resolve by 3 months.  Staying active and continuing your normal activities should help with recovery.

The educational resources below will provide you with information on common reasons why people develop lower back pain, what you can do to help yourself recover as well as providing some guidance on things you may wish to discuss with your Physiotherapist. 

 

The Dudley Group Acute Low Back Pain – Patient Information Leaflet

Osteoarthritis of the spine – information and exercises 

10 things to know about back pain

901 exercises for back pain

Injured at work, public or private place

Ten sciatica facts – South Tees Hospitals NHS Foundation Trust 

Ten Lumbar Spinal Stenosis Facts – South Tees Hospitals NHS Foundation Trust 

Pain is a vital function of the nervous system in providing the body with a warning the body of potential or actual injury. It is both a sensory and emotional experience, affected by psychological factors such as past experiences, beliefs about pain, fear or anxiety. 

Persistent Pain