Musculoskeletal conditions
Musculoskeletal (MSK) conditions affect many people and can affect your joints, bone and muscles. Sometimes, they also affect associated tissues, such as your nerves.
MSK conditions can range from minor injuries to long-term conditions. Over 20 million people – almost one third of the population – have an MSK condition such as arthritis or back pain, and MSK conditions account for approximately 30% of all GP appointments in England. MSK symptoms can include pain, stiffness and limited movement. These symptoms can affect quality of life and independence.
How to access physiotherapy support
Most residents of Bath & North East Somerset, Swindon and Wiltshire can now access an musculoskeletal First Contact Physiotherapist (FCP) at their GP surgery without waiting to be referred by their GP. First Contact Physiotherapists in GP surgeries can help people with musculoskeletal issues such as back, neck and joint pain by:
- assessing and diagnosing issues
- giving expert advice on how best to manage conditions
- referring on to specialist services if necessary
Your GP receptionist will be able to tell you whether your practice has a First Contact Physiotherapist and how to make an appointment.
In addition, a wealth of resources has been created by Physiotherapists across Bath & North East Somerset, Swindon and Wiltshire to help people manage common MSK conditions, such as low back and neck pain.
Physiotherapists can help with conditions that cause pain, stiffness, weakness, pins and needles or other symptoms. These types of problems can result in difficulty with daily tasks, sleep, work, leisure or sport.
Examples include:
- Back pain
- Neck problems
- Spinal operations
- Knee pain
- Osteoarthritis
- Fractures
- Hip pain
- Ankle pain
- Frozen shoulders
- Tennis elbow
- Joint replacements
- Amputees
- Sports injuries
- Post op rehab
Please aim to arrive 10 minutes prior to your appointment as we ask all patients to fill in a pre-assessment questionnaire relating to your past medical history. Please bring with you a list of your medication, reading glasses (if necessary) and shorts if you will be uncomfortable just being in your underwear.
Your first appointment will normally last around 45 minutes, in which you will receive a full assessment.
- We give time to listen to you, in order to understand your individual condition and the problems it causes and how it is affecting your life.
- We examine you thoroughly to form an opinion on diagnosis. It is very likely that you will be asked to undress. We discuss our findings with you and how the condition may best be treated.
- We will offer you advice and information about your condition, especially in regards to how you can help yourself manage your condition better.
You are permitted to bring an adult relative with you, but we request that you do not bring children if possible. We do not provide crèche facilities and are not able to take responsibility for accompanying children attending the premises, unless properly supervised. Some areas contain equipment which is intended for clinical use only and should not be used as play areas.
- Exercises (as an individual or in groups) to stretch and strengthen; to improve posture; to improve your core stability muscles; to become physically more active; to improve general health and fitness and to help rehabilitate to work, sport and leisure activities.
- Mobilisations, massage and manipulations – movements we or you can apply to joints or muscles and tissues.
- Acupuncture – (available in all sites except Calne).
- Electrotherapy
- Any combination of the above
The number of treatments will vary with each individual, but this can be discussed with the Physiotherapist after the initial assessment. Follow-up appointments will be booked by you to be as convenient as possible.
All the Physiotherapists are fully qualified and have to be registered with the Health and Care Professions Council. You can check any Physiotherapist is registered on this website by looking in the Physiotherapist category. We have both male and female Physiotherapists; please tell us if you would prefer a gender for your physiotherapist.
Some Physiotherapists have done additional training to enable them to offer acupuncture for pain relief. T
The Physiotherapy assistants are not qualified but are highly trained, experienced and supervised by qualified Physiotherapists. We frequently have physiotherapy students gaining clinical experience with us from the surrounding universities. You may be asked if it is alright for you to be treated by a student, which you can say no to.
The student is well supervised by our qualified staff, even though this may not be obvious to you. We are also visited by the University staff to make sure that we are supporting the student.
Our Administrators are usually your first contact with the department either over the telephone or when you attend your appointment.
Osteoarthritis (OA)
Osteoarthritis (OA) is the most common form of arthritis and effects 8 million people in the UK. Osteoarthritis is a degenerative disease where the cartilage at the ends of the bones becomes worn and rough making movement stiff and painful. It can also affect the muscles around arthritic joints, making them weaker and again effecting movement.
Some of the signs of OA include:
- Pain
- Stiffness
- Swelling
- Giving way
- Noises like clicking and grinding.
If you think you have hip or knee OA or some of these symptoms, then please contact your GP.
Research has shown that exercise is an important way of helping to manage your OA.
Performing a mixture of strength, cardiovascular, flexibility and balance exercises weekly are recommended by the NHS physical activity guidelines to help with numerous health conditions.
Particularly for Osteoarthritis, the pain can weaken the muscles that help support your joints. Regular exercise to strengthen these muscles helps to stabilise and protect your joints and has been shown to reduce pain.
Please see below OA exercise videos:
Knee OA – https://www.nhs.uk/conditions/nhs-fitness-studio/knee-problems-pilates-exercise-video/
General OA – https://www.nhs.uk/conditions/nhs-fitness-studio/arthritis-pilates-exercise-video/
The key thing is to move your joints so that they stay strong, but in a way that does not cause a flare up. Painkillers can help with this.
- Contact your GP regarding the following symptoms:
- Pain
- Stiffness
- Swelling
- Giving way
- Noises like clicking and grinding
- Your GP will then complete an assessment and send you for an X-ray.
- If osteoarthritis is confirmed on the X-ray a questionnaire will be completed. If you score within the referral requirements you will be referred onto physiotherapy.
- Once the physiotherapy departments receive the referral you will attend a group initial assessment.
- You will then complete a 6 week osteoarthritis pathway where you will undertake 6 weeks’ worth of exercise either at home independently with telephone support from our exercise instructors, or a group face to face class in one of our departments
- Following the completion of the 6 week classes a physiotherapist will review your process. At this point a shared decision will be made to whether a self-management approach would be most beneficial or a referral onto a consultant for an opinion on a joint replacement.
Versus arthritis – https://www.versusarthritis.org/
NHS arthritis – https://www.nhs.uk/conditions/arthritis/
Arthritis saction – https://www.arthritisaction.org.uk/
Age UK – https://www.ageuk.org.uk/information-advice/health-wellbeing/conditions-illnesses/arthritis/
Arthritis – https://www.arthritis.org/
Community pain service
Pain is complex and sometimes it continues for months and possibly years. Sometimes medications and surgeries do not successfully reduce pain. Sometimes we must learn strategies to live well with pain and this is where the community pain service can be useful. It takes a holistic (meaning whole person) view of the pain problem and then can work with you to improve your physical function, your sleep quality, how you manage stress and mood, and help overall quality of life.
The Honest Physiotherapy Pain Management Guidebook is a very good read on the approach we take – Pain Management Guidebook
Your GP or orthopaedic interface service can refer you to the community pain service.