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Best Care for Musculoskeletal Pain

Posted on 28th August 2019 by

What does best practice care for musculoskeletal pain look like? A recent review was published by The British Medical Journal, that came up with 11 consistent recommendations to help form ‘best practice’ in the care of musculoskeletal pain.

In today’s blog, we explore these recommendations, how we implement them at goPhysio and what it means to you guys, the people with the pain or injury.

11 Best Practice Recommendations for care in musculoskeletal care.

#1 Care should be patient centred This goes without saying, but you’re the one and only person that matters to us. We take time to get to know you, learn how your injury is impacting you, and work with you to understand your lifestyle, so we know what we are aiming for. Everyone and everyone’s circumstances are SO different and individual, so it’s crucial our approach to each and every person we see is individualised too.

#2 Screen for serious conditions We take this incredibly seriously and although it may go un-noticed by you, we make sure that there is nothing serious going on. If we are in any way concerned, we’ll make sure we point you in the right direction and will provide any letters, phone calls or support that you need.

#3 Assess psychological factors The body and the mind are inextricably linked. The power of the mind is incredible. You need to feel reassured, informed and have an appropriate understanding of your injury. Any doubts, fears, worries or misconceptions will really impact on your recovery. We make sure we consider any psychological factors that may be impacting you and address them appropriately.

#4 Only refer for imaging if specifically indicated It’s a commonly held myth, that a scan or an X-Ray is needed in order to diagnose an injury. In fact, referrals for imaging (X-Rays or scans) are only needed in very specific cases. Why? Because all too often, symptoms do not relate to imaging results. So, an image may not show any damage or injury, but you may be getting symptoms. Equally, you may have damage on imaging, but be symptom free and seeing the damage on imagery can cause issues in itself! If we think that there is indication for a scan or X-Ray we will make sure we assist you with this. We can even refer directly to low cost, quick, private scanning – so you don’t have to get referred by a Dr, saving you even more time.

#5 Physical examination This is our bread and butter. Using all our senses – looking, feeling, testing, questioning and putting it all together with our evaluation skills in order to explain to you exactly what’s going on.

#6 Evaluate progress Together, we will set your goals, what you want to achieve through coming to see us. That’s the most important bit. However, we will also take measurements and document certain testing, so that we can measure your progress and ensure we’re on the right track.

#7 Education We want to make sure that you fully understand what’s going on in as much detail as you need. Some people only want the basics, some want an in depth explanation. But if you can understand what’s going on and what you can do to help yourself with your recovery, you’re much more likely to succeed in achieving your goal. This may include modifying your activity or lifestyle slightly, changing a routine, adapting a training programme or work activity.

#8 Address physical activity / exercise As a team go health professionals, it’s important that we support everyone in living a healthy and active life. As part of this, we can provide the necessary support and advice you may need to start or increase your physical activity. Some people find having an injury a bit of a wake up call to make some changes and often, getting more active is one.

#9 Apply ‘manual therapy’ as an adjunct We use a huge range of treatments to help you with your recovery. Using our hands (manual therapy) is just one tool, and can be very beneficial in many ways for lot’s of different injuries and to help ease pain. It is very important though that it is used as an adjunct to more active approaches, such as exercise and education/advice. Manual therapy alone is unlikely to be a solution to your recovery, as it’s effects are often short lived – it’s the strengthening, stretching, confidence and education that makes the most impact on recovery.

#10 Discuss non-surgical approaches (unless surgery indicated) Unfortunately, people still remain entrenched in the ‘medical model’ of belief, thinking that medicine and/or surgery are the only answer. They often want quick fixes and magic cures! Much of the evidence is now very clear on when surgery is indicated and it’s not as often as you may think! Physiotherapy and physical treatments are often much more effective than surgery when given the chance in many conditions. Obviously, there are cases when surgery is absolutely the right decision. In these cases, our Clinicians will help with referrals and work very closely with many local Consultants to ensure you receive the most appropriate care. We can also closely liaise with your GP to facilitate this.

#11 Facilitate continuation or return to work Staying at work or returning to work ASAP when you’ve had an injury is crucially important for your recovery. We can help advise on modifying your activities so this is possible. It may seem a bit daunting, especially if you’ve had to take time off work because of your injury. But remaining in work helps in so many ways.

If you’ve got an injury and want the best possible care, then do give us a call on 023 8025 3317 and see if we can help you.

Helping local people live a healthy, active, positive life, pain and injury free.

goPhysio


goPhysio FAQs: What conditions can you help?

Posted on 31st August 2018 by

goPhysio FAQHere at goPhysio we understand that choosing to see a someone if you’re injured or in pain may be a bit daunting? Lots of questions may go through your mind before you decide to make an appointment……….“What will they ask me? Will it hurt? Will I have to get undressed? How do I know it’s going to help?”

We aim to provide a very caring, comfortable and professional environment for you to come and get your problem resolved.

To help answer some of the thoughts you may have if you’re unsure about picking up the phone to make an appointment, we’d like to address some of the questions you may want to ask.


What conditions can you help?

As Physiotherapists and Sports Therapists at goPhysio, our  specialist area of expertise is in assessing, diagnosing and resolving musculoskeletal issues. Musculo = muscles, Skeletal = skeleton (bones, joints, nerves, ligaments, tendons). So, most conditions affecting those areas, we can help.

Here’s a (not exhaustive) list of some of the most common conditions we help resolve here at goPhysio in Chandlers Ford.

Back

Neck

Hip Problems

  • Osteoarthritis
  • Hip impingement
  • Gilmore’s groin
  • Groin strain
  • Total hip replacement
  • ITB issues
  • Piriformis syndrome

Knee Problems

  • Anterior knee pain
  • Ligament injuries (Anterior, posterior, medial & lateral cruciate ligaments)
  • Cartilage (meniscus) injuries
  • Hamstring strain
  • Runners knee
  • Muscle strain or tear (quadriceps, hamstrings)
  • Osteoarthritis
  • Osgoods Schlatters 
  • ITB syndrome

Ankle & Foot

Shoulder

Elbow, Wrist & Hand

And not forgetting……..

If you are suffering with an injury and want help to guide you through the frustrating maze, please get in touch. We aim to offer you an appointment within 24 hours, often the same day.

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National Health Research Review

Posted on 13th July 2018 by

A new report from the National Institute for Health Research (NIHR), titled Moving Forward: Physiotherapy for Musculoskeletal Health and Wellbeing, has NHR Moving Forward Physio highlighted how effective physiotherapy is at improving outcomes for MSK conditions.

MSK or musculoskeletal conditions, are those that affect the bones, joints and muscles of the body, like back pain, arthritis, sprains, strains and overuse injuries. These conditions have a huge impact on our daily lives and it’s what our team at goPhysio specialise in managing. Musculoskeletal conditions are the leading cause of pain and disability in the UK, affecting more than one in four people. The evidence coming out of Moving Forward: Physiotherapy for Musculoskeletal Health and Wellbeing highlights the importance of physiotherapy for treating these conditions.

This review presents evidence from a range of physiotherapy-related studies. Data from these studies shows the beneficial impact physiotherapy has on a range of MSK conditions, including rheumatoid arthritis, chronic knee joint pain and low back pain.

The key findings show that:

  • There is overwhelming evidence that exercise and activity are effective and should be a core treatment in musculoskeletal pain.
  • A rehabilitation programme including targeted exercise, is effective at reducing knee joint pain.
  • Investment in high quality rehabilitation adapted to individual patient needs, leads to better outcomes, reduces the need for further investigations and treatment, such as surgery or joint injections.
  • Work absences can be reduced by an average of five days when people receive advice on low back pain from physios.
  • Stretching and strengthening hand exercises can improve function for people with rheumatoid arthritis.

Make exercise a core treatment

The key message from the review is that there is overwhelming evidence that exercise and activity are effective for musculoskeletal pain. This is something that is fully integrated into our care at goPhysio.

  • When you see one of our Physio’s or Sports Therapists, you will always be given a customised exercise programme to help support your recovery. This will be emailed to you along with explanatory videos and/or pictures, so that you have access to the exercises and are confident what you should be doing in between your appointments.
  • We aim to keep you as active as possible whilst you recover from your injury. We offer solutions and alternatives to balance your recovery with staying active wherever possible. We rarely advocate complete rest!
  • We offer a comprehensive, specialist rehab service. Led by our Sports Therapy team, you will have the option to come along to supervised small group rehab sessions, where evidence based exercise is used to optimise your recovery and prevent long term issues. Read more about our rehab service here.
  • We also offer a range of specialist Clinical Pilates classes, which help build long term strength, flexibility and durability. A fantastic way to help recovery, manage long term MSK conditions and ward off injuries.

Our whole ethos here at goPhysio is “Helping local people live a healthy, active, positive life, free from pain & injury”, so it’s great to hear what we are doing and the way we work is supported by the last research.

Download the full report here.

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Do we need a Dr-Patient ‘culture shift’?

Posted on 22nd September 2016 by

I read with interest this week about a new scheme in Wales where patients are being urged to take more control of decisions about the care and treatments they receive. The scheme, Choosing Wales Wisely, aims for a more equal doctor-patient relationship.

Central to the scheme, are 4 questions that patients should ask when seeing their Dr.

Questions to ask your doctor

Although there are fears that this move may be in an effort to cut costs, I think it’s a great initiative for patients to be inspired to take more responsibility for their own care and also explore alternatives, not just taking a single Doctor’s advice and recommendations as gospel.

The questions that this initiative proposes patients ask are certainly very valid.

If you’re suffering with musculoskeletal (MSK) pain, so issues with joints, muscles and other soft tissues, the all too common advice of take painkillers and rest just isn’t good enough. The majority of our patients at goPhysio are told this when they see their GP. Frustratingly, so many are also told that physio won’t work so don’t recommend it.

Yet, there are so many treatment options that would mean people recover faster and don’t suffer with a repeated cycle of injury. The long term benefits of this is not relying on painkillers, staying in work, being able to keep active and so the consequential health benefits of this…….the list goes on!

So, with patients being inspired to actually ask Dr’s what there options are, it may encourage Dr’s to have a broader and more open view of the valid options.

Another common misconception held by people with MSK problems is that only a scan or X Ray will actually reveal what’s going on and this is often re-enforced in a medical setting. However, research has demonstrated that this isn’t true. Many studies have found there to be changes on X Ray or scans in people with no symptoms at all and visa versa, there to be no symptoms in people with physical changes on imaging.

By patients questioning

Do I really need this?

This could avoid waiting for unnecessary and costly imaging, that actually won’t change the best treatment or management options. More often than not, treatment is the same irrelevant of what a scan or X ray shows.

A very powerful question is

What can I do to help myself?

People who take responsibility for their care are generally more likely to follow a treatment programme. So, rather than be a passive recipient of care or medication and wait for someone to ‘fix’ them, people can be empowered to help themselves.

This is a great move and people really want the right information, to be empowered with some knowledge and be directed to the right sources. There are lot’s of places to look yourself online, but without knowing the validity of the information, you can be afraid that it’s not the right thing to do. So, with a little guidance on this, patients could access relevant resources that may help them manage the problem themselves.

A core part of our management of MSK conditions at goPhysio is enabling and educating patients to help themselves. So tailored advice, an exercise programme and information about their condition. This really is key to a patient’s overall care and recovery.

Read more about the scheme here and there is also a page dedicated to managing back pain, which 8 out of 10 people will suffer with at some point in their lives.