Physiotherapy Outpatient Musculoskeletal Service

Our physiotherapists provide a holistic assessment and treatment for a range of conditions that affect both joints, muscles, and nerves.

We treat symptoms that are affecting your day-to-day life, sleep, hobbies and work.

• Back pain
• Fractures
• Neck pain
• Osteoarthritis
• Post-surgery
• Joint pain
• Sports injuries
• Long term pain conditions

What to expect at your first appointment:

We are now seeing a majority of initial assessments face to face.

Please arrive no earlier than 5 minutes prior to your appointment.

• Wear a face covering
• Wash your hands prior to entering the department
• Therapist will also be wearing face coverings

Your appointment is likely to take 1 hour. It is likely you will be expected to undress so please dress appropriately.

Within the hour we will listen to you, to understand how this condition is affecting you.

Examine you to help form a clinical opinion to what may be the cause of your symptoms.

Discuss our findings and how best to manage this.

How can I see a physiotherapist?

We receive referrals from GPs, Consultants, and other health professionals. We also have physiotherapists located in the majority of GP practices within the area. You can book directly with them by phoning each individual surgery. You can also self-refer through our self-referral paperwork.

• If you live in the BA1 postcode area you can self-refer to the Royal United Hospital
• If you have a BANES GP and do not live in BA1 then you can self-refer to one of our three sites.

Once we have received your referral, we will prioritise it to assess how quickly we need to see you. We try to see everyone as soon as we can, however waitlist times can vary dependent on the time of the year.

If we need to see you quickly, you will be contacted by our central booking department, offering you an appointment within one to two weeks

If our admin team are unable to contact you via telephone to arrange an initial appointment, an appointment letter will be sent to you in the post.

Once an appointment has been arranged you may receive an automated text message reminding you to attend your appointment the day prior to your appointment.

If for any reason you do not attend your appointment and do not phone within 24 hours with a valid reason for not attending, you will be discharged.

Physiotherapy self-referral – Physiotherapy outpatients self referral form

Physiotherapy referral form for professionals – Physiotherapy professionals referral form

Please return it to us by:

Post: Keynsham Health Centre, St Clements Road, Keynsham, BS31 1AF

Email: vcl.bathnesphysio-outpts@nhs.net

Feedback is vital to help us improve and develop our service for the future.

Please follow the link below to leave your annoymous feedback via our friends and family questionnaire

Codes:

Paulton = B0047

St Martins = B0045

Keynsham = B00153

Pain Clinic = B0138

• Neck
• Shoulder
  • Frozen shoulder
  • Anterior deltoid strengthening
• Elbow
• Upper back
• Lower back
  • Core stability exercises
• Hip
  • Lateral hip pain
• Knee
  • Anterior cruciate ligament repair
• Foot/ankle
• Pregnancy
  • Separation of abdominals 
• General activity/strengthening
• General Complex/persistent pain
  •  Living well with chronic pain
• Osteoarthritis – Hip and Knee exercise booklet
• Other
  • Joint or soft tissue injection leaflet 
  • Acupuncture

Osteoarthritis (OA)

What is OA?

Osteoarthritis 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.

Exercise and OA

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/

Hip OA – https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/exercises/exercises-for-hip-problems

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.

Osteoarthritis Pathway:

Currently, there is no cure for OA. Ways to manage it include using painkillers, pacing your life, and exercising. If the pain becomes unmanageable, then surgery is the next option.

Here at BANES Physiotherapy Outpatients, we run the Osteoarthritis Pathway; exercise classes and advice designed to strengthen the muscles around your hips and knees. If you are considering joint replacement surgery, your GP will ask you to take part in these classes prior to having surgery.

If you think you have knee or hip osteoarthritis:

1. Contact your GP regarding the following symptoms:
   1. Pain
   2. Stiffness
   3. Swelling
   4. Giving way
   5. Noises like clicking and grinding
2. Your GP will then complete an assessment and send you for an X-ray.
3. 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.
4. Once the physiotherapy departments receive the referral you will attend a group initial assessment.
5. 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
6. 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.

To support the Pathway, we have produced OA information and exercise booklets which anyone is welcome to download and use.

• OA information booklet 
• OA hip and knee exercise booklet 

As well as the Pathway, there is also the Escape Pain website which is a free, award winning programme of online exercise and advice videos structured to give patients a progressive structure to their rehabilitation.

Helpful link

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/

For helpful advice, tips and tools to help you with your health and wellbeing visit: NHS live-well

For mental health support visit: NHS talking therapies

For local events and classes please look at our helpful boards or speak to our physiotherapist within the department to give you advice on any opportunities within your local area

Useful resources:

We are undefeatable – https://weareundefeatable.co.uk/

Better health – https://www.nhs.uk/healthier-families/

Age UK – https://www.ageuk.org.uk/

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.

Don’t take our word for it, check out the Flippin’ Pain website:

And this leaflet from other people with pain

The Honest Physiotherapy Pain Management Guidebook is a very good read on the approach we take – Pain Management Guidebook

HCRGCaregroup pain management leaflet – Coming soon

Your GP or orthopaedic interface service can refer you to the community pain service.

The orthopaedic interface service (OIS) provides assessment and diagnosis of musculoskeletal pain problems. It is staffed by highly experienced musculoskeletal physiotherapists and podiatrists who will take your history, examine you physically (as required) and arrange any further investigations if these are indicated. The OIS service works closely with orthopaedic surgeons, rheumatologists, and other consultants.

The service can be accessed following a referral from a GP or physiotherapist.

Orthopaedic interface service information leaflet 

• We are able to assess and treat children from the age of 12 years old. We would prefer for children to attend any appointment with a parent or guardian.
• We do not accept self-referrals for children under the age of 16 years old
• If you require a chaperone for your physiotherapy appointment, please contact our admin department prior to your appointment.

Our physiotherapy service is located in 3 areas across BANES

• St Martins Hospital
• Paulton Memorial Hospital
• Keynsham Community Health Centre

Tel: 03002470063

Email: vcl.bathnesphysio-outpts@nhs.net