During your first consultation with us your Chartered Physiotherapist will conduct a thorough physical assessment. This essential first step will assist us in determining what the structural source of your musculoskeletal pain complaint is most likely to be and enable us to provide a diagnosis followed by a planned course of treatment.
Your assessment will involve a combination of you answering relevant questions and your Physiotherapist conducting a hands-on, physical assessment of the affected body area.
Questions we will ask you
Firstly we will need to understand, in as much detail as possible, the history of your condition. Your Physiotherapist will ask you:
- When did the problem start
- Was there an injury sustained, or
- Did the problem arise for no apparent reason
In order to get an impression of how your symptoms respond to certain activities we also need to know:
- What makes the pain worse
- What eases the pain
- What has no effect on the pain
How your pain may fluctuate over a 24 hour period and how it feels at night is also important.
We also need to know:
- Relevant past injuries, similar or different
- Are you taking any medication
- Have X-Rays or other scans been performed
- State of your general health
We have a list of ‘red flag’ questions which will help us determine if the problem is likely to respond to conservative physiotherapy treatment or whether an onward medical referral may be required. This is very important.
This list of 'red flags' also help us screen for a potential medical emergency, which although very rare in this setting, must be considered and arrangements will be made if necessary.
This last point is extremely important and gives patients confidence in consulting a chartered Physiotherapist knowing they have been medically trained and can identify more serious pathology.
Following this initial discussion about your history an experienced Physiotherapist will already have a provisional diagnosis which will then be confirmed or modified as needed with the physical assessment that follows next.
The Physical Assessment
The physical assessment helps us determine how your symptoms respond to movement of the affected part of the body, as well as the effects of adjustments in posture and alignment.
Certain special tests can be employed which are useful in determining which structures may be at fault by gently loading or provoking them to determine if your pain is reproduced.
Hands-on palpation tests can also be used to determine the location of pain sensitive tissues such as muscle, joint or nerve structures.
The scientific evidence is moving in favour of tests which look for dysfunctional patterns of movement and correcting these if needed in order to ‘offload’ pain sensitive structures as needed.
The physical assessment may need to be moderated if pain is very severe on the first visit.
Your treatment plan
At the end of the assessment your Physiotherapist will have a working diagnosis and be able to plan a course of treatment. Treatment is then aimed at settling pain sensitive tissues, restoring movement and then your physical function as required.
We have a variety of techniques we can use ranging from hands-on manual therapy, exercise techniques as well as medical acupuncture, all of which are supported by up-to-date scientific evidence for use in a physiotherapy setting.
The length of time and number of visits to your Physiotherapist before your condition is healed will depend on a number of factors. Of course the severity of your condition will be a consideration but for how long your problem has been present is a very important factor. Conditions that have been on-going for a long time, referred to as 'chronic conditions', as opposed to a more recent or 'acute' injury, are typically not quick-fixes.
Related article: Chronic vs Acute pain
The longer pain symptoms have been present, the longer they may take to settle so it is important to be patient and have realistic expectation of the treatment process. So the rule of thumb is not to sit on a potentially serious problem hoping it will heal itself but rather get it assessed sooner rather than later for quicker results.
Related article: The risk of delaying treatment
If you need a referral
A small percentage of patients may require onward medical referral if they are not responding as well as we would hope and within the appropriate time frames. If surgery or other intervention is required, it is more likely to be successful if you have received some physiotherapy beforehand. For example, many surgeons will insist on this and not consider surgery unless a complete course of physiotherapy has been undertaken first.
For the best chance of a quick recovery from a musculoskeletal pain complaint - consult a Chartered Physiotherapist who will assess you, provide you with a diagnosis, implement an evidence based course of treatment and get you back to full function as soon as possible.