Musculoskeletal (MSK) Service
This service specialises in the assessment and treatment of muscle and joint problems and provides a range of speciality services ranging from diagnostic to ultrasound injection clinics.
What does this service provide?
Who we are
The musculoskeletal (MSK) service is a large team of experienced chartered physiotherapists and podiatrists who specialise in the assessment and treatment of muscle and joint problems.
What we do
We support local GPs, physiotherapy and orthopaedic services by triaging patients to receive the most appropriate care, by the right service at the right time.
Through expert assessment, ability to organise investigations, and skill to perform interventional procedures, the MSK service offers patients a comprehensive service to effectively manage musculoskeletal complaints. The MSK service provides a range of specialty services ranging from diagnostic to ultrasound injection clinics.
This service also combines clinical experience with modern facilities to provide a first-class service to MSK patients across Sussex.
Assessment clinics
The main service provided by our team is to provide expert MSK assessment clinics. The focus of these clinics is to ensure patients are accessing the most appropriate care for their MSK problem.
Following an assessment, patients may be provided with a treatment plan to follow, or it may be that further investigations or treatments are organised. The service acts as a central hub to effectively manage musculoskeletal patients as well as having access to a wide range of supportive specialist services.
Supporting MSK services
The MSK service is supported by a wide range of clinics and services throughout Sussex and further afield. The MSK service has direct links to a number of radiology centres who provide a range of investigations, for example MRI, X-ray and CT scan.
Clinicians of the MSK service also work closely with local physiotherapy, orthopaedic, rheumatology and pain services ensuring that the most appropriate patients are referred to these services when their expertise is required.
Physiotherapy
The MSK clinic works side by side with the physiotherapy service and this supportive working partnership ensures patients timely access to both services.
The physiotherapy service is provided by a large team of experienced chartered physiotherapists who specialise in the assessment and treatment of muscle and joint problems. The physiotherapy department provides a range of specialty services ranging from hydrotherapy to state-of-the art gym facilities.
Injection clinic
While exercise-based therapy is often the gold standard treatment for many musculoskeletal problems, sometimes other treatments in conjunction may be needed. Evidence shows that injections are rarely the solution on their own. Our clinicians are very experienced in providing a wide range of injections that may not be seen so frequently in other clinics. The aim of our injection clinic is to provide quick access to injections for pain relief when needed to complement your other treatments.
Ultrasound clinic
Ultrasound is increasingly used for soft tissue musculoskeletal problems due to its safe patient use with no known side effects, its ability to track problems over a large area and view tissues on both sides for comparison, and its quick access. Ultrasound may be a useful investigation to understand your problem better and your clinician may refer you for a scan. We have four specialist MSK sonographers within the team providing diagnostics for local GP practices, MSK and physiotherapy teams.
Ultrasound injection
Certain injections may need ultrasound to guide the needle to the target. This may be because the structures are quite deep, or they may be quite complex due to the surrounding blood vessels or nerves. Sometimes you may be referred for an ultrasound scan and the injection in the same session. There is good evidence to show better accuracy using ultrasound, but many injections are easy to complete without the use of ultrasound and these are usually explored first. We provide specialist ultrasound treatments including hydrodilatation and barbotage of the shoulder, nerve blocks and many other soft tissue and joint injections.
Appointment information
We offer face to face, telephone and video appointments. The majority of our initial appointments are provided as face-to-face consultations, however, some may be via telephone. Follow-up appointments can be provided in person but they are often offered as telephone appointments as many of our patients prefer this type of appointment.
You will meet with a clinician who is best able to deal with your condition. Please allow about 30 minutes for your appointment (this may be longer or shorter depending on your clinical need). During the consultation you will be able to discuss your history and symptoms and the clinician will assess your condition.
You will get a chance to talk about different options for treatment and receive information to help you manage your condition. The clinician will explain any medical treatments available, including risks and benefits.
If you agree, medical students or other trainee clinicians or colleagues may observe in the consultation as part of their training or supervision. The clinician will ask your permission for this to happen first.
Please bring a list of your current medicines, including prescribed and non-prescribed medicines such as over the counter medicines and supplements. You do not need to bring your medicines with you.
If you have had a scan or X-Ray outside your local NHS provider, please send us your CD and contact us to arrange for these to be available at your appointment. Please bear in mind that it can take a long time to get hold of these, so the sooner you can let us know the better.
Depending on your condition, you may need to expose the area so you can be examined properly.
If appropriate, you may be offered a steroid injection during the appointment. Your clinician will always discuss this and ask for your consent first. If you do have an injection, you will be advised to rest for 30 minutes afterwards, and then consider whether you are safe to drive home.
You are welcome to bring a relative or a friend to your appointment. Alternatively, we can arrange a chaperone if you would like someone to be with you. This is an independent person specially trained to support patients. Please let our team know on 01243 623 548 before the appointment if you would like a chaperone.
You will be able to discuss with the clinician what will happen next which may be one or a combination, of the following things:
- You may be discharged from the service
- you may be offered a follow-up appointment, either on the telephone or face-to-face
- you may be referred to another service if different advice or treatment is required
Whatever happens, you will receive advice on how best to look after yourself and manage your condition. If you have any other questions, please let us know by contacting 01243 623 548 and our team will be pleased to help you.
Muscle and joint pains are a frequent complaint, which can sometimes be concerning, particularly where the pain is severe. However, it is important to be aware that the majority of muscle and joint problems will:
- respond well to altering your activity for a period of time
- improve by performing specific exercises
- be helped by understanding that the pain is rarely caused by something serious
How can I access this service?
Most muscle and joint problems will settle naturally in time with little or no help. Occasionally you may need some extra help to get better.
If you feel you would like to talk to a healthcare professional to help you further with your problem you can fill in a physiotherapy self-referral form.
If it is felt that a specialist opinion or investigations are required, your GP, nurse practitioner or physiotherapist will refer you to the MSK service.
Where can I access this service?
The MSK service is provided at multiple locations across the Coastal Sussex region.
Services in the coastal region cover Arundel, Bognor Regis, Midhurst, Worthing, Littlehampton, Shoreham and Steyning.
Opening hours
Clinics open at various times from 8:00am to 5:00pm. Please contact your local clinic for exact opening times.
Contact details
Please refer to the CSIMS contact us section for telephone and contact details for all locations regarding appointments, active referral queries and any other queries.
Locations
Where can I find resources for this service?
Our specialist clinicians have compiled a selection of resources to help you manage your symptoms while you are waiting to be seen. It is important to know that a large number of muscle and joint problems do improve with time and can be effectively managed by following appropriate advice and guidance. We have drawn together a range of helpful resources. These include suggestions for managing muscle and joint problems, exercises you can do at home and information on local and national support services.
The videos below discuss how to keep moving and exercise while suffering with long term pain.
The best advice is to try and continue as normally as you can but that it may be sensible to make some adjustments to activities that aggravate your symptoms. Watch the 'not as fit as I thought' video.
Exercise, particularly strengthening exercise, is the best medicine for most aches and pains. Exercise can be anything that challenges your muscles and does not need to mean going to the gym or the swimming pool, as not everyone enjoys these things. Watch the 'importance of fitness' video.
In most cases, having an X-ray or a scan is not useful in helping you get better. In certain situations, they are important and necessary, but often the results show us things that are normal for your age and are not related to your pain. This is why your GP or clinician may say that it is not needed. Watch the 'do I need an MRI scan?' video.
Information about how your condition presents, how it's progressing and whether interventional treatments may be needed are keys bits of information that help to work out whether investigation are needed. Therefore, if your condition does not show any alarming signs, it is improving and does not indicate that interventional treatments are needed be reassured that an investigation is not required. Being anxious that every ache and pain is something serious can prevent many patients from getting better. Muscle and joint problems are more often ‘non-serious' and being positive has proven to be important factor in achieving success. Watch the 'health benefits' video.
The majority of muscle and joint problems improve without the need for surgery. Through following some simple principles and giving the body time to heal often leads to patients to avoiding surgery. Watch the 'will surgery fix it?' video.
Over the counter pain medications, if used correctly, can often help with the recovery of many muscle and joint problems. Prescription medications can often cause side-effects and therefore it is advisable to try over the counter medications in the first place. Watch the 'pain medications' video.
The Cuppa Routine – a video series of exercises you can do in the time it takes the kettle to boil. Please be aware this video may have adverts before or during its runtime.
Improve Your Balance in Five Minutes – an exercise video to help improve your balance in just five minutes.
NHS Fitness Studio – a range of NHS fitness and activity support information and videos.
Age UK – general advice, where to start, and how to become more active as well as links to local groups.
Arthritis Foundation Walk With Ease – the Walk With Ease programme is offered as a self-guided course or in a community setting.
CSP Love Activity, Hate Exercise – The Chartered Society of Physiotherapist’s campaign offers help with being active with a long-term condition, getting started with exercise, and advice on getting inspired.
Couch to 5K – Couch to 5K is a running plan for absolute beginners. It was developed by a new runner, Josh Clark, who wanted to help his 50-something mum get off the couch and start running, too.
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Contact details
You can contact PALS by the following:
Telephone: 01273 242 292Email: sc-tr.pals@nhs.net
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