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.


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 


Face-to-face appointments

On the day of your appointment, please go to the department named in your letter and register with reception. Please follow any local instructions regarding hygiene, such as wearing face masks and direction of travel around the hospital or clinic. This information will be given to you in advance of your appointment.  

Telephone appointments

All our clinicians can provide an expert assessment and will discuss your symptoms with you over the phone or online. They will also discuss appropriate management options for your problem. They will be able to send you advice, exercises and video guidance depending on what is most appropriate for your particular condition.  If you are contacted by telephone, please note that the call may come from an unknown number.

Online appointments

Appointments can also be provided using a video platform. A video appointment is normally organised following a telephone appointment when your clinician feels that they need to assess your movement to gain a better understanding of your problem. Your clinician will email you a link to access your video appointment and will discuss with you the necessary steps for getting the most from your video appointment. 

Frequently asked questions

I am booked for an injection, what do I need to know?

Steroid injections are known to be a useful treatment for pain, swelling and stiffness within a joint or the area around the joint. The joint is injected with a preparation of local anaesthetic and corticosteroid.  

The anaesthetic is intended to reduce the pain initially for 30 minutes and the corticosteroid should reduce the inflammation and therefore it may take up to two weeks for the effects of the injection to start working.  

The response to the injection varies from person to person but can last from several weeks to many months. There is some research to suggest that steroid may be harmful to tendon tissue so your clinician will discuss the risks and benefits for your condition on an individual basis. 

There are some health conditions for which an injection of steroid and anaesthetic is restricted. Please let us know if any of the following apply to you before you attend the clinic for an injection and your clinician will discuss these with you:   

  • you have open wounds such as leg ulcers or cellulitis at the site of the injection 
  • you have any artificial joints present in the area to be injected 
  • you are taking any antibiotic treatment for an infection or within 48 hours of stopping 
  • you have an allergy to local anaesthetic or steroid 
  • you are taking any immunosuppressant drugs, for example for HIV or arthritis 
  • you are receiving any chemotherapy treatment for the management of cancer 
  • you are taking a blood thinner such as Warfarin 
  • you have uncontrolled Diabetes Mellitus 
  • you are pregnant or breast feeding 

What should I expect after my joint injection?  

We advise you spend 30 minutes resting quietly in the clinic waiting area and make sure you feel well before you leave. Report to reception if you feel unwell. Avoid strenuous activity for the rest of the day. The injected area may be numb for up to 24 hours and the injected site may be sore for one to two days as explained in the side effects. Do not use heat pads or any other form of heat on the injection site for two days following the injection. You may however choose to use an ice pack on the injection site for pain. 

For a weight bearing joint we recommend that you rest and gently potter at home for two days after your injection to improve the likelihood of a good response.  

You may develop a bruise at the injection site. Most people notice improvement in their pain in two weeks, however maximum improvement of your pain may take up to six weeks following your injection. If you are having a vaccination within 2 weeks of your injection, please contact your GP. 

Important: if you develop a rash or if the injection site is red, hot, swollen or painful, you may be developing an infection. Please contact the PACE team or your GP. If you are unable to contact either of these and continue to have concerns, please go to Accident and Emergency. 

Are there any side effects from having an injection?  

Side effects of a steroid injection are rare. Your clinician will discuss the side effects with you at the time of the injection.

What are the potential side effects?  

Flare Up – affects about 1 in 10 people. Occasionally people notice a flare in their joint pain within the first 24 hours after an injection. This usually settles on its own within a couple of days. Take your usual pain killers to relieve symptoms.

Infection – very rarely, infection might be introduced into the joint at the time of an injection (estimated as 1 in 23,000 people). If the joint or area becomes more painful and hot, red, or swollen you may be developing an infection. You should see your doctor immediately or if this is not possible, go to Accident and Emergency.

Thinning of skin – occasionally some thinning of the skin or dimpling skin colour change may occur at the injection site. This is more likely to happen if you have a higher dose of steroid.

Facial flushing – steroid injections may sometimes cause facial flushing or interfere with the menstrual cycle making them irregular temporarily. You should consult your GP if concerned, or if it persists.

Mood change – treatment with steroids may cause changes in mood – either elation or depression. This may be more common in people with a previous history of mood disturbance. If you have concerns, please discuss this with your doctor.

Change in glycaemic control – People with diabetes may find that the steroid injection affects their blood sugar control and may notice a temporary blood sugar rise. It is recommended that you check your blood levels more regularly as it may take between one to three weeks for them to settle. 

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.

How can I contact 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.


Bognor Regis
Where to find us
Address: Bognor Regis War Memorial Hospital, Shripney Road, Bognor Regis, PO20 9PP

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Where to find us
Address: Munro Unit, St. Richards Hospital, Spitalfield Lane, Chichester, PO19 6SE

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Where to find us
Address: Littlehampton Health Centre, Fitzalan Road, Littlehampton, BN17 5HG

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Where to find us
Address: Central Clinic, Stoke Abbott Road, Worthing, BN11 1HE

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Address: St. Lawrence Surgery, 79 St Lawrence Ave, Worthing, BN14 7JL

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Where to find us
Address: Steyning Medical Practice, Steyning Health Centre. Tanyard Lane, Steyning, West Sussex, BN44 3RJ

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Where to find us
Address: Southlands Hospital, Upper Shoreham Road, Shoreham-by-Sea, BN43 6TQ

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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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