What does this service provide?

Who we are 

We are a team of advanced practice health professionals who provide a free service to support the musculoskeletal health and wellbeing for those who are registered with a West Sussex GP Practice.

What we do

We triage patients to receive the most appropriate care, by the right service, at the right time.  We offer patients a comprehensive service to better live with, manage or improve musculoskeletal complaints.

Following an assessment and a shared decision making conversation, you may agree a treatment plan, or it may be that further investigations or treatments are organised.

We provide a range of specialty services from our modern facilities, including:

  • diagnostic imaging (for example x-rays, MRI and CT scans when needed)
  • injection clinics
  • internal diagnostic ultrasound team
  • blood tests
  • rehabilitation strategies and onwards referrals

We work closely with local rehabilitation and physiotherapy, orthopaedic, rheumatology and pain services and can refer to these services when their expertise is required.


Further information on what we do

Physiotherapy and Rehabilitation

Our MSK Advanced Practice Clinicians work side by side with the Physiotherapy and Rehabilitation team to ensure patients have timely access to both services. We can offer advanced practice support to those being seen in the Physiotherapy Rehabilitation team, where needed.

Musculoskeletal injections

While exercise-based therapy is often a successful treatment for many musculoskeletal issues, sometimes other treatments may also be needed. Many of our clinicians are experienced in providing injections. Evidence shows that injections are rarely the solution on their own, however these may be offered as part of your holistic support plan, if appropriate. Some injections are referred externally to other providers in the area.

Diagnostic ultrasound clinic

Diagnostic ultrasound can be used for soft tissue musculoskeletal problems, if appropriate to do so. We have advanced practice specialist MSK sonographers within the team.  It may be a useful investigation to understand your problem better and your clinician may refer you for this after discussing this with you.  

Appointment information

Who you’ll see at your appointment

You will meet with a clinician who is best able to support you with your condition. Our team includes consultant and advanced practice physiotherapists, chartered physiotherapists, podiatrists, occupational therapists, and osteopaths, who all specialise in the assessment and treatment of muscle and joint problems.

Appointment types

We offer face to face, telephone and video appointments. Appointments are available across our sites. Please let us know if there is an appointment type that would best suit your needs.

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 to prepare for your appointment

To support the examination, you may be asked to remove some items of clothing during your appointment. Please ensure you dress appropriately to enable this. 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.

Please bring a list of your current medicines. 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 contact our administrative team beforehand so we can aim to have these available for your appointment.

What happens after my appointment?

You will be able to discuss next steps with the clinician at your appointment, which may be one or a combination of the following:

  • you may be discharged from the service with or without a patient initiated follow up process, which means you can access the service for the same musculoskeletal issue within six months
  • you may be offered a follow-up appointment, either via telephone or in person
  • you may be referred to another service if different advice or treatment is required

Testimonials

My initial assessment was wholly professional and thorough, and above all, reassuring and friendly. For the first time in months or even years, I felt heard and understood about the level of pain and discomfort in my back and legs. I was given a plan to work to, hopefully improving the symptoms and moving forward. The ensuing exercise plan was set by a physiotherapist, who was also very thorough, understanding and patient. The gym at Bognor is extremely well equipped and the staff have been kind, supportive and encouraging, helping me to progress with bespoke exercise and use of the gym equipment.

Service user

The appointment was a great way to assess my issues and for the clinician to be able to act as the person between me as the patient, my GP, and the surgeon.

Service user

It was explained and shown to me how my hand should be working. They knew exactly what the problem was. Two injections and twenty-four hours later I can move fingers and hand without locking and a lot less pain.

Service user

It was the first time I felt really listened to. The practitioner took time to explain the condition clearly and the options available.

Service user

From day one I was treated as an individual, looking at my specific realistic outcomes and was set a programme to work with to achieve this. I had lost confidence in my ability to move well and was unable to do some simple movements. With ongoing treatment and support I am improving well and doing so much more than I thought I could ever do again before treatment. We've looked at treatment and prevention and continue working towards goals for full recovery. I am so very grateful to have been taken under the care of MSK, it has improved my wellbeing considerably.

Service user

The clinician was friendly, polite, and knowledgeable. They fully explained the results of my MRI and ensured that I had plans for further improvement of my injury. They said they would keep the file open for six months in case I needed another appointment.

Service user

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 musculoskeletal issue 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?

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

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

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

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

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

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Shoreham
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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