In August 2013 Parkside Medical Centre was successful in bidding to provide a level 2 musculoskeletal pathway as part of a pilot scheme to redesign the musculoskeletal services in Milton Keynes. As a result of this bid we will be able to provide an Extended Scope practice assessment and treatment service using our GPwSI in Musculoskeletal Medicine, Dr Cave, and two experience Extended Scope Physiotherapists (ESP) to address more complex problems. Dr Cave will be able to provide advice and joint consultations with the physiotherapist to provide the most comprehensive care for the patient.
The Level 2 service has been designed as a comprehensive, multi-disciplinary MSK service for patients who would normally have been referred to an orthopaedic consultant by their GP. The service will cover referrals relating to lower limb, upper limb and spinal or back pain (functional, chronic and non-surgical).
The following conditions would be appropriate for the Level 2 service.
- Patients with complex musculoskeletal conditions unlikely to require surgery or consultant advice
- Diagnosis and advice when the referrer is uncertain whether a consultant referral is required e.g. patients previously unresponsive to outpatient physical therapy for the same condition.
- Patients who may benefit from corticosteroid injection therapy for peripheral conditions.
Each patient’s referral will be triaged by the team and then given to the appropriate clinician for initial assessment. The clinician will then assess the patient and in discussion with the patient will decide on appropriate management.
Treatments may include, but not be limited to the following:
- Manual therapy: joint mobilisations and manipulation
- Soft tissue mobilisation: muscles, ligaments, cartilage, neural
- Exercise programmes
- Therapeutic Injections
- Acromio-clavicular joint sprain, capsulitis or osteoarthritis
- 1st carpo-metacarpal joint capsulitis or osteoarthritis
- De Quervain’s tenosynovitis
- Lateral or medial epicondylitis
- Autologous blood Injection for lateral epicondylosis
- Trigger finger, trigger thumb or flexor tendon nodule
- Plantar fasciitis
- Olecranon bursa
- Sub-acromial bursitis or sub-acromial impingement syndrome
- Capsulitis or osteoarthritis of the knee
- Capsulitis or osteoarthritis of the shoulder
- Trochanteric bursitis
- Carpal Tunnel syndrome
- Advice on self-care.