What are Musculoskeletal (MSK) Problems?
These are the aches and pains, arthritis, rheumatism, stiffness and injuries we are all prone to suffer from at sometime to our muscles, ligaments, tendons or joints.
It has been found that 20-30% of GP consultations can involve MSK complaints. A lot of these problems are minor and will resolve on there own with time and self care measures.
The secret to managing MSK injuries is EARLY self care with pain killers and exercise. Sometimes it may help to discuss your problem with a healthcare professional such as a doctor, nurse or physical therapist (physiotherapist, osteopath or chiropractor).
Parkside Musculoskeletal Clinic
Your GP may offer to refer you to the Parkside MSK clinic. This is run by Dr Martin Cave. He has a special interest, extensive training and experience in MSK and Sports medicine. The purpose of this clinic is for our Parkside patients to have the benefit of a more expert opinion and possibly treatment at the practice, rather than needing to be referred outside the practice which may have a longer waiting time.
If your GP suggest this clinic, a request will be made to Dr Cave who will then make arrangements for you to have an appointment with him, if it is appropriate. You DO NOT need to speak to Dr Cave. Alternatively if you have initially discussed the problem with Dr Cave already he may book you in his musculoskeletal clinic himself, as they are longer appointments. Usually patients will be offered the first available appointment.
What happens after I am referred to Parkside Musculoskeletal clinic?
You will be contacted by the practice staff either by phone or letter & offered the next available appointment that suits you. The clinic is held on Wednesday mornings. Usually the wait for an appointment is only 2-3 weeks. Occasionally this may be longer.
What kind of problems does Parkside Musculoskeletal Clinic treat?
All kinds of MSK problems are seen in this clinic including; back pain, joint pains, hand & foot problems and nerve pains. The initial appointment will be an assessment & diagnosis of the problem. A treatment plan will then be discussed, this may include;
- An injections during the appointment (Shoulder, elbow, hand, foot , knee, wrist)
- Pain relief
- Referral for an x-ray or scan
- Referral to physiotherapy
- Referral to an Orthopaedic surgeon or Rheumatologist
Occasionally special spinal injections (epidurals) are needed when there is nerve pain in leg associated with a disc problem on the lumbar spine (low back), if this is required you will be given another appointment, as this requires a longer appointment and a nurse assistant.
What should I wear and bring with me?
You will be examined & may therefore have to take clothing off. For a shoulder your top clothes will need to be removed (not ladies bras). For backs & knees etc you will need to remove your lower garments, down to underwear. For back examinations you may need to remove top & bottom garments. You need to bring nothing else with you. If you might have an injection it can be a good idea to come with someone else, but this is not essential.
What are the injections given when needed?
The injections that are used for some conditions are mainly ‘cortisone’ (steroid) injections. This is similar to steroids produced in the body by the adrenal gland. They are not related to the steroid injections body builders use. These are anabolic steroids, often similar to the male hormone Testosterone. Cortisone has a very powerful anti-inflammatory effect which is put directly where the problem is. The cortisone is mixed with local anaesthetic which means the injection is NOT usually painful. So don’t believe your friends and relative stories about how painful they are. Dr Cave has done thousands of injections and is very skilled. After an injection the area may be numb form the anaesthetic for a couple of hours (like a dental anaesthetic injection). You will then be advised to give the injected area ‘relative rest’ for about a week. This means no strenuous activities but you can perform most of your normal daily activities.
There are risks associated with joint injections. Please read this leaflet on Steroid Injections.
What happens if I fail to attend my Parkside MSK appointment?
These appointments are scarce, valuable resources and appointments are usually 20-30 minutes long. Patients have to wait for them. You will have prevented another patient from having an earlier appointment. If you fail to attend without cancelling you will NOT be offered another appointment. You will be able to request another and if offered one, you will be put at the back of the waiting list. Please cancel you appointment in advance either online, by phone or in person, so that someone else can benefit and you will be given a new appointment without going back on the waiting list.
Referrals to other external Musculoskeletal Services
When you consult your doctor about a MSK problem and your doctor feels that you need additional services outside of Parkside Medical Centre, you will be referred to a central Hub, which will screen all such referrals to ensure to you are seen in the right clinic. These clinics include physiotherapy, rheumatologists, pain clinic or orthopaedic clinic.