Acute & Sub-Acute Injuries

• Soft tissue injuries (up to 12 weeks)
• Post-fracture or dislocation rehab (as guided by Orthopaedics/Emergency Department)

Spinal Pain

• Low back pain ± leg symptoms per Low Back Pain pathway (nhsl-low-back-pain-pathway-v21docx.pdf)
• Neck pain ± arm symptoms with no significant cervical red flags
• Thoracic pain with no significant red flags

Peripheral MSK complaints e.g.

• Tendinopathies
• Frozen shoulder
• Undifferentiated MSK pain
• Mild to moderate osteoarthritis apart from hand OA which should be referred to the Primary Care Occupational Therapist. Primary Care Occupational Therapy Service - NHS Lanarkshire Encourage self-management of osteoarthritis firstly. Arthritis UK | A future free from arthritis

Other

• Complex Regional Pain Syndrome (CRPS) — with appropriate referral to hand therapy, podiatry, neuro or chronic pain services as required. If previously seen by AHP but requires further input to help with management, please consider referring to chronic pain team.
• Walking aid/splint assessments. Note: Patients must be able to attend outpatient department- can self-refer via: Physio MSK 

AMBER: Patients may benefit from MSK Physiotherapy

• Hypermobility with MSK complaint and agreed rehabilitation goals; patient understands need for active self-management.
• Coccyx pain with no improvement with advice – coccyx pillow and anti inflammatories.
• Back pain with BMI > 40 if weight is felt to be primary issue consider referral to weigh to go first.
• Osteoporosis with functional limitations or pain.

FURTHER INFORMATION

Make sure all red flag concerns have been managed prior to Physiotherapy referral

Condition-Specific Exclusion

• Moderate–advanced osteoarthritis requesting orthopaedic opinion → Orthopaedics
• Hand OA (mild–moderate) → Primary Care Occupational Therapy Service - NHS Lanarkshire
• Mid foot/forefoot (e.g. plantar fasciitis, Morton’s neuroma) → Musculoskeletal MSK Podiatry - NHS Lanarkshire
• Traumatic shoulder dislocation (first or recurrent) in active patients aged 16–20 → Orthopaedics
• Falls, sarcopenia, or reducing mobility → Lanarkshire Falls Prevention - NHS Lanarkshire± strength & balance class/ Active Health
• Carpal Tunnel Syndrome where splints have failed → Orthopaedics
• ME/Chronic Fatigue syndrome → Chronic Fatigue Syndrome/ ME - NHS Lanarkshire
• Widespread Chronic Pain → Chronic Pain Service | NHS Lanarkshire and sign posted to Pain Association Scotland

Population Exclusion (See Physiotherapy Service Map on First Port for information on where to refer) PowerPoint Presentation

• Under 16s
• Housebound patients
• Pregnancy related MSK condition
• Pelvic floor dysfunction

Patient Consent and Engagement

• Patient does not consent to MSK Physiotherapy referral
• Patient unable or unwilling to engage in rehabilitation (incl. behavioural/lifestyle change)
• Previous MSK Physiotherapy completed for the same condition within the last 12 months

Referrals requesting MRI or imaging alone