Are you one of the 310,000 people waiting to see an NHS physiotherapist about a musculoskeletal issue? Distressingly, a quarter of those in the queue won’t be seen for three months or longer, in which time issues can become chronic and increasingly painful.
So what can you do while waiting for your appointment? Leading physios share their advice on how to manage common ailments.
LOWER BACK PAIN: What is it? “A dull or sharp pain below your ribs to the top of your legs, this affects most people at some point in their lives,” says physiotherapist Lucy Macdonald at Octopus Clinic, London.
“Most low back pain improves with self-care and physiotherapy, so staying active with gentle movement throughout the day rather than prolonged sitting down is crucial.”
Try this: Lucy says: “The superman exercise involves you on all fours trying to remain as stable as possible as you lift one arm and the opposite leg, stretching them gently away from your body and back again. Repeat with the other arm and leg. Do three sets of this exercise 10 times.”
Seek immediate medical attention if you experience reduced sensation or weakness in your legs or genital area.
SHOULDER IMPINGEMENT: What is it? “The shoulder is a ball and socket joint with a complex layering of muscles all around it,” says physio Ben Lombard of Ben Lombard Physiotherapy in North London.
“A common cause of pain is where the tendon inside this already small space gets pinched, causing swelling.
“It’s often triggered by overuse – for instance, if you spent your weekend painting a ceiling, a task you don’t normally do. You might feel pain in the shoulder or arm when you move it in an arc from your side up to your ear.”
Try this: “A simple external rotation exercise using a cheap resistance band (a set of five costs under £3). Attach one end to a door handle and hold the other with your elbow bent and tucked against your side. Slowly move your arm outwards, away from your stomach before moving it back to your side. Do three sets of 20 repetitions daily.”
LATERAL HIP PAIN: What is it? “Often felt as a constant dull ache or a sharp pain on the outside of the hip, it can also flow down the thigh,” says specialist hip physiotherapist Mehmet Gem of The Hip Physio, Exeter.
“The gluteus medius and minimus tendons [the bands of tissue which connect the gluteal muscles in the buttock to the hip bone] are usually where this pain starts. Although more common in women during menopause due to hormonal changes, it can also be brought on by a sudden increase in exercise or having a high BMI.
“Walking or even standing on one leg can provoke pain, as can lying on either the affected or unaffected side, so disturbing sleep.”
Try this: “Supine bridge exercises involve lying on your back with your knees bent and bum off the floor. As you progress, you may want to lift one leg off the ground. Hold for three seconds and repeat 10 times as your glutes become stronger.”
SCIATICA: What is it? “Sciatica is a nasty pain along all or parts of the sciatic nerve which runs down the back of the leg, through the buttock and is often caused by a lumbar disc injury,” says Lucy Macdonald. “As over 90 per cent of cases improve with self-care and physio, stay active and avoid sitting slumped in positions.”
Try this: “Best done wearing fluffy socks and lying on your back, slide your leg up and down the wall beside you with your other foot on the floor. Try to move your leg gently until you’re on the edge of pain. Do three sets of the exercise 10 times.”
SHIN SPLINTS: What is it? “It’s a pain or tenderness along the front of your lower leg, the shin, usually brought on by an increase in activity or time on your feet,” says Mathew Harrison, physio at Homerton Healthcare NHS Foundation Trust, East London.
“Ideally reduce activities for two or three weeks to help recovery while also using ice packs (try a bag of frozen peas) wrapped in a towel for 15-20 minutes every few hours for one week.”
Try this: “Avoid running or long walks but keep exercising with different activities such as swimming, Pilates or yoga. Meanwhile, keep your leg muscles strong. Rise up and down on one leg on your toes while waiting for the kettle to boil.”
ANKLE SPRAIN: What is it? “If we roll over our ankle, it can easily stretch its ligaments supporting the small bones and joints, resulting in pain, swelling and inability to bear weight,” says Sam Bhide, an advanced practice physio at Kingston Hospital NHS Foundation Trust, Surrey.
“An ankle sprain usually takes about six weeks to heal. Heat packs, ibuprofen and alcohol all affect healing, so are best avoided for a few days after suffering this injury.”
Try this: “Sit with your ankle elevated, for example, on a stool. Move your foot to ‘draw’ in the air all the letters (both small and capitals) of the alphabet to improve your ankle movement. Try this exercise two or three times a day.”
CARPAL TUNNEL SYNDROME: What is it? “It’s when the carpal tunnel [a narrow passageway surrounded by bones and ligaments] inside your wrist swells and squeezes a nerve, which can result in numbness, tingling or a weakness in your fingers, hand and arm,” says Sam.
“Symptoms, which can be painful, tend to worsen at night, possibly disturbing sleep, although you may notice it most when you wake in the morning. Certain repetitive activities such as writing, typing or housework might exacerbate it when you’re holding items for a long time.
“Pregnancy, arthritis and thyroid disease can bring it on, so it’s important to be professionally assessed.”
Try this: “Do wrist stretches holding a light weight such as a tin of beans. Stretch your arm out in front with your palm facing downwards. Slowly bend your wrist upwards before returning to the starting position. Do three sets of 10 repetitions.”
KNEE PAIN: What is it? “It can be caused by lots of different conditions,” says Mathew. “Pain around your kneecap can be patellofemoral or patellar tendinopathy (sometimes known as jumper’s knee), which affects the main tendon at the front of the knee.
“Typical symptoms of both are pain happening after sitting for a long time, kneeling or an increase in recent activity. If it’s a tendon issue, it can sometimes feel better once warmed up, but often feels worse the following day.”
Try this: “Make sure your knees and legs are comfortable if you work at a desk, so adjust your seat height so your legs aren’t always bent. Take regular breaks to stretch your legs.”
PLANTAR FASCIITIS: What is it? “The plantar fascia is a fibrous tissue covering our heel, arch and sole of the foot which can become irritated when strained, causing pain when weight bearing,” says Sam.
“In the first 24 to 48 hours use the POLICE regime (see box below) and avoid wearing tight, pointy, hard-soled footwear or walking barefoot. In some cases, recovery can take up to 18 months.”
Try this: “Use a cold drink bottle or golf ball and massage from the top of your foot to the heel for between 60 to 90 seconds, two or three times a day.
■ For more information go to the Chartered Society of Physiotherapists’ website, csp.org.uk/askthephysio