MSK Physio

What is Osteoarthritis?

Osteoarthritis, often abbreviated as OA, is a common and chronic joint condition that primarily affects the cartilage in the joints. Cartilage is the tough, slippery tissue that covers the ends of bones where they come together to form a joint. In osteoarthritis, this cartilage gradually breaks down and wears away, leading to pain, swelling, and reduced joint mobility.

The exact cause of osteoarthritis is not always clear, but it can be related to factors such as ageing, genetics, joint injuries, and obesity. As the cartilage deteriorates, the bones in the joint may begin to rub against each other, causing further pain and joint damage. Osteoarthritis commonly affects weight-bearing joints like the knees, hips, and spine, as well as other joints such as the hands and fingers.

Symptoms

The symptoms of osteoarthritis can vary from person to person and depend on which joints are affected and the severity of the condition. Common symptoms of osteoarthritis include the following:

Management

Osteoarthritis is a long-term condition, and while it cannot be cured, there are various treatment options to manage its symptoms and improve quality of life. These may include lifestyle changes (such as weight management and exercise), pain-relief medications, physiotherapy, and in some cases, surgery to repair or replace the damaged joint. The goal of treatment is to reduce pain, improve joint function, and enhance the individual’s overall well-being. It is useful for individuals with osteoarthritis to work closely with healthcare professionals to create a personalised treatment plan based on their specific needs and the severity of the condition. Remember that managing osteoarthritis is an ongoing process, and it may involve trying various strategies to find what works best for you. A positive outlook, proactive management, and a support network can make the journey with osteoarthritis one of growth, adaptability, and resilience.

You can explore our self-care and self-management information pages for advice on how to get started with joint specific exercises.

Versus Arthritis

“Versus Arthritis,” is a charitable organisation, offering a range of resources and support to help individuals who are affected by arthritis and related musculoskeletal conditions. They provide information, resources and support to individuals with arthritis, as well as their families and caregivers. Their services are designed to empower individuals with arthritis to manage their condition, improve their well-being, and connect with a supportive community.

To benefit from Versus Arthritis, you can visit their website or call their helpline (tel: 0800 5200 520)

Other Resources

• A Guide for People who have Osteoarthritis – Keele University (Long Read – 30 mins)

Physiotherapy treatment feedback

Please tell us about your experience of the physiotherapy care you have received. You can do this directly with us using the Physiotherapy treatment feedback link below or use the Care Opinion Link to go to the national feedback platform. All feedback is anonymous.

Complaints

While we aim to deliver high quality care, sometimes things go wrong. If you wish to find out more about making a formal complaint please follow the link below.

The MSK Physiotherapy Service in NHSGGC

NHS Greater Glasgow and Clyde has the largest MSK team in the UK and we are committed to providing the highest quality of care to our patients, and in return we invest in your development.

How To Apply

Our vacancies are advertised on the NHS Scotland Job Portal. All vacancies are listed in regions please select NHS Greater Glasgow and Clyde to view the opportunities within our Health Board.

Follow our Twitter account for up-dates and job opportunities

More information about the Greater Glasgow and Clyde area

• Greater Glasgow and The Clyde Valley | Scotland.org
• You Can Make Glasgow (hscp.scot)
• Living in Scotland | Scotland.org
• NHS Greater Glasgow and Clyde homepage
• NHS Greater Glasgow and Clyde MSK Physiotherapy homepage

There are several ways you can access our service:

• GP: You can ask your GP/Doctor to refer you if you and your GP are within Greater Glasgow and Clyde health board.
• Hospital doctor/clinic: You may be referred to us through another NHS service e.g. orthopaedics. 
• Yourself: If you live and have a G.P. within Greater Glasgow and Clyde you can refer yourself directly by filling in our printable Self-referral form. Please deliver or post your form to your Local Physiotherapy Department
• Paper copies are also available from your local physiotherapy department or GP surgery.
• NHS Staff: If you are a member of staff within NHSGGC and wish to refer to physiotherapy, please go to the Occupational Health webpage on HR Connect

We are unable to accept a self referral if

• You are not registered with a GP within NHS Greater Glasgow and Clyde.
• You are under 14 years old – please ask your GP to refer you to Children’s Services.
• You are currently pregnant – please self-refer to Maternity Physiotherapy, if you do not have the contact details in your maternity pack, please contact your midwife.
• You are currently attending or are under the care of Rheumatology – please self-refer to Rheumatology Physiotherapy by contacting the self-referral line on 0141 531 3703.
• You have attended Accident and Emergency or Minor Injuries Unit within the past 2 weeks for condition – we need a referral from your hospital clinic.
• Your condition is due to a fracture or break within the past 3 months – we need a referral from your hospital clinic to make sure physiotherapy is appropriate.
• You have had surgery for this condition within the past 3 months – we need a referral from your hospital clinic to make sure physiotherapy is appropriate.
• You require a home visit – please ask your GP to refer you to Community Rehab Services.

 Further Information

This  What Happens Next leaflet explains what will happen once we receive your referral. 

The Patient Information About Your Appointment With a Musculoskeletal Physiotherapist leaflet will give you more detail about what to consider and expect once an appointment has been arranged.

Musculoskeletal (MSK) physiotherapy involves the assessment and treatment of muscles, tendons, ligaments, bones, joints, nerves and other structures in order to:

• improve your movement and strength.
• help you to do more of your normal activities.
• help you to understand and manage your condition.

Treatment is likely to include an exercise program specific to your needs.

We are unable to accept a self referral under certain circumstances. Please read and answer all of the following questions.

MSK Physiotherapy may not help if you:

• have had physiotherapy treatment for the same condition within the past year.
• are referring yourself for widespread aches and pains.
• have previously attended the Pain Clinic for the same condition.

If you have recently or suddenly developed:

Please consult your GP URGENTLY or NHS 24 Call NHS 24 on telephone number 111

• difficulty passing urine or controlling bladder / bowels
• numbness or tingling around your back passage or genitals
• numbness, pins and needles or weakness in both legs

Please inform your GP of this self referral if you:

• have recently become unsteady on your feet
• are feeling generally unwell / fever
• have a history of cancer
• have any unexplained weight loss

Reasons why we may not accept your self referral

If you come across any blank options when completing the form it may be down to the below:

Here is a list of the main problems and concerns when we would recommend you get checked out by a health professional before commencing self-management exercises. These are called Red Flags and may indicate a more serious problem that requires medical assessment.

Symptoms That Are Present After Trauma

If your symptoms are caused by a recent traumatic incident (e.g. a fall, football tackle) and you have any of the following symptoms:

• Significant bruising and swelling in the area
• Difficulty in moving elbow or seems locked in one position
• Looks a different shape to the other side, new lumps and bumps that have appeared since the injury.
• Loss of ability to use your hand normally.

Note: If you have an underlying poor bone density (e.g. osteoporosis) smaller amounts of force can cause the problems listed above.

Symptoms Where No Trauma Was Involved

• Hot, red and/or swelling of elbow
• Tingling, numbness and/ or pins and needles into arm, hand or fingers
• Worsening weakness in your arm and/or loss of movement
• Unexplained lumps or bumps which are changing/growing
• Fever and generally feeling unwell at same time as elbow pain developed
• Pain and/ or stiffness in other joints at the same time as elbow pain developed
• Constant pain which appears to not change with rest/ activity.
• Significant worsening pain at night in bed
• Unexplained weight loss and/ or previous history of cancer.

NOTE: Special attention should be taken if you have a history of long-term steroid use/immunosuppressive drugs, recent joint replacement, surgery, steroid injection. Rheumatoid arthritis or other joint disease. Recent infection, intravenous drug use or alcohol misuse.

Resources

Elbow Information leaflets

• Tennis Elbow information sheet (3 min read)
• Golfers Elbow information sheet (3 min read).

Exercises

Here are some specific exercises to help you get your arm moving better. You may need to build these exercises up gradually.

You may be uncomfortable when you start doing these exercises – make sure the level of discomfort feels acceptable to you and that it doesn’t take too long to settle once you are finished.

The exercises should get easier the more consistently you manage to practice them and this may allow you to progress to more difficult exercises.

These are self help exercises:

• Try to enjoy the exercises and work at a pace and level that feels safe
• Please use a common sense approach when deciding which ones to try
• The exercises listed are not designed as an alternative to professional advice.

Exercise videos

Information leaflets/links

• What is wrist and hand pain (5 min read)
• Osteoarthritis of the thumb (including exercises)
• De Quervains/ Wrist tendinopathy (5 min read) – NHS
• Trigger finger (2 min read)
• Carpal tunnel information and exercises (5 min read) CSP
• Carpal tunnel management (5 min read) – NHS
• Thumb Osteoarthritis (5 min read).

Important Facts About Your Upper Back 

Please read the following information and then use the links at the bottom of the page if you are looking for further information or exercise.

Here is a list of the main problems and concerns we would recommend you get checked out by a health professional before commencing self- management exercises. These are called Red Flags and may indicate a more serious problem that requires medical assessment.

Symptoms That Are Present After Trauma

If your injury is caused by a recent significant traumatic incident to your head, neck or body (e.g. a fall from a height, significant car accident) please have this checked out by a health professional before commencing with an exercise program.

NOTE: if you have a known diagnosis of osteoporosis (low bone density) a small amount of force (e.g. strenuous lifting) may cause problems that require medical assessment.

Symptoms Where No Trauma Was Involved

If you feel any of these signs appear rapidly or over a longer period of time please have these checked out by a health professional.

• Severe restriction in the movement of your neck/ trunk or arm
• Changes in your balance and the way you are walking e.g. tripping, falling
• Weakness and/ or altered sensation into both arms and/ or legs at the same time
• Electric shock sensations into both arms and legs on forward bending of your head or looking down
• Problems with coordination of upper and/ or lower limbs e.g. writing, standing and walking
• Pain or altered sensation around your trunk e.g. can be described as a band of pain/ numbness around the chest
• Chest pain, excessive yawning and/or altered/ difficulty breathing
• Fever or generally feeling unwell at same time as mid back symptoms developed
• Constant severe pain which does not change with rest or activity
• Significant pain and/or night sweats
• A previous history of cancer/ unexplained weight loss
• Unexplained lumps or bumps that are changing/ growing
• Increasing number of joints that are painful and/ or stiff
• Sudden change in height and/or curvature of your spine, inability to be upright
• Significant changes to bowel, bladder habits and/or sexual function required IMMMEDIATE MEDICAL ASSESSMENT. WARNING: Cauda Equina Syndrome (CES) This a rare but extremely serious spinal condition that requires immediate assessment. 

For further information on CES: 

• CES info leaflet
• CES short video
• CES Information in other languages.

NOTE: Special attention should be taken if you have a history of long-term steroid/ immunosuppressive drug use, recent joint replacement, dental surgery or steroid injection. Previous spinal surgery. Rheumatoid arthritis or other joint disease, recent infection, previous history of tuberculosis, intravenous drug use or alcohol misuse

Upper Back Exercises

Please make sure you have read through the important information about upper back pain before proceeding.

Here are some exercises to help you get your upper back moving better. You may need to build these exercises up gradually.

You may be uncomfortable when you start doing these exercises – make sure the level of discomfort feels acceptable to you and that it doesn’t take too long to settle once you are finished.

The exercises should get easier the more consistently you manage to practice them and this may allow you to progress to more difficult exercises.

These are self help exercises:

• Try to enjoy the exercises and work at a pace and level that feels safe
• Please use a common sense approach when deciding which ones to try
• The exercises listed are not designed as an alternative to professional advice.

Exercise videos

Important Facts About Your Back Pain

Here is a list of the main problems and concerns we would recommend you get checked out by a health professional before commencing self-management exercises. These are called Red Flags and may indicate a more serious problem that requires medical assessment.

Cauda Equina Syndrome (CES)

Warning: CES is a rare but extremely serious spinal condition that requires immediate assessment. 

If you are experiencing the symptoms described in (1) or (2) below, then please have these checked out urgently – usually your GP if within normal hours (8.30am – 6.00pm) or call NHS 24 on 111 at other times.

1. Significant changes in your bowel or bladder habits and/or sexual function. This includes difficulty passing or controlling your urine flow/ signs of recent bowel incontinence
2. Changes to sensation in between your legs e.g. difficulty feeling the toilet paper when you are wiping your bottom.

Further information on CES

• CES info leaflet
• CES short video
• CES information in other languages.

Symptoms That Are Present After Trauma

If symptoms are caused by a traumatic incident to your back (e.g. a fall, car accident), please have this checked out by a health professional before commencing with an exercise program.

NOTE: If you have underlying low bone density (e.g. osteoporosis) or long-term steroid use then smaller amounts of force may cause problems that require medical assessment.

Symptoms Where No Trauma Was Involved

If you feel any of the following signs develop rapidly or over a longer period of time please have these checked out by a health professional.

• Severe restriction in the movement of your lower back and legs.
• Sudden or newly worsening leg pain which extends below the knee
• Changes in your balance and the way you are walking e.g. tripping, falling
• Weakness and/ or altered sensation into both arms and/ or legs at the same time
• If one or both feet are feeling very floppy or feel very weak on walking
• Problems with coordination of upper and/or lower limbs e.g. writing, getting dressed, walking.
• Pain or altered sensation around your trunk e.g. can be described as a band of pain/ numbness around the chest
• Pain and/or stiffness in other joints at same time as low back pain developed
• Fever and generally feeling unwell at same time as low back pain developed
• Unexplained lumps and bumps that appear or are changing/ growing
• Constant pain that does not change with rest or activity
• Significant worsening night pain, unable to lie flat
• Night sweats
• Unexplained weight loss and/or previous history of cancer
• Increasing number of joints that are painful and/or stiff.

NOTE: Special attention should be taken if you have a history of long-term steroid/ immunosuppressive drug use, recent joint replacement, dental surgery or steroid injection. Rheumatoid arthritis or other joint disease, recent infection, previous history of tuberculosis, intravenous drug use or alcoholism.

Resources

Information leaflets/links

• General advice about back pain (10 min read)
• Physiotherapy advice about back pain ( 1 min watch)
• Information on acute low back pain (5 min read)
• Back Facts (5 min read)
• Facts about sciatica (5 min read)
• Back pain with leg pain (15 min read)
• Spinal stenosis information and exercises (10 min read)

Lower back exercises

Please make sure you have read through the important information about lower back pain before proceeding.

Here are some exercises to help you get your lower back moving better. You may need to build these exercises up gradually.

You may be uncomfortable when you start doing these exercises – make sure the level of discomfort feels acceptable to you and that it doesn’t take too long to settle once you are finished.

The exercises should get easier the more consistently you manage to practice them and this may allow you to progress to more difficult exercises.

These are self help exercises:

• Try to enjoy the exercises and work at a pace and level that feels safe.
• Please use a common sense approach when deciding which ones to try.
• The exercises listed are not designed as an alternative to professional advice.

Exercise videos

Important Facts About Your Hip

Here is a list of the main problems and concerns we would recommend you get checked out by a health professional before commencing self-management exercise. These are called Red Flags and may indicate a more serious problem that requires medical assessment.

Symptoms That Are Present After Trauma

If your symptoms are caused by a recent traumatic incident (e.g. a fall, football tackle) and you have any of the following symptoms:

• Extensive bruising and/ or swelling around your hip and thigh
• Severe pain and very limited movement of your hip/ Leg
• Leg deformity e.g. foot not sitting in normal position
• Difficulty putting weight through the injured leg.

NOTE: If you have underlying low bone density (e.g. osteoporosis) smaller amounts of force can cause the problems listed above.

Symptoms Where No Trauma Was Involved

• Severe pain and/or inability to stand on one leg
• Significant loss of hip movement
• Heat, redness and swelling around your hip
• Fever or generally feeling unwell at same time as hip pain developed
• Pain and/ or stiffness in other joints at the same time as hip pain developed
• Constant pain which does not change with rest or activity
• Significant pain at night with or without night sweats
• Unexplained weight loss and/ or a previous history of cancer
• Unexplained lumps and bumps that appear or are changing/growing.

NOTE: Special attention should be taken if you have a history of long-term steroid use/ immunosuppressive drugs, recent joint replacement, surgery or steroid injection. Rheumatoid arthritis or other joint disease. Recent infection, Intravenous drug use or alcohol misuse.

Do you have pain at the side of your hip?

• Is the side of your hip painful to touch?
• Is it painful when you lie on your side?
• Have you been diagnosed with Trochanteric bursitis, Gluteal tendinopathy or Greater Trochanteric Pain Syndrome (GTPS)?

If you have answered Yes to any of these questions then you may be eligible to participate in a new research study.
We are conducting research to learn about how pain at the side of your hip affects function, quality of life and physical activity.
To participate you must be aged 18 yrs or over and currently reside within Greater Glasgow and Clyde.
For further information please contact:
Dr Chris Clifford, Musculoskeletal Physiotherapist by telephone on 0141 331 8806 or by email chris.clifford@ggc.scot.nhs.uk

Resources

What is Osteoarthritis video (video 3 min watch)

Hip Exercises

Please make sure you have read through the important information about hip pain before proceeding.

Here are some beginner-to-progressive exercises to help you get your hip moving better. You may need to build these exercises up gradually.

You may be uncomfortable when you start doing these exercises – make sure the level of discomfort feels acceptable to you and that it doesn’t take too long to settle once you are finished.

The exercises should get easier the more consistently you manage to practice them and this may allow you to progress to more difficult exercises.

These are self help exercises:

• Try to enjoy the exercises and work at a pace and level that feels safe.
• Please use a common sense approach when deciding which ones to try.
• The exercises listed are not designed as an alternative to professional advice.

Exercise videos

Information Leaflets

• Lateral hip pain/ outer hip pain information leaflet (Greater Trochanteric Pain Syndrome)
• Lateral hip pain/ outer hip pain information leaflet (Greater Trochanteric Pain Syndrome)- printer friendly