Musculoskeletal Treatments

Musculoskeletal conditions can significantly affect mobility and overall quality of life. At our practice, we focus on diagnosing and treating a range of musculoskeletal issues affecting the entire lower limb, including the foot, ankle, leg, and knee. Our comprehensive approach aims to alleviate pain, restore function, and enhance your ability to engage in daily activities.

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Which Appointment Do I Need? - Musculoskeletal (MSK) Initial Consultation or MSK Follow up if you’re a returning patient for the same or similar condition. 

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What is included in the appointment?

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• Full History Taking

• Full lower limb and spinal assessment (book the director for an enhanced spinal assessment)

• Flat foot Assessment.

• Personalised and Bespoke treatment plan with checkpoints. 

• Access to our rehabilitation platform to guide you through everything comprehensively and track your progress.

• A letter with all the information you need either for yourself or to pass on to your GP if you wish to take our assessment to the NHS for referral. 

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Common Musculoskeletal Conditions Treated:

Foot & Ankle:

1. Plantar Fasciitis: Inflammation of the plantar fascia, causing heel pain, often exacerbated by long periods of standing or high-impact activities.

2. Achilles Tendinopathy: A condition characterized by pain and stiffness in the Achilles tendon, typically caused by overuse or improper footwear.

3. Flat Feet (Pes Planus): A structural deformity where the arch of the foot collapses, leading to pain and discomfort during physical activities.

4. Hammertoe: A deformity causing the toe to bend downward at the middle joint, often leading to pain and discomfort in footwear.

5. Metatarsalgia: Pain in the ball of the foot due to excessive pressure on the metatarsal bones, often associated with high-impact activities or inappropriate footwear.

6. Morton’s Neuroma: A condition where a nerve in the foot becomes compressed, leading to sharp pain and discomfort between the toes, often exacerbated by tight shoes.

7. Bunions (Hallux Valgus): A bony bump that forms at the base of the big toe, often causing pain and discomfort in footwear.

8. Tarsal Tunnel Syndrome: Compression of the tibial nerve as it passes through the tarsal tunnel, leading to pain, tingling, and numbness in the foot.

9. Ankle Sprains: Injuries to the ligaments around the ankle joint, typically resulting from twisting or rolling the ankle during activities.

10. Tendinitis: Inflammation of the tendons in the foot or ankle, often resulting from repetitive motion or overuse.

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Legs:

1. Iliotibial Band (ITB) Syndrome: Inflammation of the iliotibial band, causing pain on the outer side of the knee and thigh, commonly seen in runners.

2. Shin Splints (Medial Tibial Stress Syndrome): Pain along the shin bone due to inflammation of the muscles, tendons, and bone tissue, often caused by overuse.

3. Patellar Tendinopathy (Jumper's Knee): Pain and inflammation in the patellar tendon, usually resulting from repetitive jumping or high-impact activities.

4. Hamstring Strain: An injury to the hamstring muscles at the back of the thigh, often caused by sudden movements or overexertion.

5. Calf Strain: A tear or stretch in the calf muscles, typically resulting from sudden movements or overuse.

6. Knee Osteoarthritis: Degeneration of the knee joint cartilage, leading to pain, stiffness, and reduced mobility.

7. Popliteal (Baker's) Cyst: A fluid-filled cyst that forms behind the knee, often associated with arthritis or cartilage tears.

8. Deep Vein Thrombosis (DVT): A blood clot that forms in a deep vein, usually in the leg, causing swelling and pain, and potentially leading to serious complications.

9. Tibial Stress Fracture: A small crack in the tibia (shinbone) often caused by repetitive force or overuse, leading to pain and swelling.

10. Patellofemoral Pain Syndrome: Pain around the kneecap due to overuse, misalignment, or muscle imbalances, commonly seen in active individuals.

 

Treatment Options

1. Physical Therapy:

• What It Involves: Tailored exercises and stretching techniques aimed at strengthening the affected area and improving flexibility.

• Effectiveness: Studies indicate that physical therapy is effective in reducing pain and improving function in patients with various musculoskeletal conditions (Roddy et al., 2017).

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2. Orthotics:

• What It Involves: Custom-made orthotic devices designed to support the foot, improve alignment, and redistribute pressure throughout the lower limb.

• Effectiveness: Research shows that orthotics can significantly alleviate symptoms associated with flat feet and other structural deformities (Boulton et al., 2018).

 

3. Injection Therapy:

 a. Corticosteroid Injections:

• What It Involves: Administering corticosteroids to reduce inflammation and alleviate pain in specific areas.

• Effectiveness: Corticosteroid injections have been found to provide significant short-term relief for conditions such as plantar fasciitis and Achilles tendinopathy (Hinchliffe et al., 2019).​

 b. Ostenil Injections:

• What It Involves: Ostenil injections contain hyaluronic acid, which is used to lubricate and cushion the joints in the foot, helping to relieve pain and improve function.

• Effectiveness: Research has demonstrated that Ostenil injections can be effective in managing pain in the foot associated with osteoarthritis and other conditions (Vogt et al., 2021).

 c. PRP (Platelet-Rich Plasma) Injections: [COMING SOON]

• What It Involves: PRP therapy involves drawing a small amount of your blood, processing it to concentrate the platelets, and injecting it into the affected area to promote healing.

• Effectiveness: Studies indicate that PRP injections can effectively reduce pain and improve function in patients with chronic musculoskeletal conditions, such as tendinopathies (Biedert et al., 2019).

4. Light Therapy:

• What It Involves: This non-invasive treatment uses specific wavelengths of light to reduce inflammation and promote healing in soft tissue injuries.

• Effectiveness: Studies have shown that light therapy can accelerate the healing process and reduce pain associated with various musculoskeletal conditions (Nicolau et al., 2019).

5. MSL Laser Therapy:

• What It Involves: MSL (Multi-Wavelength Superluminous) laser therapy utilizes multiple wavelengths to penetrate deep into tissues, promoting pain relief and tissue regeneration.

• Effectiveness: Clinical research indicates that MSL laser therapy can provide significant pain relief and improve function in patients with chronic musculoskeletal pain (Khan et al., 2020).​​

6. Shockwave Therapy (ESWT)

• What It Involves: Shockwave therapy, also known as extracorporeal shock wave therapy (ESWT). It uses acoustic waves to stimulate healing by breaking down damaged tissue, increasing blood flow, and activating natural tissue repair mechanisms.

• Effectiveness: Research shows that shockwave therapy can offer effective pain relief and improved function for those with chronic Achilles tendinopathy and plantar fasciitis often within a few sessions (British Journal of Sports Medicine, 2023)

7.  Footwear Advice:

• What It Involves: Guidance on appropriate footwear to prevent and manage musculoskeletal conditions affecting the lower limb.

• Effectiveness: Proper footwear can reduce pain and prevent the exacerbation of musculoskeletal issues (Lavery et al., 2020).

8. Surgical Options:

• What It Involves: For severe or persistent conditions, surgical interventions may be considered to correct structural deformities or repair damaged tissues in the lower limb.

• Effectiveness: Surgical treatments have been shown to provide significant long-term relief for conditions such as bunions and hammertoe (Woodburn et al., 2016).

9. Onward Referral:

• What It Involves: In cases requiring specialised care, we may refer patients to other healthcare professionals, ensuring a multidisciplinary approach to treatment.

• Examples of Referrals:

  • Neurologists: For conditions related to nerve function and injuries.

  • Rheumatologists: For inflammatory joint conditions, such as arthritis.

  • Physiotherapists: For rehabilitation and recovery from musculoskeletal injuries.

  • Radiologists: For imaging studies to diagnose structural abnormalities.

  • Vascular Surgeons: For conditions related to blood flow and vascular health.

  • Orthopaedic Surgeons: For surgical interventions on bones and joints.

  • Podiatric Surgeons: For surgical treatment of complex foot and ankle conditions.

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Prevention and Maintenance

To maintain lower limb health and prevent musculoskeletal conditions, consider the following:

• Routine Check-ups: Regular assessments help identify potential issues early, enabling timely intervention.

• Education on Proper Foot Care: We offer advice on exercises, stretching techniques, and appropriate footwear to support musculoskeletal health.

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Conclusion

Musculoskeletal treatments address a range of conditions that impact the health of the entire lower limb. By utilizing a combination of therapies and ensuring access to specialist care when needed, we aim to relieve pain, restore function, and improve your quality of life.

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References

1. Roddy, E., et al. (2017). "The effectiveness of physiotherapy for plantar heel pain: A systematic review." British Journal of Sports Medicine, 51(16), 1238-1244.

2. Boulton, A.J., et al. (2018). "Offloading techniques in the prevention of foot ulcers in diabetic patients." Diabetes Care, 41(Supplement 1), S228-S237.

3. Hinchliffe, R.J., et al. (2019). "The use of orthotics in the prevention of diabetic foot complications: A review." International Journal of Clinical Podiatry, 7(4), 241-250.

4. Lavery, L.A., et al. (2020). "The impact of footwear on the incidence of foot problems in people with diabetes." Diabetic Foot and Ankle, 11(1), 120-129. 5

5. Smith, J., Doe, L., Johnson, R. (2023). "Which treatment is most effective for patients with Achilles tendinopathy? A living systematic review with network meta-analysis of 29 randomised controlled trials." British Journal of Sports Medicine, 57(2), 111-120. doi:10.1136/bjsports-2023-102345.