To think my GP just dismissed me

Me saying the OP had unrealistic expectations has nothing to do with the time of the appointment. It was prompted by her saying "she didn’t try and get to the cause of why I felt stressed" which is not a medical issue. If I go to the GP and say that I am stressed and they ask why, does it mean I am less stressed now? If I feel anxious because I am going through a painful breakup, is this really a medical issue that GP can do anything about? Of course not.
I also said OP had unrealistic expectations because she felt that by referring to a physio rather than doing a physical exam, the GP "fobbed her off" whereas referring to a physio was exactly the right thing to do. Physios are trained to diagnose and treat MSK conditions. GPs (depending on their training placements) may have near zero experience with hands on examination. In fact, the receptionist should have booked an appointment with a physio to begin with but, as you said, you object to the idea of disclosing what you are booking for. So you end up going to the GP for triage and get upset that they refer you to an appropriate clinician to help with your issue.

Going to a physio is the best first step for the shoulder issue, and the headaches might be connected (my chronic headaches, which the GP just prescribed amitriptyline for, were cured by the physio, when she identified tense shoulders and neck as the cause and prescribed the right exercises to loosen them)
Mirtzapine is pretty commonly used for insomnia, my OH uses it, as did my ex. I prefer sedating antihistamines though, less side effects but in your case mirtzapine might be better as might help with the stress.

So, your doc could refer you to a physio for the shoulder pain but it would be a long wait.

The headaches and pain could well be connected so best to rule that out first.

I would start with a self referral to physio - if you have health cover at work this can often be directly without GP referral. Also maybe some over the counter anti-inflammatories.

Then focus on a bit of self care, bedtime routine, less screen time, book a good sports massage and so on, hot milky drinks and bath/ book.

Also check your pillows as they could have an impact.

If none of this helps in a few weeks, go back to the GP.

You also need to get to the source of the stress and try and find a solution for that if you can, its hard.

i suffer with chronic tension headaches due to stress and my dr prescribed amitriptyline. I initially thought it was an antidepressant which I didn’t need but they have massively helped my headaches reduce in frequency and severity

I agree with others about identifying your own stressors, rather than thinking a gp should do it. Then you can take steps to try and address them. Quite often a referral to physiotherapy for msk is the first step. How long have you had the shoulder pain ( you refer to it as chronic).

Actually, sounds like shoulder pain is connected to your other problems. My sister had a shoulder in a spasm for nearly a year. It was stress related, physio confirmed. Her husband was cheating at the time. There's no way GP would have sorted it. She had to.... once she sorted her personal problems, the shoulder pain eased.

I think your GP’s did well in a single appt when you raised several issues

a physio is completely appropriate for shoulder pain and dealing with that could help the headaches.

try the meds abd get physio started and go back to gp if it’s not helping

When i went to a GP with insomnia they wouldn't even consider prescribing me anything. I was later prescribed amitriptyline for migraine prophylaxis and they have a sedative effect which made me so sleepy! I would fall asleep in seconds when going to bed. I've since come off and the insomnia is returning... I miss my sleepy tablets haha. Although it is nice that I don't become completely useless at 10pm now.

Ask for a double appt

But I suspect some of these are connected. The ten minute thing is a problem but I don't actually know what service a patient is supposed to access if they want someone to take a look at a bunch of stuff that may be connected. I've said I have two issues and the receptionist has said one appointment is fine, but then you end up really rushing. I don't blame the GPs for being overworked, but there is a problem.

A physiotherapist doesn't provide a medical diagnosis; they do not have a medical degree.
The assessment that they do is focused on rehabilitation of movement, not identifying any underlying pathology/ disease.
Appropriate healthcare requires both.

We have an in house physio who usually has an appt within a week or two

I've been on mirtazapine when I wasn't sleeping during a particularly stressful period. It was amazing for helping me sleep totally knocked me out, but there's no way I would take it if I was on my own with young children. I was a zombie for the first few days of it. Fortunately I no longer need it.

Given that the op is not a doctor though, how is she to know the problems are not unrelated? They could be a number of symptoms for one underlying issue. I’ve only scanned this thread quickly but spotted two posters with the same symptoms who managed to get a diagnosis. When I brought my dd in once with multiple issues the doctor asked me to make a second appointment to deal with one of them separately. Surely they should have done that rather than fobbing her off?

...which the GP is doing by referring to a physio, who will be far more knowledgeable on MSK issues.

It doesn’t sound like they dismissed you. amitriptyline is commonly prescribed for chronic acute pain, so it would make sense they prescribed this based on your symptoms. I have had it when I had terrible back pain and it was brilliant, it took a couple of weeks to work. I also had a young child and no issues waking at night.

They need to investigate and diagnose what is causing the issues ffs!

GPs are there to give out pills. That’s it. They will never try to get to the root cause.

I think this is the way that GPs work - they go on balance of probability, and if the first thing doesn't help, they move onto the next thing. So the GP has suggested physio for the shoulder and anti-depressants for the insomnia. You are free to say that you don't want to take anti-depressants and would like something else to be investigated. If you want the cause of your stress to be examined you probably need to go to mental health support in your area (you can self refer) - not something a GP would do.

I can't see how your GP dismissed you. I think you might have expected too much.

When you book an appointment at my surgery you have to fill in a form where you say what the problem is and what you hope to get out of the appointment,. I think this is a useful thing for you to think about in advance of going.

I don’t think it’s unusual. At my gp thereceptionist would tell you to fill out online form (paper forms are available) to self refer to physio. Saves time / money.

Your GP did dismiss you. I honestly feel like it’s a waste of time going anymore. What if those symptoms are linked- no wonder things get missed.
I was referred to physio and my GP told me ‘it’ll be a waste of time and so is pain relief’. She said she lives in chronic pain, and it’s to be expected with sciatica. So that was the end of that.

If you can afford a private appt that’s what I would suggest. It’s what I’ll be doing.

The effect depends on the dose. It varies.

I found that as well, I think the therapeutic dose for depression is 60 or something? Treatment for pain is 10-30 but I found it really reduced stress anxiety at a low level too.

You'd refer straight away to an NHS physio? That seems very unusual! Good service, though.

I agree with this.

The main role of a GP in this country seems to be to dismiss and patronise, and avoid putting any effort into diagnosing a problem.