To think a physiotherapist can’t help me over the phone? (And probably not face to face either)

[MyFingerHurts21]

I have pain in various joints but predominantly in my fingers. This has been going on for about five years now (comes and goes). My fingers keep swelling and the pain keeps me from sleeping. I find it hard to grip and my fingers feel stiff. Two of the fingers on my right hand have changed shape and one of those fingers I can’t bend properly anymore. The pain is mostly in the middle (PIP) finger joints - they feel bruised if they are touched.

I have pain in other joints too (have done since childhood really) but it’s the fingers that are impacting most on my life as I can’t do activities I used to find fun due to the pain. I also have pain in my elbows, lower back, and knees. I have been to the GP several times over the past few years when the pain flares. They did a blood test about three years ago and concluded from that I don’t have rheumatoid arthritis. Well that’s great - but what is causing the pain? GP then decided I had DeQuevins tendonitis and tennis elbow and referred me to physio. Went to physio they gave me a splint for my thumb, told me to rest my hands and said my hands had low muscle tone and are extremely bendy (this is true all my fingers bend backwards). That was it, they discharged me and said they couldn’t really help.

Fast forward to now and the pain in my fingers is worse than ever. I had a consultation with GP asked to be referred to a rheumatologist as I want answers. GP wouldn’t refer me, told me I didn’t have rheumatoid arthritis, and gave me Naproxen for the pain. Rheumatoid arthritis is not the only joint condition though is it? As an example I could have Psoriatic arthritis, which is not beyond the realms of possibility considering I have Psoriasis.
A few weeks later I contacted the GP again (econsult) asked again for a referral. Again they say I had a blood test previously which shows I do not have rheumatoid arthritis. The pain is likely caused by hypermobility as suggested previously by physiotherapist. And they said they would refer me to the MSK team. I assumed this meant I would get to see an actual doctor who specialises in this sort of thing and can help me. But after waiting weeks it turns out no, it’s just physiotherapy. The letter said to call for an appointment, which I did. I was then told it would be a telephone appointment. In a months time! How is that actually going to help me? I’m so frustrated.

That’s encouraging that this initial physio appointment might be able to refer me to someone for a diagnosis.

Physios are able to do face to face appointments now so I'm not sure why they are saying it has to be a telephone consult?

@ViciousJackdaw I googled swan neck and boutonnières and it’s not really like that. The Swan neck a little as my PIP joints are often hyper-flexed. It’s more like the PIP joint just looks bigger making my finger not straight anymore. My nails are currently ok, I have longitudinal ridges and some like tiny splinter haemorrhages. I have had pitting in the past but never beaus lines.

Exactly @Twinkie01and the telephone appointment is over a month away.

Is it expensive to go private?

Physio can assess over the phone and arrange a f2f appointment if needed.

@MyFingerHurts21

My private physio is about £60 for the initial appointment where they diagnose the problem, then £40ish each for any further appointments. Phone appointments are cheaper though - around £30.

Good luck, I hope you can make some progress

@MyFingerHurts21

Can you have hypermobility and psoriatic arthritis? As I do think I could maybe have both.

I wouldn’t have thought hypermobility would change my finger shape. Unless of course it’s osteoarthritis due to extra wear and tear from the hypermobility.

Either way, I really hope this telephone appointment yields solutions.

I have psoriatic arthritis and hyper mobility. I don't have psoriasis but it is in my family. I generally get pain in my hands and feet. I take naproxen daily and have been on Hydrocychliroquine for years. This is a DMART drug that damps down the inflammation. Despite this, my fingers are all lumpy and bumpy. Although probably not as bad as they would have been without the drugs. I found the rheumatology physios and nurses to be the most helpful of all the staff I've seen. I'd give the physio a chance and ask if you can be referred to the rheumatology nurse. They're a mine of helpful information.

I’m hypermobile and symptoms initially presented very like rheumatoid arthritis - that was the diagnosis I was expecting. Your physio should be able to refer you to rheumatology for further investigations. I see my physio face to face and face throughout the 2nd and 3rd lockdowns.

And have! Phone has obviously decided I like the word face!

*hydroxychloroquin

YABU.
The physio (or even OT as they also work in hand therapy clinics) will assess you, treat you, offer advice on how to adapt and modify your lifestyle. Provide splints or pressure gloves to control any swelling/reduce pain if necessary. Provide an exercise plan if appropriate.
Even teach you to cope with the nightmaee situation that you are in.
They are also the gateway to consultant level care and can refer to them if they feel the need.
A telephone consultation will be more of a triage call, to ascertain exactly what the problem is and offer you the most appropriate face to face appointment according to that units waiting times. It can also be used to gain all the useful background info that will free up time in your face to face appointment, for clinical care.
Drs really aren't the only professionals who know what they are doing.

Our local photos is £50 for 45 minutes-so not overly expensive.

Twinkie01 But a private local physio won't have a direct line to her consultant. I'd keep the NHS appointment OP. Apart from anything else you will most likely see a therapist who is specialised in rheumatology and hands.