Why physio?

[Picklypickles]

I've been experiencing a lot of pain in my feet over the past year, the pain is in my toes and across the top of my feet and the sides of my ankles. I've seen my GP about this and have had bloods taken and x-rays done. I think the GP was thinking along the lines of arthritis or something like that.

Anyway, bloods all came back normal and so did the x-rays. So I asked what else it might be and where I go from here, all my GP said was that I should self-refer for an appointment with a physiotherapist, which I have done and am waiting for an appointment.

I don't understand why though? I don't know what is wrong with my feet, neither does anyone else. What will a physiotherapist be able to do? I have to admit I'm not very happy about having to go to see one, my dad's ex wife was a physiotherapist and was always talking about how physio's are all sadists who love to torture their patients.

This is nonsense. How can all physios (or even most) be young?they are highly trained professionals and can help with all sorts of issues with muscles, joints and connective tissue.

I agree that physiotherapists are wonderful health care practitioners, but this is worth a bit more consideration I think:

Anyway, bloods all came back normal and so did the x-rays. So I asked what else it might be and where I go from here, all my GP said was that I should self-refer for an appointment with a physiotherapist, which I have done and am waiting for an appointment.

The basic markers 'for' arthritis in first-line tests ordered by GPs do not show up all cases of inflammatory arthritis - far from it. Most cases of psoriatic arthritis are missed this way, as are over approx 30% of rheumatoid arthritis cases.

X-rays too are an imperfect tool for inflammatory arthritis and won't pick up co-morbidities like developing synovitis for example.

(I'm a long term psoriatic arthritis patient.)

This just isn't true - physiotherapy is a registered profession. I've underwent physiotherapist for a couple of different issues, and was very pleased with both the treatment that I received and the results.

I’ve seen some excellent physios in the last inc an nhs one. Latest private physio discovered my bone tumour in my ankle so they do know what they’re doing.

sounds like you might need a podiatrist though? But the physio will say so if they think that’s the case. Or or could be something mechanical higher up which is causing the problems in which case they should sort it.

Not 100% no, I first had the skin issue on my arm as a teenager and the GP I saw back then looked it up in a medical book and told me it was lichen planus. I was given a steroid cream and that cleared it and I had no more issues with it until my 30's when it started to show up on the soles of my feet and around my ankles and toes. My dad has it too on his calves, his is much worse than mine. I have seen my GP about it fairly recently as I had huge clumps of blisters on the sole of my foot, they had no record of my previous diagnosis strangely - same surgery! Looking at pictures of psoriasis though it doesn't look the same.

I had a wonderful physio who worked magic. I had a sudden horrific pain in one ankle, followed by the other ankle a couple of weeks later. Doctor couldn't find anything wrong and insisted I must have just injured myself by twisting an ankle or something, even though I was sure I hadn't, and that they'd get better with rest - they didn't. Physio took one look at me walking and spotted that my arches had an issue and my ankles were rolling, gave me adjusted insoles and the pain stopped within days. She also gave me exercises to do that strengthened my feet and ankles massively.

Actually after a bit more googling I've stumbled upon palmoplantar psoriasis, which looks exactly like what I get.

Thank you, this is all really helpful.

We're not all cruel to our patients.🙄
If I had a quid for every time someone said 'oh the physio-terrorist's here'.....sigh......

I'd try a podiatrist first, one who does ultra sounds and a proper bio mechanical assessment.

My physio misdiagnosed but two podiatrists agreed with a separate diagnosis.

Good to know, my dad's ex wife gleefully referred to herself as a physio-terrorist on a regular basis. She was a very strange person, good to hear she's probably in the minority!

Well she was a piece poor one or one with a twisted sense of "humour"
Brilliant (but private and not cheap) physio has been seeing both of us on and off for years, from DH sports injuries to my postural issues from hotdesking and bad pc use habits. He's professional but warm,explains all the treatment and what we can do to help ourselves in between appointments, even spotted from my odd pattern of shoe wear that I have knock knees and a weak ankle!
I recommend him to everyone.🙂

Autocorrect is prissy
Piss poor.

Even if it is arthritis, seeing a physio is a good idea. My daughter has arthritis and the physio is the HCP she sees the most. There's a specialist arthritis physio attached to her arthritis clinic. Whilst the DRs deal with the medication and the long term plan, the physios deal with the problems caused by the arthritis.

For example, my DD had arthritis in one knee. It caused her to walk differently and her affected leg lost tone, couldn't see anything was wrong with it at all, until the physio pointed out how much skinnier one leg was compared to the other. It was quite shocking the difference when pointed out. It's amazing how they see things so differently. A quick course of physio soon sorted the problem out. Physios can also give joint injections now.

It was also the physio who spotted my daughter had arthritis. The GP dismissed it as my daughter being a teenage girl who wanted attention! 😡

a physio will be able to help you with joint/ muscular pain far better than a GP. It’s a 4 year degree, they are highly trained. Unfortunately it often takes time and effort to follow the treatment plan as it’s often about ensuring you do the exercises they give you.

Physio cured me every time I've needed it

Our DS has been under a physio for many things. The GP missed the fact that he was hypermobile so had 'elastic' tendons and that, when he was younger, his feet hurt because of this. The physio got him to walk up and down the room, then up some stairs and noticed his feet 'twist' when he walks. She explained that, because of that motion, a mile walk would feel like four miles to him. She gave him some exercises, got him special insoles to help his gait and saw him regularly. The muscles have now developed enough to correct the floppy tendons so he not only walks properly but can now play football - he couldn't stand still on one leg before!

I've seen a physio because of a shoulder problem. Three sessions later I was pain free having seen the GP and been on pain killers plus having had x-rays.

And a couple of years ago, during first lockdown, I developed a problem with my arm. I couldn't reach up beyond a 45 degree angle to my body, couldn't get my arm behind my back or in my pocket. I had a steroid injection, x rays and was told by my GP that an operation was the only thing to fix it (rotator cuff injury). I saw a physio on line because of Covid restrictions. I hadn't been able to move my arm properly for 6 months by that time despite the steroid injection. Within three months I had full movement back again.

I think they're wonderful.

I have that myself, which is what made me wonder.

First thing that came to mind was lumbar L5 spinal issues. A physio assessment should be helpful.

My physio is excellent. She takes time to do proper examinations and has diagnosed problems more accurately than the GP (and explained the diagnosis). She’s sorted several problems out for me. I’d always be happy to go to a physio with a musculoskeletal problem.

I've 'discovered' physiotherapy since leaving the UK, it's routinely prescribed for my condition (MS) here in Belgium. It's fantastic.

Maybe the NHS these days does a cut-price version that is just stretches. But the practice I attend has lots of useful gear and the therapists see a lot that a doctor never has time to notice, about posture, movement, tension, asymmetries.... so definitely try.

Bollocks.

It might sound obvious but what sort of shoes have you been wearing? Are they a slip on type? I have had on and off problems with my feet - and I have worked out one of the issues is as I have gotten older when I wear shoes where the muscles in my feet have to work harder in shoes with little support that I develop foot pain. Improves dramatically when I wear trainers which have to be laced up as my feet are not working over time to keep shoes on / help me keep my balance. If your toes hurt is there a chance you a scrunching them to keep your shoes on? Do your shoes support you around your ankle? If not could explain your ankle pain. Particularly relevant if you have put on weight the last few years.

Usually trainers, at the moment flat walking sandals. I am overweight (working on it!) There's not many styles of shoe I can wear these days, my feet are a bit of a funny size and shape and I have ingrown toenails so I don't wear anything that's tight around my toes.