To think NHS Physiotherapist aren't up to scratch?

[WinterBones]

I concede it may just be my immediate Health Area.. but holy shit.

I have suffered with chronic back/hip pain since i was a teenager, i'm now in my mid 40s... i have seen the NHS physiotherapy team at least 5 times in that period.. both the hospital and my GP's own physiotherapist.

The hospital physios have only ever laid a hand on me once, which ended in a referral, but every other time they just ask me what's wrong, which i tell them, but they do ZERO investigation or assessment of my movements/mobility, throw the same 6 exercises at me, and tell me to lose weight.

This last time i went through the same thing, no hands on, despite me reporting even worse pain and losing mobility, then the GP one decided i needed the pain management clinic. (who refused the referral ftr)

Out of desperation and pain i finally coughed up £100 for a private sports physio to look me over and do a proper assessment. In the hour i was with him he moved and manipulated and tested and checked every aspect of my movement and pinpointed some quite alarming problems that were the cause of some of my other pain, things that the NHS would never have picked up on.

26 years i've been in pain, 26.. and NHS have missed multiple opportunities to help me, and failed me every damn time.

The Private Physio has put a letter in to my dr and now got me more referrals and scan requests, and is also working with me to try and help me move better/with less pain, rather than handing me a sheet and telling me to do it myself.

This isn't ok, and i am so angry with the NHS right now.

I feel the same OP, and I’m pretty angry that I was left to suffer with severe hip and back pain from drop foot (caused by MS), along with an agonising trapped nerve in the affected ankle, and a level of fatigue from how much work my body had to do to compensate that I lost my financial independence.

An NHS Neurophysio ‘diagnosed’ me over the phone with sciatica and suggested I stop running. I didn’t stop running, as running and yoga were all I had to keep me physically and mentally well. Running was easier than walking because of the way the leg lifts.

After 10 years of pain and increasing inability to walk more than short distances without a rest, I was lucky enough to speak with an OT who immediately saw I had foot drop and referred me for a device which flexes my foot for me when I walk.

I’m furious about the years I lost, and the pain I endured, and now if I have any mechanical issues with MS I google my symptoms for physio exercises. If I’d listened to the supposed specialist physio back then, I wouldn’t now be able to walk well enough to use the FES device which she denied me for a decade. I shudder to think how many people have become permanently disabled on such poor treatment.

I think it probably varies a lot. The NHS physio who treated my frozen shoulder was honestly brilliant.

I agree, I have had private physio and NHS physio the two things aren't comparable.
The NHS physio sees you for 5mins and prints off a sheet of paper with exercises on it hands it to you and you are on your way.
Private one examines and manipulated you, demonstrates exercises, gets you to video them doing the exercises for reference, then checks you can actually do them. Will see you weekly (obv you're paying!) NHS will see you monthly if you're lucky.
Sadly I thought NHS physios are a bit of a waste of time they really need to examine you, manipulate you/massage you.
I did see one excellent physio for a frozen shoulder who "broke the rules" by manipulating me, but told me he is wasnt really allowed to do it, sadly I only saw him twice.

The problem with the NHS is that it has now reached the stage of it being so inefficient and useless it becomes a cycle.

People aren’t treated or diagnosed properly at the initial appts. This stores up more problems further down the line that then cost more to fix.

This “they can’t spend that much time on an appointment” - well if they did they wouldn’t be so fucked further down the line.

They do have lots of physios. At least mine does.

CBT and pain meds are there, but they want to help you get moving without pain, so there’s really specialised physios too

That is a massively sweeping statement, @WinterBones.

My toddler had the most amazing NHS paediatric physiotherapist.

@Toddlerhelpplease123 wow! would you possibly DM me if your x-ray physio is based in Scotland?

I don’t think this is necessarily the physios fault but the fault of the nhs. I’ve seen both nhs and private and the fact is nhs physios literally have 20 minutes to see you and assess you and give you exercises etc. the sessions are specifically developed to be mostly hands off in outpatients. This is an nhs decision rather than individual physios.

I paid a huge amount for private physio and she had much more time for hands on work, special treatment and specialist equipment. But I was paying for that service.

Current physio applicants have to show a very good understanding that 95% of physiotheray work is in hospitals working with neurological teams and occupational therapists usually with patients following strokes rather than on a rugby player's sport injuries. My daughter has applied and this was made abundantly clear and they especially wanted to see work experience in these nhs departments to support the application.

See an osteopath. I’ve seen physios for injury recovery and for weakness after a major surgery, but they aren’t the best professionals for managing long term pain. An osteopath was amazing for my back pain. I saw her maybe every 6-9 months for a few years for one visit and hardly ever now.

Ime all physios are like this. I went to a private one for ages and she did at least touch me but missed that I had EDS.

went to see an osteopath who within ten mins told me he thought I had EDS. He was right.

I know a physio lecturer and she says current training is very much exercise advice focused not hands on. I can ask chatgpt for that.

I currently see a good level 7 qualified sports injury therapist. Best by far out of all. Very hands on plus exercise regimen for recovery.

But agree you absolutely need scans etc after this time frame so good the private physio has started that. And that he’s hands on

i just has an MRI after twenty years of back and hip pain and have been diagnosed with ankylosing spondylitis. If I hadn’t gone and told my gp I thought I had it no nhs person would have diagnosed me

Absolutely my experience too. I very suddenly became debilitated with back pain so severe I couldn’t sit on the loo or walk. NHS ruled out cauda equina and sent me on my way (in a wheelchair!) with no diagnosis. NHS physio appt came through 2 months later and I was handed a printout of 1 page of exercises.

By then I’d had 8 sessions of private physio which including manipulation of the area and I had recovered 80% of my mobility. Whatever the NHS spends on physio is a waste imo - they might as well not bother!

As far as I know NHS physios are limited with what they can offer, my friend put her back out and the physio said she could benefit from soft tissue massage but she wasn't allowed to do that via the NHS any more. So friend paid for it privately at another physio and got the problem sorted.

The guy i'm seeing is a sports rehab specialist, Definitely a diamond of a find!

The statistics re: physiotherapy graduate jobs unfortunately don’t match up with that statement. Only 1/3 of last year’s cohort at our local university are now working in hospital based jobs. A close friend lectures on ICU physio and many students are largely disinterested with that aspect of the profession. The vast majority take the trendy sports physio route or just go and work in private outpatient MSK clinics fresh out of university - there’s nothing wrong with that but new graduates have a huge amount still to learn + experience which can only be achieved via the variety (and supervision) you get on B5 rotations in a hospital based setting. There should be a compulsory 2 years of post-graduate foundation training like there is with medicine in my opinion.

I wish your DD all the very best with her applications - she sounds really motivated and knowledgeable. It’s a brilliant, diverse career and I can truly say that I love my job!

NHS physios provide a totally different service to private physios. It’s like comparing apples and oranges.

Ours are truly awful. You get a sheet of exercises and are told to get on with it.

and two large elastic bands ha ha

Yep. I have had the exact same experience. I have started to think it's the Emperor's New Clothes physiotherapy-wise.

Yep. Went for 2 years and they wouldn't touch me. Exercises, stretches. Wouldn't refer me.

Paid private and the Dr. physically put my kneecap back into the correct place. Walked out without a stick. Have had a long recovery because all the other tendons, muscles etc adapted to my limping. But kneecap in correct place now

Exactly this and same applies to mental health. It's so short sighted

@CerealPosterHere okay but you know that osteopaths aren’t real health professionals and it’s just quackery right?

I'm actually barred from NHS physio treatment.
My crime?
I asked if I could see a different physio because the one I had seen on 3 occasions ignored me when I said her manipulation of my neck was actually causing me a significant enough amount of pain that I felt sick, and on that last occasion I actually burst into tears. I did so politely, suggesting I expected some discomfort as that was what she had told me, but this was agonising and actually, rather than improving my situation, it was actually making it worse and taking several days of painkillers to get over seeing her.

When she was then rude and defensive, I made a point that I hadn't wanted to offend her but she had said if I felt pain or discomfort to say something.

I left the appointment and spoke to the lady who booked the next appointment. Mentioned that I would like to try a different physio, she asked me if I had been crying and I said, yes, this is why I would like to try someone else. She then said she would get someone to call me before booking a different appointment.

I then received a request to call my GP two days later.

GP told me physio had now refused me any further appointments due to "racism" and "aggressive abuse" to the physio!

GP was surprised by this and said he wanted to understand my side of the issue, which I told him. I said nothing about anyone's race and certainly wasn't aggressive.

He said he would contact them and get back to me. He did so and they denied it all, been when I suggested checking CCTV and asking the lady on the appointments desk who denied I had mentioned it.

About 6 months afterwards, I met a mum at a party who had seen the same person, who had also been injured by her and when she raised it, politely like me, she was also accused falsely of aggression and racism. She had met others who faced the same accusations for saying, actually that hurts

Unfortunately, I can't afford private physio, so I'm now in constant pain- I hadn't had constant pain prior to seeing the physio.

So I covered tertiary education.

Wrt training, she’s an orthopaedic surgeon so one assumes she has some idea of the training of the physios she’s referring her patients to.

However, her comments related more to her own personal experience of physio as I was complaining I had been referred to NHS physio 3x and all they did was give me exercises. She recommended hers and said she was NHS trained originally but older and now works in private practice.

I cannot tell you what happens these days between physio degree and NHS practice, as the students who go into NHS and private work have presumably studied the same things. I’d assume NHS provide further training of its own. But it certainly seems that outpatient practice is very different.