iPCHS research reinforces the importance of physiotherapy in treating musculoskeletal conditions


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Posted on 11 July 2018

The National Institute for Health Research (NIHR) Dissemination Centre has released their latest Themed Review, which demonstrates the return on investment in physiotherapy research for musculoskeletal conditions such as back pain, osteoarthritis, and rheumatoid arthritis. The review summarised 55 research studies, many of which were led by the Research Institute for Primary Care and Health Sciences (Keele University), working in partnership with local and regional NHS Trusts and GP Practices. 

Musculoskeletal conditions (pain in the joints, ligaments, muscles, nerves, tendons) are the leading cause of pain and disability in the UK, affecting more than 10 million people. These conditions can have a huge impact on a person’s quality of life, as well as affecting their family, friends, carers and the wider society.

The review, ‘Moving Forward: Physiotherapy for Musculoskeletal Health and Wellbeing’, published this week, brings together high-quality research from over the past decade, with the aim to give a clear direction to patients, physiotherapists, researchers, commissioners and planners of physiotherapy and musculoskeletal services.

Amongst the research featured in the review, was the ‘PhysioDirect’ Trial, a collaboration between Bristol and Keele Universities and four NHS physiotherapy services. The randomised trial assessed the use of a telephone assessment and advice service to provide patients with faster access to physiotherapist advice.

The service provided faster access to physiotherapy, with a waiting time of 7 days as opposed to 34 days. Fewer face-to-face appointments also provided a substantial return on investment in healthcare savings.

Public Health England went on to recommend the service as one of seven preferred interventions for treating patients with a musculoskeletal condition.

Also featured, is the Keele ‘STarT Back’ stratified care approach for low back pain, developed and tested by Keele researchers over the last decade in a randomised trial and a quality improvement (or implementation) study.  The STarT Back tool identifies an individual patient’s risk of persistent disabling back pain and helps healthcare professionals to better match patients to the available treatments.

STarT Back intended to improve patient’s outcomes and make good use of healthcare resources. It was successful in reducing unnecessary investigations and saved money by reducing repeat GP consultations, referral rates to secondary care, medications, and investigations such as MRI scans.

Both Public Health England and the National Institute for Health Care Excellence (NICE) guidelines recommend STarT Back, and the tool is now freely available to the NHS.

NIHR Professor of Musculoskeletal Health in Primary Care, Nadine Foster, and ARUK Professor of Musculoskeletal Therapies, Krysia Dziedzic, were part of the expert group steering the Themed Review over the last six months. Both Prof Foster and Prof Dziedzic presented at the official launch on Tuesday 10th July in BMA House in London, where they showcased some of Keele’s research studies, and led a discussion on implementing the high-quality evidence presented within the review.

Professor Foster commented: “It’s absolutely fantastic to see so much of our research showcased in this important review, which celebrates how the quality and impact of musculoskeletal research is delivering improvements in the quality of patient care.”

“This NIHR Themed Review is really relevant to physiotherapists, patients, service managers and commissioners of musculoskeletal services, and will help disseminate key research further, and make a real difference in the way that practitioners treat patients with musculoskeletal conditions.”

Professor Dziedzic added: “I really hope that this review will act as the benchmark for wider engagement in research, evaluation and implementation within the field of musculoskeletal health. I’m looking forward to working with all key stakeholders, including patients, carers, and the public, to see how this evidence can transform physiotherapy services for those with musculoskeletal pain.


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