Case Studies

Symptoms started a year ago, and surgery for a nerve block procedure four months previously had left her in significant pain (scored between 7 and 8/10), on a high dose analgesic and unable to move. NHS physiotherapy treatment had had no effect.

Following the self-referral to fast-tracked physio, the treatment provided by Physio Solutions consisted of discussion and reassurance, progressive exercise, pacing, sleep advice, gradual but progressive introduction of normal activities of daily living (ADL), thermotherapy (heat to treat chronic pain) and we reviewed her analgesia (pain management).

At eight weeks following the self-referral, and five sessions later, she was able to return to work, with no neurological pain and residual pain of 4/10. She was able to complete day to day activities and her analgesia was reduced. Most importantly the individual was confident and knowledgeable about how to self-management her condition in the future.

She described a constant burning sensation around the knee, thigh and shin with a pain score 4/10. She was on restricted work duties and taking regular breaks away from her desk to rest her knee. She was taking over-counter pain killers and reported difficulty in walking.

Following a self-referral to PhIL, her treatment consisted of progressive exercise prescription, and advice was provided around posture, activity pacing, pain management, and how to take microbreaks during work.
The treatment lasted seven weeks and during that time telephone interventions were delivered.

Upon discharge, symptoms had fully resolved and she returned to full duties with no restrictions. She was experiencing mild, residual weakness; however, she was competent in doing her self-management exercise plan and she had now had both the plan and the skills to manage her knee on a long-term basis.

She continued to work full duties despite pain and difficulty sleeping. This was starting to impact her home life, which was demanding with four children plus her husband, and she started to experience strong emotions (with tears becoming more regular). Following self-referral to PhIL, treatment consisted of advice and education, pacing, micro breaks, progressive exercise prescription, physiology of healing, activity encouragement, stress management, trigger management, coping mechanisms, plus an onwards referral for psychological support.

Treatment lasted for 12 weeks. On discharge, she had virtually no pain. In terms of continuing self-management, she had the tools and the plan for ongoing stress management and preventative exercise program. She remained in work on full duties throughout the treatment.

Over the four years, she had sought help from her GP and tried both NHS and private physiotherapy. She’d made changes to her lifestyle and home but neither had any lasting effects.

She made the referral to Physio Solutions at the start of the pandemic (April 2020) in desperation, as there was no further support via the NHS. Physio Solutions assessing physiotherapist immediately identified red flags and wrote to her GP requesting an MRI, which had not been previously requested. The MRI identified an extensive spinal pathology and she was referred to a pain clinic and further spinal services were instigated.

She was discharged from Physio Solutions physiotherapy services but continued her treatment under a Consultant for ongoing investigations regarding a more sinister pathology.

This case was not resolved by PhIL, but we were able to quickly ensure this individual was signposted to the most appropriate medical intervention, which tragically had been missed for four years.

She was a regular runner and there was no other obvious trigger. Her pain score ranged from 5 to 8/10. She was able to continue with full work duties.

Following a self-referral to fast-tracked physio, treatment included advice, education, a progressive home exercise program, pacing, physiology of healing and a plan to return to running in 6-8 weeks.

An MRI identified bilateral medial tibial stress syndrome and collapsing arches; therefore, Physio Solutions instigated a referral to podiatry. Orthotics and prescription running shoes were prescribed by podiatry.
We continued with the physio treatment remotely which consisted of strength, conditioning and pacing to bilateral feet and ankles. Treatment lasted for five months.

She was discharged with all issues fully resolved and was running 5 km, three times per week with no issues.

She had undergone injection therapy without any improvement. She was remaining in work, on full duties, despite difficulties in lifting her leg, turning her hip, walking and sitting. She had disturbed sleep, her pain scores varied between 2 and 7/10 and she was taking over the counter medication.

Following self-referral, to PhIL her treatment plan consisted of a progressive exercise program, sleep advice and support, thermotherapy (heat to treat chronic pain), and advice around activity and how to avoid aggravating factors. Treatment lasted seven weeks.

Upon discharge, all issues were resolved.

He thought the trigger was bending forwards to lift. His pain score was 3/10, and was managing it with over-the-counter painkillers. He was able to remain in work on full duties.

Prior to lockdown he had attended privately funded physiotherapy, with some benefit. He was normally very active however had become more sedentary as a result of the closure of gyms and onset of pain. Following self-referral to PhIL, his treatment plan included a progressive exercise program, with strength, conditioning and pacing. His treatment was over a five-week period.

He was discharged from PhIL with significant improvement in his symptoms, and he was armed with a preventative back care management programme.

He returned to physical activity gradually and was able to reintroduce more aggressive impact activities.