Physios have specialist skills – we must not underestimate the knowledge, skills and value of the physio

Liz, 52, from Stanhope County Durham, a Business Support Manager at Durham County Council explains how Connect Health physio identified symptoms of psoriatic arthritis, averting a potential unnecessary operation.

Symptoms were picked up that raised suspicion that psoriatic arthritis could be the cause of debilitating knee pain, which severely affected Liz’s mobility.

 

I work as a Business Support Manager at Durham County Council, a role I have had for 4 years and involves managing a variety of teams including quality, administration and management information.

About a week before lockdown, I saw my GP with pain and lack of movement in my right knee resulting in having an x-ray. I was given telephone feedback from the GP to say I had moderate arthritic changes in the knee. Once clinics were back to normal I would be able to start treatment, which would potentially involve an operation on my knee.

No one knew the extent of the lockdown at that stage. Then about a month later my other knee had similar symptoms. Going up and down stairs and getting out of the chair was becoming extremely painful. My knees were swollen, lumpy, full of fluid and didn’t bend.

I rang the doctor and he told me to take the highest dose of ibuprofen and another medication to protect my stomach. It did help and made a difference, but I was still struggling to walk.

Six weeks into lockdown, I noticed on the Durham County Council intranet page an article that showed that employees could access remote physiotherapy.

I’d already been told by the GP that physio would be useful so I was interested to find out more. I did what the intranet said and that resulted in me having a telephone conversation with Mark, the Connect Health OH Physiotherapist.

The physio wrote to my GP to request a rheumatology opinion.

As part of the questions asked, I informed the physio that approximately 4-6 weeks before my first knee had become painful, swollen and unable to bend, I had mentioned to the GP that my psoriasis had flared up.

My symptoms presented as osteoarthritis but due to the other symptoms, the physio suggested there may be a link that required further GP and rheumatology attention.

In addition, when Mark found out that I was responding to ibuprofen, he said that could signal a type of arthritis that could be linked to psoriasis. He gave me some exercises to do. But I couldn’t do them as my legs were almost frozen.

He advised me to ring the GP with his ideas and the GP agreed with his diagnosis and that there could be a link. The GP said he would speak to a consultant rheumatologist to explain the case on my behalf and they both agreed with the physio that it was extremely likely I had psoriatic arthritis.

The new diagnosis required a completely different treatment option.

I was given a short course of steroids for 6 weeks and within the first few days, movement had returned. I could bend my legs, walk my dog and walk upstairs. It was literally within the first week that mobility returned.

If I hadn’t taken the steroids, there would be a risk of permanent damage to my joints.

I could have been left with constant swelling. I’m still stiff but not on any medication now. I can sit in a chair, get upstairs and can drive again.

I’m doing the exercises now which are helping. It’s hard to believe that since early March I have had so very little movement until recent months.

The physio’s questions had given thorough answers.

I now have to see the rheumatologist – the condition I have won’t go away but it can be managed with different medication when I have a flare up. An interesting side effect is that my psoriasis has calmed down. I’ve had it since I was a child and I didn’t realise that it was an inflammatory condition.

The physiotherapy from Connect Health was completely brilliant.

I think I’m very lucky to have it paid for by my employer. The OH physio had a specialism that the GP surgery didn’t have on the condition. It is easy to assume from someone’s age that it’s the most obvious diagnosis but that isn’t always the case.

Mark was very thorough with the questioning. A couple of times when I spoke to him, he was doing training with young physios over the call which I thought was really good. Obviously, his questions had given him the answers for further investigation.

Amazingly all this has been achieved by not seeing anyone face to face due to Covid.

The next step is to physically see a rheumatologist and work out long term how I can stay mobile. I’ve also looked into my diet and hope to reduce inflammatory foods, such as sugar.

The Connect Health remote physiotherapy service was excellent. It was very easy to access and, in my case, made a huge difference. The physio was very efficient, everything was dealt with quickly and the level of knowledge was extremely high. Overall, I had a very positive experience.

 

 

Download Liz’s full story here

Find out more about Connect Health’s Occupational Health Physiotherapy Services here

 

(Name has been changed and photograph posed by model to protect individual’s privacy).