At the Consortium Physiotherapy Clinic Hull we see regularly see a large volume of patients complaining of back pain, neck pain, shoulder problems and knee issues.

Published in the British Journal of Sports medicine this year was a systematic review (source) of 44 best clinical practice guidelines. They highlighted huge gaps between what the growing body of research and evidence says we should do and what is actually provided in many clinics.

11 recommended key points

1. Care should always focus around YOU the patient

2. Your clinician should always screen you and try to rule out serious and sinister conditions

3. You should also be assessed for a variety of cognitive, social, lifestyle and emotional factors that are likely to influence your care

4. Imaging should not be routinely used unless you are suspecting serious pathology, have failed treatment and/or your symptoms are progressing and are hard to explain

5. You should be physically examined which may include neurological screening tests, functional tasks, flexibility and/or muscle strength

6. Your progress should be measured using tools called outcome measures which are often questionnaires that assess your musculoskeletal health

7. Education about your condition and the options open to you to help manage it is essential

8. Participation in physical activity and/or exercise should form a key part of your management plan

9. Passive treatments where you are mobilised, massaged or manipulated should only be used alongside other evidence-based treatments, this type of treatment should not make up the majority of your care

10. You should always be offered evidence based conservative management before being referred for a surgical opinion or considering surgery

11. Where possible we should help your either continue to work or assist you in getting you back to work