GREEN: Patients likely to benefit from MSK Physiotherapy  

Please provide as much detail as possible to help with the vetting process. Decision of priority remains with the vetting clinician.

Acute/ Sub-acute Soft tissue injuries/ trauma (0-12 weeks)

Post Fracture/ Dislocation (as deemed suitable by Orthopaedics/ A&E)

Low back pain +/- referred leg symptoms as per Low Back Pain pathway.

Note: Objective clinical examination findings including neurological assessment findings detailed on SCI referral will assist with appropriate prioritisation of referral.

Neck pain +/- referred arm symptoms 

Note: Objective clinical examination findings including neurological assessment findings detailed on SCI referral will assist with appropriate prioritisation of referral.

Thoracic pain 

Note: Ensure differential diagnosis considered and no significant red flags 

Specific MSK conditions i.e. Tendinopathy, Frozen Shoulder, Sub acromial pain

Undifferentiated MSK conditions

Mild to moderate Osteoarthritis (OA)- please direct to self-management resources initially (Physio MSK ) and Physiotherapy if required 

Note: If moderate to severe OA on x-ray with high levels of disability consider referral to Orthopaedics if the patient’s wishes are for surgery.

Complex Regional Pain Syndrome (confirmed or suspected)  

Note: Hand- Refer FAO Hand Therapists (Occupational Therapy in North Lanarkshire and Physiotherapy in South Lanarkshire). Foot- Refer to Podiatry. Post CVA- Refer to Neuro service. If previously seen by AHP but requires further input to help with management, please consider referring to chronic pain team.

Walking Aid/ Splint self-referrals for Walking Sticks, Elbow Crutches, 3 Wheel Walkers, 4 Wheel Walkers, Wrist Splints and Thumb Spicas (By appointment only)  

Note: Patients must be able to attend outpatient department- can self-refer via: Physio MSK 

AMBER: Patients might benefit from MSK Physiotherapy

Joint Hypermobility  

Note: If general joint hypermobility consider provision of self-management information (Versus Arthritis Hypermobility) and self-referral card to the patient. Patient can then self-refer if they feel they are at a point where they wish to engage in Physiotherapy.

Coccyx pain 

Note: Consider analgesia, ice pack and use of Coccyx cushion initially

Back pain with BMI > 40 if weight is felt to be primary issue 

Note: Consider referral to local weight management services if weight is felt to be the primary issue: LWMS 

Osteoporosis

Note: Consider referral onwards to Strength & Balance in Lanarkshire Leisure.

RED: When not to refer

Patients with suspected undiagnosed sinister/ serious pathology demonstrating red flags 

Information below is for guidance but clinical reasoning should be used in all individual cases.

Patients who are not at the stage where they can commit to a course of rehabilitation which may incorporate behaviour and/ or lifestyle changes

Patients who do not actively consent to being referred to the Physiotherapy MSK service

Non MSK conditions such as Respiratory conditions/ Systemic Neurological conditions/ Cardiac Rehab/ Long Covid/ Facial Palsy/ Temporomandibular Joint/ Intermittent Claudication

Age < 14. Referral information: Paediatric Physio

Referrals requesting MRI or imaging alone

Moderate to advanced OA in patients (based on combination of symptoms and functional impact +/- Radiological findings) who wish to be assessed by Orthopaedics and consider surgical intervention/ do not wish to engage with Physiotherapy

Heel Pad Pain, Metatarsalgia, Morton’s Neuroma, Hallux Valgus and other foot/ toe conditions 

Note: Patients can self-refer to Podiatry on 01698 753753. Website: Podiatry 

Widespread Chronic Pain

Note: Patient can be referred to chronic pain service Chronic Pain Service | NHS Lanarkshire
Note: Patient can be signposted to Pain Association Scotland
Note: Useful Information leaflet Living Well with Chronic Pain Information for patients 

Previous attendance at pain management service for same condition

Physiotherapy re-referral for patients who have completed Physiotherapy treatment for the same condition in the last 12 months  

Note: Consider reviewing the discharge letter from the Physiotherapy MSK service for further guidance/ information

House Bound Patients- Refer to Community Rehab in your area:  Community Support Service

Referrals for Wheelchairs- Refer to Westmarc if appropriate: Westmarc 

First time or recurrent traumatic shoulder dislocation/s in younger patients (aged 16-20) who are physically active 

Note: These should be referred directly to Orthopaedics

Referral for a specific stand-alone intervention e.g. Acupuncture referrals, Electrotherapy, Hydrotherapy, Steroid Injection.

Pelvic Floor Dysfunction- Refer to Pelvic Health Physiotherapy via SCI Gateway

Pregnant Patients with MSK condition related to their pregnancy or patients with pelvic floor issues up to 6 months’ post-partum. 

Note: Patients can self-refer to Mat Physio- send a text to 07792356516 with name/date of birth and brief message.

ME/ CFS

Note: As a first point of help the attached Patient Information Leaflet contains useful information on how to help manage this condition Myalgic Encephalomyelitis/Chronic Fatigue Syndrome 

Mild to Moderate Hand OA

Note: Patients can be referred to the Primary Care Occupational Therapy Team (Attached to GP practices)