​Review highlights evidence for investment in physiotherapy for musculoskeletal conditions

A new report from the National Institute for Health Research (NIHR) shows investment in physiotherapy services for musculoskeletal conditions improves patient outcomes and reduces overall healthcare costs.

This themed review brings together more than 30 physiotherapy-related published studies funded by the NIHR and selected studies from other research organisations, which have made a difference to musculoskeletal care in conditions such as rheumatoid arthritis, low back pain and chronic knee joint pain.

Musculoskeletal conditions are the leading cause of pain and disability in the UK, affecting more than one in four people. The evidence coming out of Moving Forward: Physiotherapy for Musculoskeletal Health and Wellbeing highlights the importance of physiotherapy for treating these conditions.

"This is a wonderful showcase of high quality physiotherapist-led research that is making a difference to the lives of patients with musculoskeletal conditions," says Nadine Foster, Director of Keele Clinical Trials Unit and NIHR Research Professor of Musculoskeletal Health in Primary Care.

"It provides evidence of the difference that investing in musculoskeletal pain research makes for patients and the NHS."

Physiotherapy is important for preventing and reducing the negative impacts of musculoskeletal conditions. Moving Forward is particularly aimed at physiotherapy staff involved in direct clinical practice but is also relevant to other clinicians in the musculoskeletal care team.

Findings in the NIHR review include:

• Investment in high quality rehabilitation adapted to individual patient need leads to better outcomes, reduces further investigations and treatment, and reduces costs
• Physiotherapists offering advice on lower back pain reduced absence from work by an average of around five days.
• Telephone assessment by physiotherapists meant people waited an average of seven days for contact with a physio, compared to a usual average waiting time of 34 days.
• A rehabilitation programme including targeted exercise reduced knee joint pain and health care costs.
• Stretching and strengthening hand exercises improved function for people with rheumatoid arthritis
• There is overwhelming evidence that exercise and activity are effective and should be a core treatment in musculoskeletal pain. An NIHR review of over 60 trials – most for knee osteoarthritis – showed clear benefit of exercise

"This review brings together important current and impactful musculoskeletal research, giving clear direction to patients, physiotherapists, researchers, commissioners and planners of physiotherapy services," says Karen Middleton, Chief Executive of the Chartered Society of Physiotherapy.

"There are still challenges ahead, not least the long gap between the funding research and its impact on practice and patient care. We need clinicians and researchers to work more effectively together, for clinicians to be open to new ideas and new ways of working."