Accepted referrals to the MSK Service

1. Dysfunction or pain related to the MSK system	Upper limb Shoulder Elbow Forearm, wrist and hand Lower limb Hip Knee Spinal Foot and ankle – this includes paediatric patients under secondary school age for MSK Podiatry.
2. Spinal pain	Mechanical presentation Neuropathic if no evidence of significant neural compromise/cord compression.
3. MSK/Orthopaedic post-operative rehabilitation	Please state rehabilitation protocol if outwith routine practice. Please add details of when treatment should be started and weight bearing status if appropriate.
4. MSK Persistent pain with functional disability	Consider if patient is ready to engage in self-management. Expectation of referral for improved function more than improved pain. Consider third sector support alongside the referral to MSK services.
5. Rehabilitation post MSK trauma or injury	Further investigation (X-ray) through primary care should be considered as deemed clinically appropriate and in accordance with clinical guidelines.
6. Mild to moderate osteoarthritis (O.A) for self- management	If over 45 and appropriate, please consider for x-ray and await results prior to referral to service. If moderate to advanced O.A is shown with significant functional disability, please consider an orthopaedic referral if the patient is suitable (medically fit, with no excessive BMI etc.)
7. Advanced MSK Pathology (degenerative changes) in patients that are medically unfit or non-consenting for surgical opinion	Please manage patient expectations that the focus of treatment would be towards long term self-management rather than significant pain reduction.