Invest in physiotherapy to improve outcomes and cut costs, says national health research review

^{The review highlights that exercise is effective for musculoskeletal pain}

This is according to a new report from the National Institute for Health Research (NIHR), titled Moving Forward: Physiotherapy for Musculoskeletal Health and Wellbeing.

The review, published on 9 July, presents evidence from a range of physiotherapy-related studies, including 30 funded by the NIHR as well as many others from various research organisations.

Data from these studies shows the beneficial impact physiotherapy has on a range of MSK conditions, including rheumatoid arthritis, chronic knee joint pain and low back pain.

The findings show that

• investment in high quality, individually-tailored, physiotherapy led rehab could reduce further investigations, cuts costs and lead to better outcomes
• work absences can be reduced by an average of five days when people receive advice on low back pain from physios
• knee joint pain and health care costs can be reduced by a physio-led rehab programme, which includes targeted exercise
• stretching and strengthening hand exercises can improve function for people with rheumatoid arthritis

Nadine Foster, a physiotherapist and NIHR research professor of musculoskeletal health in primary care, said: ‘This is a wonderful showcase of high quality physiotherapist-led research, which is making a difference to the lives of patients with musculoskeletal conditions.

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

Make exercise a core treatment

The review also highlights that there is overwhelming evidence that exercise and activity are effective for musculoskeletal pain.

For example, in over 60 reviewed trials – most of which focused on knee osteoarthritis – exercise showed a clear benefit.

As a result, the review advises that exercise should be a core treatment.

CSP chief executive Karen Middleton said: ‘This review brings together important current and impactful musculoskeletal research, giving clear direction to patients, physiotherapists, researchers, commissioners and planners of physiotherapy services.

‘There are still challenges ahead, not least the long gap between the funding of 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.’

Evidence-based interventions

The NIHR research review follows the launch, on 4 July, of an NHS England consultation that is seeking feedback about its plans to identify procedures that are not clinically effective, or which only work when performed in specific circumstances.

The Evidence-Based Interventions programme initially aims to examine the effectiveness of 17 interventions. These include knee arthroscopy surgery for osteoarthritis, arthroscopic shoulder decompression for subacromial shoulder pain  and injections for people with low back pain who don’t have sciatica.

A public consultation on the proposals, which is open until 28 September, will include a series of webinars and face-to-face events, where professionals and patients can share their views.

Responses can also be submitted via an online survey or by emailing: england.EBinterventions@nhs.net

Author: Robert Millett