Physiotherapy

This information is for anyone with axial spondyloarthritis (axial SpA), including people with ankylosing spondylitis (AS)

What is the role of physiotherapy?

A physiotherapist can help you improve your mobility and flexibility while reducing your pain. They can help you lead an active and independent life.

We recommend that everyone sees a physiotherapist for an assessment when they are diagnosed. You should then make sure you see your physiotherapist at least once a year after that. In many rheumatology departments you can now self-refer to physiotherapy if you have a flare so it’s worth checking the system in your department.

Your first visit

Your physiotherapist should carefully assess you. They should:

•     Listen to your medical history
•     Check your posture
•     Measure your flexibility, particularly in your back, trunk, neck and hips.

They will then be able to put together an individual treatment programme designed specifically for your needs.

This might include a course of treatment to help get you started with your exercises or to work on a particular area that may be causing you trouble at that time.

If you enjoy a particular sport or type of exercise then do chat about it to your physiotherapist to see if there are any adjustments you could make to avoid problems.

Your treatment could include exercise in a gym or in water, it may include ultrasound, gentle mobilisations or even acupuncture for pain relief.

Education

A big part of your physiotherapist’s role is to help educate you about your axial SpA, how it can affect you and what you can do to help you minimise the effect your axial SpA has on you and your family. Make sure you ask any questions you might have about work, sleep or anything else that may be worrying you.

Physiotherapists can give advice on posture at work, how to sit correctly at a desk, how a computer screen can be positioned and what height it needs to be.

If you do a lot of driving the physiotherapist can talk you through correct seat position, head rests and advise you on taking regular breaks.

Keeping your posture

A physiotherapist will teach you how to check your posture on a regular basis to monitor that it is not getting worse.

Developing a daily exercise programme

A physiotherapist will teach exercises you can do every day at home. A typical programme will include:

• Stretches, particularly to stretch out the muscles on the front of your chest, shoulders and hips
• Mobility exercises to help maintain or improve your range of movement in your neck, trunk, back and hips
• Strengthening exercises which will help you maintain excellent posture

A physiotherapist can also discuss the type of cardiovascular exercise that might be suitable for you to maintain your general fitness.

Physiotherapy referrals and self-referral

You can be referred for physiotherapy either by your GP or your rheumatologist or you can self-refer in many parts of the UK.

Wales – Anyone can self-refer to physiotherapy in Wales and details are available on individual Health Board pages of the NHS Wales website how to do so.

Scotland – How you get access to MSK services depends on where you are. Your local health board decide how each service is accessed and whether you can self-refer or if you would require to get a referral from a GP or other healthcare professional first.

Northern Ireland – Anyone can self-refer to physiotherapy in Northern Ireland and details are available on individual Health and Social Care websites on how to do so.

England – Not all areas in England offer self-referral, you can find out if it is offered in your local area by contacting your local NHS Trust or Clinical Commissioning Group. Most NHS Trust websites will have a page on physiotherapy which will tell you if you can self-refer or not. You can find your local NHS Trust or Hospital via the NHS England website.

You can access regular group physiotherapy sessions through NASS Branches.

If you are able to pay for your own treatment or have private medical cover then you can refer yourself for private physiotherapy treatment. To find a physiotherapist use the Chartered Society of Physiotherapy Physio2u Directory.  Some large companies also have occupational health schemes where physiotherapy may be available.