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Please be aware that the MSK service may utilise telephone and video software to enable the physiotherapist to complete a remote assessment. The telephone number will be withheld so please make sure that your phone allows you to receive incoming calls from withheld numbers.
If a video call is required, you will need to download the appropriate software to your mobile phone/tablet/laptop/PC and ensure that you have a web camera and microphone. In order to send the invite to the video call, we will require an e-mail address. If a video call is not possible, you will still receive a telephone assessment.
Self-refer into our physio service
Before you complete the self-referral form
- Have you been using the advice and tips on the self-help sections for around 8 weeks?
- Are you still feeling pain or discomfort?
- Are you registered with a GP practice in Evesham, Droitwich, Pershore, Malvern, Tenbury, Worcester, Upon, Redditch or Bromsgrove?
If you have answered yes to all the above then you should complete the below form, providing as much information as possible.
Please enter the following information and press submit once. Once submitted you will receive a read receipt via a no-reply e-mail.
Outcome of referral:
Your referral will then be triaged by a physiotherapist. Please note, from triage, there are different options that a physiotherapist may deem appropriate including:
- referral directly into the Joint Pain Education Group
- referral for a 1:1 consultation with a physiotherapist (either remote or face to face)
- referral directly into specialist services (e.g. Functional Restoration).
Following your consultation the physiotherapist may also deem it appropriate to refer you to other services or groups:
- Advanced Physiotherapy/Podiatry Practitioner
- Functional Restoration
- A strength or exercise class
If you are offered a remote appointment you will be informed of this at the time of booking.
You can call 0300 790 0599 (Monday - Friday: 8.30am – 12.30) to check the progress of your referral or to cancel an appointment that you no longer require.
*Please note if you are unable to complete this online form you can contact 0300 790 0599 (Monday - Friday: 8.30am – 12.30) and a paper version will be sent out in the post to you.
Important patient information
‘Cauda Equina Syndrome’, although rare, can cause a permanent change to your bladder and/or bowel function, or foot strength. Cauda equina syndrome is a condition that occurs when the nerves at the base of the spinal cord become squeezed in the spinal canal. This can happen quite suddenly or gradually. It can cause pain in the lower back and/or legs, numbness or weakness in one or both legs, in the buttocks or between the legs (the ‘saddle region’). It can also cause problems with bladder or bowel control and sexual function.
If you are suffering with low back pain and if you have any changes regarding the following since your pain started;
- Bladder or bowel function (i.e., Increasing difficulty when you try to urinate, increasing difficulty when you try to stop or control your flow of urine, loss of sensation when you pass urine, leaking urine or recent need to use pads, inability of knowing when your bladder is either full or empty, inability to stop bowel movement or leaking, loss of sensation when you pass a bowel motion)
- Loss of sensation / tingling around genitals, back passage, buttocks or inner thighs
- Erectile or ejaculation problems or loss of sensation in genitals during sexual intercourse
- Loss of sensation/ tingling or numbness in both legs
- Weakness in foot (i.e. floppy foot or inability to lift front of foot when walking)
If yes, call NHS 111 or go to an emergency department immediately.
If you are suffering with constant pain and if you have any of the following;
- a history of cancer
- unexplained weight loss
- feeling generally unwell, have a fever or lack of appetite
- relentless night pain that cannot be relieved by changing position in bed
Please contact your GP as soon as possible to discuss if other investigations are required before referring to physiotherapy.
If you are not experiencing any of these symptoms, please confirm you have read the above information and complete the referral form to self-refer into the Worcestershire Physiotherapy Service.
Also please do not self-refer if you are referring for a fracture that you had in the last 12 months, Carpal Tunnel syndrome, Falls, or Fibromyalgia (as the main concern), please consult with your GP surgery about these instead