Is Acupuncture suitable for my condition?
There are few conditions which would fail to benefit from acupuncture. The deciding factor is frequently down to you. Acupuncture will only be used through agreement and where there is a clear indication that it will not compromise your treatment or recovery path
Is it uncomfortable?
Clearly, we would not deny that using a needle is free from any appreciation of awareness of sharp sensation. However, we are experts. We can genuinely say, even for patients who are fearful of needles, it is an anticlimax. The needle gauge is so small the most you will feel is a ‘Tap’ sensation as the needle is delivered to its target location.
What if I am Phobic?
Let's be clear, at PhysioDirect you are in control. We will not force or use a treatment technique without first gaining your agreement. However, even phobic patients have received this treatment approach without disaster. Under the right conditions and patient therapist trust and where there is a clinical promise of benefit the fear of needles can often be overcome. But remember - you are in control and you have the last say.
Are there side effects?
Acupuncture has been practised for over 2000 years without any significant problems. There are some minor issues but these are even less than you would expect when compared to giving blood which we all have to do from time to time. This includes minor bleeds and/or bruising. If you are Diabetic please let us know. Blood sugar levels can drop as well as blood pressure. Acupuncture can make you feel tired or even hungry. On the flip side we frequently receive patient reports of euphoria and a sense of happiness! It has been known for some time that endorphins and enkhaplines are produced during acupuncture treatment. The effects are:
Endorphins act as analgesics, which means they diminish the perception of pain. They also act as sedatives.
Enkephalins are small peptides that can serve as neurotransmitters in the brain.
Enkephalins act to attenuate substance P release in the dorsal horn of the spinal cord and inhibit afferent pain fibers. Opiates inhibit transmission at sympathetic and locus caeruleus synapses.
Physiotherapy & Osteopathy
Is Physiotherapy or Osteopathy for me?
Yes, if you have a sprain, strain, joint or musculoskeletal pain then we can help.
Physiotherapy is a specialist musculoskeletal service which has a wide scope of practice. If you have an ache or pain regardless of whether you have sustained a traumatic incident or it has just crept up on you we can help. The first step is down to you. We can all be guilty of delay, denial and deceiving ourselves that it will be better tomorrow. However, if you have been experiencing problems that fail to improve for more than a few days it is better to catch it early rather than later. Chronic conditions often entail more injury complications and treatment. Catch it early and we can avoid both.
Do I need an Initial Assessment?
Yes. All patients are required to have an initial assessment. Your first appointment is geared towards a detailed investigation of your complaint. Without this information there is a real risk of wasting time and effort and potentially prolonging your recovery. We use definitions such as ‘Subjective’ and ‘Objective’ findings.This allows us to correlate your ‘Subjective Complaint information with the clinical ‘Objective’ presentation. This helps us to identify and, if you like, diagnose what’s going on. This establishes what has to be done in follow-up treatments.
Why are Follow-up treatments charged at a different rate?
The time allocation for IA (initial assessments) and Treatments (shorthand Rx) are the same but the charge for IA’s is slightly more because it reflects behind the scene analysis and research that is required to individualise your management and treatment success. I am sure you can appreciate there is no ‘One size fits all’ especially where people are concerned.
How many treatment sessions will I need?
We all heal at different rates. If we are to go by NHS ( NICE guidelines) of course we can give you an average estimate. However, the level and severity of injury, your age and associated physical and non-physical health all play a part in your recovery. It is important to us that we are professional and do our best to be effective and efficient. At the end of the day we want you to be satisfied. You are, after all, our best form of recommendations!
Will I receive treatment on my first visit?
Yes, whilst it is important for us to carry out a thorough assessment we know what’s important to you is that there is no delay in starting treatment. What’s important to us is that you get the right treatment. This is the best approach. Even a few minutes on the right problem will make a difference. So as the saying goes, a Patient patience gets the best results.
How do I pay and do we give discounts?
As we have indicated our preference is to deal directly with the patient. We can offer a range of payment plans as well as PAYG charges to keep things simple. Ultimately, it is a fine balance. Our view is that cost cutting invariably means corner cutting. Discounted interventions are no substitute for proper care.
Does PhysioDirect accept insurance and Occupational Referrals?
We are registered with all primary care physiotherapy reimbursement insurers such as BUPA, Axa PPP and we welcome direct Occupational Employer referrals.
Do we accept Case Management Referrals?
We have dealt with ‘Case Management Companies’ for many years. It seemed like a positive relationship at first but gradually our experience of this type of referral frequently resulted in compromising patient duty-of-care. Intermediary businesses sit between the funding source and the patient. They offer large mostly national organisations and insurance companies centralised claims and occupational health services. They tender for contracts on a volume basis then dictate assessment and treatment protocols.This puts our profession at a significant disadvantage. In a study carried out in 2013 it was found that physiotherapists that engaged with Case Management providers reported poorer job satisfaction, professional autonomy and, ultimately, quality of service. Because of this It’s fair to say we don’t encourage their engagement. It is not the type of service we want to promote nor aspire too. So long as they don’t interfere with our core aim to put you first, there are a few good intermediary companies that remain that we still deal with.
Our Service Promise
Achieving Effective Results…
Every patient and condition is different but in our society of productivity and performance rated measured outcomes we can, as the saying goes, name that tune in …..5.5.! That’s the average number of visits across all conditions.
PhysioDirect has been around since 1995. We were one of the first to migrate our clinic records and administrative back office requirements to the Cloud. We have data that goes back to 1995 well before anybody else. A lot of water has passed under the bridge since then. However, we remain committed to data collection which not only confirms our success but also how well each of our treatments have been. This is used to fine tune what works and what doesn't in our unique ‘Patient Treatment Tracker’ system.
Our collective treatment feedback is a key performance indicator tool that continues to guide our practice. It reaffirms what actually works to help patients get better. We have delivered more than a million treatment sessions. That’s a lot of hard work and thankfully many happy success stories. That’s data which guides best practice and ensures we don’t make the mistake of removing traditional approaches without careful consideration. Whilst we do support evidence based practices such as S.M.A.R.T. Goals, Intermediary Case Management principles and N.I.C.E. guidelines are modern influences that focus on cost efficiency. Unfortunately, this is a bit like a ‘One size fits all’ approach that ignores the nuances and subtleties of patient therapist interactions and what's individually important. Falsifiable theory research and the ‘Null’ question it poses cannot be proven and most importantly still requires interpretation. That’s why our philosophy is never to rely on just one piece of research and that bias comes in all shapes and sizes!
What's important for us is to understand that your recovery is a partnership. That's why ‘Timeliness and Continuity’ of intervention is important. Anything that interferes with this process can result in complications which are more likely to stop or undo all our hard work. This is why ‘PhysioDirect' is central to our philosophy and so important to the way we work and why we believe we get the best results.
Treatment programmes are designed to give you lasting recovery. We are priced to be accessible without undervaluing our profession .
S.M.A.R.T goals - Specific, Measurable, Achievable, Relevant & Time-sensitive action plans albeit that do no conflict with the patient.
The problem with NICE Guidelines - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC539423/
Who are Desk Assessments for?
Desk Assessments can be conducted both in close contact or virtual situations. This involves a little more access than just face-time. We need to see how you are physically working so that we can determine less than optimum arrangements. And, your general physical history so that we can determine physical capacity limitations where adjustment or modifications are needed.
What does a Desk Assessment entail?
Desk assessments require both a visual/objective check of your working conditions and a full background check on your general health. There is frequently an interrelationship between these two bits of information. Specialists are looking for Subjective and Objective triggers which hold the key to improving or resolving your functional capacity in this type of working environment.
Why are Desk Assessments Important for Employers?
For good employer’s it is essential to ensure that your team remains happy, healthy and comfortable at work. Research shows that this is vital in maintaining productivity and performance targets whilst ensuring excellent staff engagement. It’s a ‘Win’ ‘Win’ and relatively inexpensive way of demonstrating your commitment to responsible human capital investment.
How much does a Desk Assessment Cost?
Desk assessment starts from £60 up to £150 for a multi contact follow-up and detailed report. Contact us today for a bespoke package.
How are home Desk Assessments carried out?
Home Desk Assessments are conducted via Video which is a great way to get advice and recommendations to improve your home set-up. We will focus on the quickest and simplest solutions to help you avoid and improve common neck, back and wrist complaints. These are conducted over our secure video conferencing facility using your computer and mobile phone!
They last 40 mins, and cost £60 or 80mins for £120, £40 for a pdf report) You can find out more.
What can I expect from a desk assessment?
During your desk assessment we will take a detailed clinical and occupational history alongside conducting a workstation assessment, which allows us to provide you with specific ergonomic solutions.
The assessment will be conducted in a private interview room (where possible) and at your workstation. It will include:
Clinical and occupational history
Workstation assessment and detailed task analysis
Postural analysis for all required working task
Postural training and task management
Report detailing any suggested modifications
Sourcing of specialist ergonomic equipment
Online Desk Assessments
How do online desk assessments work?
Our online physiotherapy platform means we can run secure video consultations with our clients. The full desk assessment process, advice and recommendations can all be delivered effectively via video.
We take a look at your desk arrangement, assess your working patterns, and organisation of work tasks. This enables us to provide practical recommendations to improve comfort and productivity when working from home. It also helps us to determine whether you could benefit from assistive technology (e.g specialist chairs). We will complete:
Workstation risk assessment
Seated postural analysis.
Postural training and task management
All online desk assessments are carried out by our chartered physiotherapists. They have specialist training in occupational health, ergonomics and health and safety.
How do I prepare for an Online Desk Assessment
We will need to see how you have set up your workstation at home. That means we will need to evaluate your position, posture, and relationship to your desk and computer. This is most likely to involve using your phone as a camera. You will need to either have a way of standing your phone independently or, most likely, a bit of help from someone who can hold your phone to help you.
How much are our Online Assessments
Our online desk assessments cost £45 for 40 mins which include a follow-up email with your physiotherapist’s recommendations.
Are online desk assessments covered by private medical insurance?
Online desk assessments are not currently covered by private medical insurers.
What is the difference between a home and Office Desk Assessment?
The primary difference is that our home assessments are less intrusive. We understand that this is your home so we must be sensitive to the limitations of what you will accept and flexible in the recommendations we can make. Apart from this the process is the same as is the end goal. To help you work happy, healthy and comfortable at work.
We offer favourable rates to employers who require 5 or more desks assessed in the same place, on the same day. Get in touch to find out more.
Display Screen Equipment
What is display screen equipment?
Display Screen Equipment (DSE) is sometimes referred to as Visual Display Units (VDU) or Computer Workstations and includes laptops, touch-screens and other similar devices that incorporate a display screen.
Any item of computer-related equipment including the computer, display, keyboard, mouse, desk and chair can be considered part of the DSE work station.
Other important definitions:
User: an employee who habitually uses DSE as a significant part of their normal work. If someone uses DSE continuously for periods of an hour or more on most days worked, they are likely to be classified as a user.
Operator: a self-employed worker who habitually uses DSE for a significant part of their work.
The risks of using display screen equipment
Many employers and employees are completely unaware of the impact on health that a poorly arranged work station can have.
A poorly equipped and arranged work station is a major contributing factor in the development of many work-related upper limb disorders (WRULDs). Conditions can be both short and long term but in most cases cause a lot of avoidable pain, discomfort and stress. Other associated symptoms include temporary eyestrain and headaches, and fatigue/stress.
The hazards associated with DSE work stations must therefore be properly assessed so that they are adequately equipped and adjustable to suit the user’s needs.
Legal duties and obligations around display screen equipment
The Health and Safety (Display Screen Equipment) Regulations 1992
These regulations require employers to carry out an analysis and assessment of the work station.
Work stations must meet certain basic requirements that enable them to be appropriately adjusted and used without unacceptable risks to health and safety.
Account must also be taken of daily work routines so that adequate breaks can be incorporated into the working day. This does not necessarily mean a complete break away from work, but a break from the DSE work (e.g. making phone calls, filing or other work that allows staff a change of activity and gets them away from the screen).
It is better if the work allows for natural breaks but it is possible to install software that can indicate when it would be appropriate for someone to take a break. Short frequent breaks are better than fewer longer breaks.
Appropriate information, instruction and training should be provided to users so that they can use the equipment provided effectively and information on eye examinations.
Free eye examinations for persons identified as users must be provided on request. The employer is responsible for paying for tests and for basic spectacles if they are required for DSE work.
The employer does not have to pay for designer frames or other additional features but many employers contribute the equivalent cost of basic spectacles if the employee pays the additional cost.
Healthy Working Lives has produced a DSE Risk Assessment Form that can help you with this process. The form takes you through the assessment process as well as offering advice that could help you to remedy some of the problems you may have in the assessment.
Download the DSE Risk Assessment Form (PDF 1.2 MB)
To view the full text of the above legislation online, please follow the links underLegislation.
Good practices for using DSE
An increasing number of people are spending more time working from home. If that work involves the use of DSE the employer should make sure that a risk assessment is carried out for the DSE work station used at home.
Laptops are used by many home workers. Laptops are primarily designed for short-term use. If they are used frequently, or for long periods, docking stations, separate keyboards and mice should be provided.
This enables the laptop user to adjust the work station in a manner most comfortable for them.
As with other aspects of health and safety the action required depends on the outcome of the Risk Assessment.
Question: My secretary has had to see a physiotherapist because of Repetitive Strain Injury (RSI). Is her work station to blame?
A: The Health and Safety (Display Screen Equipment) Regulations (1992) require employers to ensure that any regular DSE user has a suitable and sufficient assessment of their work station carried out and that daily work routines are planned, encompassing adequate breaks or changes of activity, to reduce their workload at that equipment.
To prevent other staff developing aches, pains or even RSI, you need to make sure that they:
adjust their chair and display screen to find a comfortable working position
use good keyboard and mouse techniques
do not work for excessive periods of time in the same position
take adequate breaks by carrying out other activities away from the computer.
Early management intervention and treatment of an individual's symptoms, both physical and psychological, can reduce the impact, onset and duration of RSI, thus avoiding permanent long-term damage to the individual's health.
Read more on Display Screen Equipment
Question: I work with computers. Should my employer pay for me to have an eyesight test?
A: The Health and Safety (Display Screen Equipment) Regulations (1992) cover the use of computers at work.
Display screen users are not obliged to take an eyesight test, but employers must provide an appropriate test free of charge to users who request one. They should make users aware of the arrangements for requesting an eye test.
It should include a test of vision, an examination of the eye and should take account of the nature of the users’ work, including the distance at which the screen is viewed. It should be carried out by a registered optician, or a registered medical practitioner with suitable qualifications. The employer is free to specify who should carry out the test.
Many companies have policies on eyesight tests, so check with your personnel, health and safety, occupational health or union safety representatives.
Basic glasses needed specifically for display screen work should be paid for by the employer. Alternatively, the employer can contribute the same cost to a more expensive pair (e.g. with designer frames). However, very few people (10%) ever need glasses specifically to work with computer screens