If you experience persistent pain and or fatigue and you would like support from our team, you need to be referred.
You can ask your GP, physiotherapist or Consultant to refer you.
Your APP assessment appointment will last about 45 minutes. During this time, the APP will ask you questions about your pain condition, your general health, lifestyle, social and work life, sleep, emotional wellbeing, and how the condition affects your daily activities. They will also carry out a thorough physical examination.
Please wear comfortable, loose-fitting clothes that allow you to move easily and that will let the affected area be exposed for the examination. If you use walking aids, be sure to bring them with you. If you take pain medication, take it as you normally would.
The APP and you may have decided on one or more potential further actions:
After your appointment, the APP will write a summary letter outlining the action plan and send it to both you and your GP for information and any further actions they may need to take. You may also be offered a follow-up appointment to review your progress with the management plan or to check how you’re doing after any injections.
Pain can be linked to long-term health conditions like arthritis, or it might start after an illness, injury, or surgery. Sometimes, pain can begin without a clear cause. For some people, pain improves over time. But for others, it continues beyond the usual healing period. The pain might come and go or even spread to other parts of the body.
Learning more about your pain is an important first step. It can help you find better ways to manage it and lessen how much it affects your daily life.
Joint, muscle, and nerve-related pain—whether from common issues like strains, osteoarthritis, or conditions such as inflammatory arthritis, osteoporosis, or hypermobility—is often due to increased sensitivity in the nervous system rather than serious damage. These conditions may cause discomfort, stiffness, or fatigue, but they are usually manageable with the right support. Our team helps people understand their pain, stay active, and build personalised plans using strategies like movement, pacing, and stress reduction, while investigating further or referring to specialists if needed. We work closely with our spinal and MSK colleagues.
Below are some links to conditions that can cause pain, including a few more serious conditions related to the spine. For more information on how can help you to manage Musculoskeletal pain, visit the MSK Together website for Mid Notts patients, Connect Health website for Notts County patients and Circle MSK website for Rushcliffe patients.
Fibromyalgia Syndrome is a medical condition that causes a mix of symptoms, including pain all over the body, feeling very tired, poor sleep, difficulty thinking clearly, low mood, and anxiety. The pain is often felt in the back, neck, arms, and legs. Some people also have headaches, stomach pain, or irritable bowel symptoms
There is no single test or scan to diagnose fibromyalgia, but we may do tests to rule out other conditions. There are special guidelines to help with diagnosis, and your clinician will talk you through them.
If you have Fibromyalgia, learning about it and having support from health professionals, family, and friends can help you feel more in control. Some people find medication helpful, but it doesn’t work for everyone and may cause side effects. The best way to manage fibromyalgia is often through lifestyle changes—like improving sleep and nutrition, looking after your mental health, and staying gently active. These steps can help calm the nervous system and reduce symptoms.
Sometimes injections can be used to reduce pain for a short while, making it easier for people to get back to their usual activities. Injections are used when there is a small area of inflammation causing pain, like when a spinal nerve is irritated causing leg pain (sciatica). They are not helpful for pain that is widespread or been going on a long time.
Chronic or long-term pain does not usually get better with injections. Experts have created national and international guidelines to show which injections work and for which conditions. For example, injections are not recommended for general back or neck pain as they have been found not to work.
If we do offer an injection, we will also help you make a plan to manage your recovery. This usually includes gradually building up activity and exercise again.
APP assessment appointments last approximately 45 minutes. The APP will ask questions about your pain condition, general health and lifestyle, social and work situation, sleep, emotional wellbeing, and the impact of the condition on your daily life. They will then complete a thorough physical examination. Please attend wearing comfortable, loose-fitting clothing which allows you to move freely and for the affected area to be exposed for examination. If you usually use walking-aids, please bring them to your appointment. If you usually take pain medication, please take this as normal.
Not necessarily. This will depend on whether your assessment and previous investigations show that an injection would benefit your condition. You would never have an injection as your first appointment. Injections take place in hospital settings, often under x-ray guidance (See our Injections section in Resources)
Not necessarily. This will depend on whether your assessment indicates that an MRI or X-ray would change how you manage your condition. https://www.england.nhs.uk/wp-content/uploads/2022/10/B1206-Best-MSK-Spinal-Clinician-Advice-030822.pdf
APPs refer to our medication specialists for specific advice on medication. APPs do not prescribe medication.
No. This is not covered by the NHS
We can arrange rehabilitation, sometimes within the PICS Pain Service and sometimes by referring you to another service. We will discuss the options with you when we see you.
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