The knee bone’s not connected to the shoulder bone

March 12, 2011 at 9:37 am | Posted in arthrits, rheumatoid arthritis, fibromyalgia, joint pai, rheumatoid arthritis (RA) | 5 Comments
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I posted a while ago about how the physios at the hospital ‘in line with the private sector’ were limiting appointments now, and generally becoming officially less flexible and less helpful. Well I had further proof of how in line with the private sector they aren’t on my last visit.

When I previously went for physio I had been referred for my shoulder, but when the knee flared up, knowing it was all RA, she did some work on the knee too. Now, and this is no way the fault of my physio herself I should add, it’s a typical NHS ‘powers that be’ decision, even though I couldn’t bend or straighten my knee fully, had been to the GP, had got oral prednisiolone and had had it confirmed that my knee was flaring, she couldn’t do any ultrasound on my knee at all. Because it was too inflamed? Nope. Because she wasn’t sure it was the right treatment? Nope. Because I had been referred only for my shoulder!


Fortunately the knee is actually very nicely on the mend by itself, and equally fortunately the ultrasound on the shoulder (actually the acromoclavicular joint, but I can’t keep spelling that!) has helped enormously, so not THAT much to whinge about. Also I have a cunning strategy up my sleeve if the knee doesn’t mend fast enough or gets worse again. I don’t know if it’ll work but my cunning plan is to phone the GP, explain the situation and get them to give me the referral letter, so that I can walk into the physio next time and say, ‘Here’s the letter – can you do my knee now please?’

Otherwise it’ll be the usual ‘five weeks from referral’ and I’ll be going in for six sessions for my shoulder, which will be over before the referral for the knee is officially through. This is not only a problem because if the knee needs doing it needs doing a.s.a.p; it’s also an issue because it’s 50 mins to an hour driving time to and from the hospital IN WORK TIME! So glad the NHS are working towards keeping everyone in work! HAH!



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  1. Oh man I HATE this bureaucracy crap. Seriously what a waste of everyone’s time getting you referred twice when she could’ve just done it then and there. I hope you dont need anything done to the knee!

  2. wow, what a nightmare!!!
    here in the USA,,, we are supposed to be working toward “better health care” (and i use that term lightly, cause’ it’s not my choice).. that too is becoming a nightmare…but that “politics” here in the US…
    seems pretty silly to be so “fussy” about which joint or point the referral is for, as RA like to do the “hopscotch” around the entire body…. be well girl.. and hang in there.. bj

  3. I haven’t run into that sort of problem with physical therapy through the U.S. V.A. medical center–yet. Since the VA, like NHS, is a “vast bureaucracy,” I wouldn’t be surprised if asking for help with a painful joint other than the one referred for gets refused. Bureaucracies really like to have everything done by the book.

    And I guess when you consider the incredible number of patients (and the paperwork involved in keeping track of treatment, etc. for each and every one of them), a refusal to stray from the exact treatment ordered is more understandable. Still a PITB, though.

    Glad your shoulder is improving, Polly. And I hope the knee behaves, too. Hugs for you.

  4. Yeah, that’s politics everywhere, I reckon! As to your new healthcare system … I’ve heard it’s based on the NHS … so … erm … good luck!!!! 🙂

  5. Hi Wren, Hrumph – I suppose it’s SORT OF understandable, but the most frustrating thing is that last year I was referred for the shoulder too, and there was no hesitation at all about sorting the knee out too, knowing they were clearly both RA related etc. This year though, same physio, just a new layer of bureaucracy that won’t allow her to do it! Very glad you’ve not encountered the same problems though – and I hope you never do!

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