Persistent pain and long-term conditions

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Persistent pain pathway

Please use the persistent pain pathway below to determine the best treatment option for your patient, based on their condition:
Please see the Pain Science Education Workbook which might help you understand your pain.
For more information on why we have persistent or chronic pain please watch this video:
The following link will play a back pain video in Turkish for more information on how to manage your back pain.

Long-term conditions

Physiotherapists can use a variety of techniques to help manage the symptoms of arthritis, such as walking aids or pain relieving treatments, but the best and main form of treatment is exercise.
The Arthritis Care website has factsheets for patients to download that include information about specific exercises for a range of conditions. The website also has patient booklets covering all aspects of living with arthritis and a booklet for health professionals on how to manage arthritis whilst encouraging patients to self-manage their condition.
Expert patients programme
We run a six-week programme for people living in Islington with long-term health conditions and their carers. The Expert Patients Programme (EPP) aims to support patients to cope better and feel more in control. There are two and half hour sessions each week. Topics covered include: managing symptoms (e.g. pain, fatigue, sleep problems), coping with stress or anxiety and depression, healthy lifestyle tips, relaxation techniques, communicating with family, friends and health care professionals, and goal-setting and problem-solving.
The programmes are run by people who live with health problems themselves. Programme attendees meet other people facing similar situations in a friendly environment and share experiences and ideas with each other.

MSK clinical assessment and treatment service

The musculoskeletal clinical assessment and treatment service (MSK CATS) is for patients with complex musculoskeletal presentations with failed conservative management who may require specialist assessment, access to diagnostics and possibly onward referral to secondary care. It is also for MSK patients who may require peripheral soft tissue, peri-articular and articular injections.
MSK CATS is run by specialist staff with many years’ experience, including extended scope physiotherapy practitioners and a GP with a special interest (GPwSI) in musculoskeletal medicine. The team has close links with secondary care consultants in orthopaedics, rheumatology and chronic pain.
The clinicians in the team are able to refer directly for investigations and can refer to secondary care as appropriate.

How to refer

Please complete the appropriate referral form with full, accurate information and provide any relevant investigation reports.
Referrals are triaged by a senior clinician to ensure patients are seen by the most appropriate service. A referral can be triaged into MSK physiotherapy, MSK CATS, MSK podiatry or secondary care (e.g. orthopaedics, rheumatology or chronic pain consultants).
In MSK Physiotherapy you might be directed to one of the following appointment types:
  • Our back pain education session – in this appointment you attend a specialised group session followed by your physiotherapy assessment – these sessions can take up to 2 hours
  • Our lower limb osteoarthritis education sessions – in this appointment you attend a specialised group session followed by your physiotherapy assessment – these sessions can take up to 2 hours
  • Our specialised ‘persistent pain’ appointments – these appointments may start with a group education session
  • A standard 1:1 Physiotherapy Assessment
  • Our Turkish speaking education session

You may then complete your treatment in one of our many exercise classes based across Haringey and Islington.

Contact us

For general physiotherapy queries, please call 020 3224 4789 or email

For new referrals and AQP referrals, please contact our Central Bookings team on 020 3316 1111.

For MSK CATS referrals, please call 020 3224 4744.
For MSK Single Point of Access referral queries please call 02072883317.

Advice Leaflets

Useful Apps

Please click each title to find out more.

NHS 24 MSK Help

Advice on common muscle, back and joint problems:

  • Exercises and video clips to help you get moving safely
  • Information to help with Work – Working lives information
  • Reminders to do your exercises and/or attend any appointments
  • A log to keep a note of your progress


In order to be able to treat pain effectively, pain experts recommend you keep a diary. CatchMyPain allows you to track your pain problem by using detailed drawings and by providing other relevant information. The diary will help you to explain your pain problem to any care provider.

Last updated15 Aug 2019
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