The musculoskeletal service provides support to people with new or recurrent pain problems associated with their joints, soft tissues, and nerves. The service is split into two parts:

The MSK physiotherapy team provide support, advice, and physiotherapy treatment to patients with new or recurrent MSK problems as well as those living with a long-term MSK condition.

The MSK Advanced Practice team support patients along established outpatient diagnostic pathways to determine the correct treatment and management options available to them and acts as an interface to secondary care orthopaedic services.

Our pathways and policies can be found on the ICB website: https://hnyppr.org.uk/web/york/w/msk-and-orthopaedics-specialty

The MSK service accepts referrals for patients aged 17 years and over with new, recurrent, or long-term MSK pain symptoms, providing they have no urgent medical need, and their symptoms are not attributable to an underlying systemic cause that requires alternative management.

Indicative exclusions include:

Active cancer diagnosis or treatment unless the pain symptoms have been explicitly proven to be unrelated

Active immunosuppressive therapy - unless infective cause explicitly excluded (normal bloods, no systemic signs)

Acute motor loss symptoms or other progressive neurology

Acute trauma including traumatic fracture or acute tendon rupture (except rotator cuff in patients >70 years), locked knee, hemarthrosis. Consider alternative urgent pathways (ED, urgent care centre, acute knee clinic, acute shoulder clinic)

Cauda equina syndrome, or symptoms suggestive of this diagnosis

Non-MSK conditions e.g.: neurological conditions, podiatry referrals, inflammatory joint disease, fibromyalgia, balance disorders, mobility problems (including walking aid referrals), pregnancy-related back pain, primary headache without neck pain, diastasis recti, bone health management referrals.

Patients requiring secondary care MDT pain clinic input - Referrers are encouraged to utilise secondary care pain services for patients with persisting spinal pain symptoms, that have not improved with previous input from the musculoskeletal service.

Post-surgical problems i.e. painful prosthesis

Specialist diagnostic work up or surgical opinion for scoliosis/spinal deformity

Suspicion of serious pathology (i.e. malignancy, infection)

Suspected fragility fracture

Undifferentiated lumps and bumps

The MSK service does not provide emergency or immediate care. Patients referred with symptoms that have the potential to deteriorate while awaiting clinical review should be appropriately safety netted by the referrer, and/or an alternative referral option (i.e. ED, acute shoulder or acute knee clinic) should be considered.

The MSK service is a physiotherapy led service and may, within the scope of Non-Medical Referrer Agreements, commission investigations to assist in the diagnosis and management of musculoskeletal pathology. Occasionally these investigations will demonstrate unexpected or untoward findings such as metastatic disease. In these circumstances the referring GP practice will be contacted to take over the management of the patient as it is not within the scope of physiotherapy practice to manage a new cancer diagnosis.

The MSK service aims to see all referrals within 12 weeks of triage. 

Referrals will be categorised as urgent and seen within 4-6 weeks if they meet any of the following criteria:

• Patients with a past medical history of cancer and new or ongoing musculoskeletal pain may be referred to the MSK service and will be prioritised for urgent assessment, provided the patient has had medical appraisal in primary care and there is no clinical suspicion of recurrent or metastatic disease at the point of referral

• Pain associated with subjective weakness not determined to meet the motor loss pathway

• Traumatic injury within the previous 12 weeks*

• Armed Forces Covenant (i.e. symptoms that may relate to former service)

• Dependants directly directly at risk from MSK condition

Acute back pain appointment

Patients with:

• Severe, new onset spinal pain

• Patients who have been signed off work in the past 6 weeks or where there is risk to work due to their spinal pain problem

• Patients with acute spinal pain and radiculopathy of less than 12 weeks in duration

Will be further prioritised to an initial appointment within 2 weeks.

*please see directory of service section - patients who have sustained a traumatic injury may be suitable for alternative urgent/emergency services rather than MSK 

York and Selby MSK Service  - Surgery Care Group

York and Scarborough Teaching Hospitals NHS Foundation Trust.

Below is a complete list of standardised abbreviations as used by the York and Selby MSK Service from July 2026. Some of these abbreviations may be used in patient documentation and correspondence. 

1 month = 1/12
1 week = 1/52
Abd = Abduction
ABP = Acute back pain
APB = Abductor policis brevis
ACJ = Acromioclavicular joint
ACL = Anterior cruciate ligament
ADL= Activities of daily living
AROM= Active range of motion
ASIS = Anterior superior iliac spine
BL= Bilateral
CES= Cauda Equina Syndrome
CMC= Carpometacarpal joint
DCM = Degenerative cervical myelopathy
Dflex= Dorsiflexion
DIPJ= Distal interphalangeal joint
EI = Extensor indicis
EOR = End of range
EPL = Extensor policis longus
ER= External rotation
EV = Eversion
Ext =Extension
FABER = Flexion abduction with external rotation
FADIR = Flexion adduction with internal rotation
FAI = Femoroacetabular impingement
FHL = Flexor hallucis longus
Flex = Flexion
FU = Follow up
FWB = Full weight bearing
GHJ = Glenohumeral joint
GTPS = Greater trochanteric pain syndrome
HBB = Hand behind back
HEP = Home exercise plan
HPC = History of presenting complaint
IF = Index finger
Indep = Independent
IR = Internal rotation
IV = Inversion
L = Left
LBP = Lower back pain
LCL = lateral collateral ligament
LF = Little finger
LL= Lower limb
MCL = Medial collateral ligament
MCPJ = Metacarpophalangeal joint
MF = Middle finger
MOI = Mechanism of injury
MSCC = Metastatic spinal cord compression
MTPJ = Metatarsal phalangeal joint
NAD = No abnormality detected
NSAIDs = Non-steroidal anti-inflammatory drugs
OA = Osteoarthritis
P&N = Pins and needles
PC = Presenting complaint
PCL = Posterior cruciate ligament
Pflex = Plantarflexion
PFJ = Patellofemoral joint
PFPS = Patellofemoral pain syndrome
PIFU = Patient initiated follow up
PIPJ = Proximal interphalangeal joint
PROM = Passive range of motion
PSIS = Posterior superior iliac spine
Pron = Pronation
PWB = Partial weight bearing
R = Right
RCRSP = Rotator cuff related shoulder pain
RD = Radial deviation
RF = Ring finger
RMP = Rehab my patient
ROM = Range of movement
Rot = Rotation
SCJ = Sternoclavicular joint
SF = Side flexion
SIJ = Sacroiliac joint
SL = Single leg
SLR = Straight leg raise
SLS = Single leg stand
STS = Sit to stand
Supn = Supination
TFCC = Triangular fibrocartilaginous complex
THR = Total hip replacement
TKR = Total knee replacement
TMJ = Temporomandibular joint
TTWB = Toe touch weight bearing