| Problem |
How it may present |
Possible treatment |
| Pain and Fatigue |
- Pain in any part of the body
- General tiredness at any time of day regardless of activity levels
- Increasing difficulty in completing activities
- Feeling weak, muscle tightness, struggling to keep up with others, increasing injuries
|
- Management of pain source
- Energy conservation – finding balance between activities and rest
- Exercise and therapy to improve ability to move: stretching, strengthening, general fitness
- Surgery
- Medication
|
| Arthritis |
- Joint pain during or after movement
- Joint stiffness or tenderness
- Restricted range of joint movement
- Grating sensations when joint is moved
- Hard lumps under the skin around the painful joint
|
- Physiotherapy, Occupational Therapy, Podiatry, Orthotics all aim to reduce joint deterioration e.g. muscle strengthening, stretching, balance, rest, massage, mobility, good lifestyle habits, exercise
- GP or specialist e.g. medications and general health management, surgery
|
| Mental Illness |
- Depression
- Anxiety
- Low mood or sadness
- Persistent feelings of stress and worry
- Inability to get out and about
- Lack of motivation or low energy
|
- Counselling
- Exercise
- Socialisation support
- Recreation support
- Life planning and support
- Medication
|
Neck
- Subluxations
- Nerve entrapment
- Myelopathies
- Cervical instability
- Radiculopathies
- Spondylosis
- Spondylolisthesis
- Osteophytes
- Cervical stenosis
- Fractures
|
- Pain, with or without movement
- Feelings of neck instability
- Decreased range of movement
- Headaches that do not respond to medication
- Unexplained dizziness or light- headedness
- Pins and needles, numbness
- Loss of strength over a short period of time
- Changes in bladder or bowel control
|
- Medical Review with possible investigations such as CT Scan or MRI
- Consultation with GP, neurologist or neurosurgeon
- Physiotherapy e.g. neural lengthening, mobilisations, muscle and joint retraining, strengthening, stretching or ergonomics
- Ultrasound, electrical stimulation or massage
- Regular monitoring
- Surgery with intensive rehabilitation
|
Mouth and Jaw
- Pain
- Locked jaw
- Tooth and gum problems
|
- Difficulty with eating, chewing or feeding
- Fatigue with eating
- Jaw clicking, fatigue or locking
- Neck pain
- Headaches
- Bruxism
- Snoring
- Speech difficulties
- Tooth or gum pain
- Tooth or gum infections
|
- Dental support for tooth and gum management
- Equipment such as mouth guards
- Speech pathology e.g. swallowing recommendations
- Physiotherapy e.g. mobilisation, massage and exercises
- GP or specialist consultation e.g. medications, sleep review
|
Swallowing
Aspiration
e.g. fibrosis of lungs |
- Coughing when eating or drinking
- Difficulty eating, chewing or feeding
- Fatigue when eating
- Speech difficulties
- Avoiding some foods
- Chest infections
- Regular hospitalisation for chest infections
- Regular antibiotic use
- Difficulty controlling saliva
|
- Speech pathology e.g. swallowing recommendations
- Physiotherapy e.g. respiratory management, positioning, exercise
- Occupational therapy e.g. positioning
- GP or specialist e.g. respiratory management
|
| Communication |
- Difficulty communicating with friends, family and carers
- Difficulty using a communication board, tablet or other device
- Inability to communicate with strangers or support staff
- Frustration at not being understood
|
- Speech pathology, establishing ways to communicate
- Occupational therapy, establishing ways to access communication systems and devices
|
Respiratory
- Diseases of the respiratory system
- Upper airway obstruction e.g. sleep apnoea, acute airway obstruction
- Aspiration e.g. fibrosis of lungs
|
- Coughing when eating or drinking
- Difficulty taking deep breaths or coughing
- Inability to cough
- Shortness of breath
- Unusual tiredness
- Chest infections
- Regular antibiotic use
- Snoring
- Longer than average recovery time following minor illness
- Hospitalisations
|
- Speech pathology e.g. swallowing recommendations
- Physiotherapy e.g. respiratory management, positioning, exercise
- Occupational therapy e.g. positioning
- GP or specialist e.g. respiratory management including medication, inhalers, nebulisers, ventilators or CPAP, BiPAP and cough assist machines
|
Heart
Cardiovascular problems such as arterial hypertension, coronary artery disease |
- Headaches
- Dizziness
- Vertigo
- Chest pain or discomfort which may extend to the arm, back, jaw or neck
- Shortness of breath
|
- GP or specialist consultation for medication or surgery
- Physiotherapy e.g. exercise
- Dietitian e.g. food recommendations
- GP or specialist e.g. medication
- Dietitian e.g. food recommendations
- Physiotherapy e.g. positioning and exercise
|
| Gastrointestinal |
- Reflux
- Burning in stomach tube
- Constipation
- Loose bowels
|
- GP or specialist e.g. medication
- Dietitian e.g. food recommendations
- Physiotherapy e.g. positioning and exercise
|
Shoulders
- Dislocations
- Instability
- Bursitis
- Frozen shoulder
|
- Pain at rest or with movement
- Difficulty lifting or carrying objects
- Changes in posture
- Shoulders not level
- Inability to move arms away from body
- Changes in ability to manage everyday tasks such as dressing or hanging out washing
- Difficulty using elbow crutches or a four-wheeled walker
|
- Physiotherapy e.g. pain management, postural support, muscle retraining, exercises, massage, electrical stimulation, task specific training, adjustments to mobility equipment, rehabilitation
- Occupational therapy e.g. activity recommendations, adjustments to mobility equipment
- GP or specialist consultation for medication or surgery
|
| Scoliosis or kyphosis |
- Pain
- Shoulders not level
- Inability to sit upright or turn side to side
- Ribs touching pelvis
- Difficulty lifting head or standing tall
- Difficulty taking deep breaths
- Tiredness
|
- Physiotherapy e.g. pain management, postural support, exercise, monitoring, seating systems, night time positioning, respiratory management
- Occupational therapy e.g. seating and night time positioning support
- GP or specialist consultation for long term monitoring of spine, x-rays, consideration of braces or surgery
- Orthotics e.g. braces
|
Lower back / sacrum
- Radiculopathies
- Nerve entrapment
|
- Tingling, pins and needles or numbness in lower legs
- Changes in sensation
- Changes in bladder and bowel control
- Pain
- Reduced mobility
- Difficulty bending or lifting
- Pain or discomfort when walking, climbing stairs or in transfers
- Pain or discomfort in positions including lying, bending, standing or sitting
|
- Physiotherapy e.g. neural lengthening, mobilisations, muscle and joint retraining, strengthening, stretching, ergonomics, ultrasound, electrical stimulation, massage and pain management
- Physiotherapy e.g. activity training, equipment for movement and positioning, seating, night time positioning
- Occupational Therapy e.g. seating and night time positioning
- GP or specialist consultation for medication, referral for orthopaedic or neurosurgery review and consideration of surgery
|
Elbow, forearm and hands
- Muscle contractures
- Overuse syndromes e.g. tennis elbow, golfers elbow, carpal tunnel or ulnar nerve entrapment
- Finger changes e.g. swan neck deformities
|
- Pain
- Reduced range of movement in joints
- Difficulty writing or typing
- Aching, particularly at night
- Difficulty moving thumbs
- Pressure injuries on hands from fingers and thumbs
- Difficulty spreading fingers and thumbs apart
- Tightness in hands, fingers and thumbs
- Poor or worsening grip strength
- Reduced fine motor skills
- Difficulties cleaning palms of hands
- Skin breakdown in palms of hands
|
- Physiotherapy and Occupational Therapy e.g. pain management, taping, bracing, ultrasound, laser, exercise, stretching, muscle retraining, strengthening, ergonomic assessment, active and resting splints, hygiene strategies
- GP or specialist consultation for medication or surgery
|
Hips and pelvis
- Pelvic obliquity
- Hip dislocation
- Hip displacement
|
- Arthritis
- Pain
- Reduced mobility
- Pressure injuries – especially sitting bones, ribs, pelvis and tailbone
- Changes in posture
- Feelings on instability in hips
- Difficulty sitting upright
- Slipping forward while seated
- Leg length discrepancy
- Knees shifting to one side when seated or lying down
- Changes in walking ability or mobility levels
- Knee or lower back pain
- Increase in falls or tripping
- Feeling lopsided when standing
- Limping or increased fatigue when walking
- New need for a mobility aid
|
- Physiotherapy and Occupational Therapy e.g. 24-hour positioning and movement support for seating, night time positioning, relaxation, exercise, stretching, strengthening, braces, footwear, gait and transfer training, monitoring
- Medical specialists e.g. tendon releases, tendon transfers, osteotomies, hip replacements, Botulinum toxin therapy
|
Knees
- Patella alta
- Patella fractures
- Patella displacement
|
- Pain
- Changes to walking ability
- Difficulty using stairs
- Increasing muscle fatigue with walking
- High riding knee cap
- Knee instability or sensations of knees 'giving way'
- Clicking or grinding sounds
- Tiredness with standing and walking
- Needing to rest regularly
- Increased muscular tightness in legs
- Inability to straighten knees, preferring to keep knees bent
|
- Physiotherapy e.g. pain management, stretching, strengthening, taping, bracing, mobilisation, massage, muscle retraining, activity retraining
- GP or specialist consultation for medication or surgery such as tendon releases or realignment
|
Ankles and feet
- Flat feet
- Deformities to hind, mid or forefoot
|
- Pain, aching
- Changes in walking patterns
- Increase in falls or tripping
- Reduced mobility
- Swelling
- Pain with walking or standing for long periods
- Reduced balance
- Difficulty finding comfortable footwear or wearing shoes out quickly
- Skin problems relating to walking patterns and ill-fitting footwear
|
- Physiotherapy e.g. massage, stretches, strengthening, pain management, gait retraining, mobility equipment
- Orthotics e.g. foot orthoses, ankle foot orthoses, seating and foot plate placement
- Footwear e.g. specialised, customised
- GP or specialist consultation for medication or surgery such as triple arthrodesis, tendon transfers, bony spur removal, bunion surgery, first metatarsal fusion or plantar fascia release
|
