SSR Autumn Meeting 2025

I am fortunate enough to be an occupational therapist specialising in Rheumatology, and what a joy it is to do my job! As an OT in Rheumatology I have the scope to use all my clinical skills and to truly embrace a person-centred approach.

Our work can include functional assessment, hand therapy, work and vocational rehabilitation, fatigue and self-management, joint protection advice, splinting and provision of hand orthoses.

We have specialist OTs working throughout Scotland; from the Scottish Borders to the Highlands & Islands and we work across different sites in a variety of ways. Like me, there are many lone therapists working in small hospitals but there are also large OT teams working in specialist Rheumatology units, and everything in between.

We believe it is vital that, regardless of where we work or with whom, our practice is up to date, valid and of a high quality and that we are involved in research and development of evidence based practice. We do this in a number of ways, such as through the Royal College of Occupational Therapy (RCOT) Specialist Section, development of clinical competencies, regular webinars, and latterly, as a result of the COVID pandemic, a hugely popular WhatsApp group. The group has been invaluable in connecting the profession at a national level and provides a forum to ask clinical questions, share good practice, inform others of upcoming training opportunities and, hugely important in the middle of a pandemic, to support each other. The Rheumatology OT WhatsApp group has been so successful it is likely to continue, regardless of the status of the pandemic.

I will endeavour to keep adding to this micro-site as information likely to be of interest comes up.

Nicki Gray, Specialist Rheumatology Occupational Therapist

Working as a Rheumatology physiotherapist is varied and enjoyable, using a wide variety of clinical skills and truly embracing a person-centred approach. This role may include musculoskeletal assessment, exercise therapy, functional and gait rehabilitation, joint injection therapy, assessment and monitoring of disease activity, patient education and self-management approaches. We also enhance patient management with onward referral for investigations and to secondary care services.  Some physiotherapists have completed their non-medical prescribing qualifications and can provide advice on medicines management, others have completed their joint injection qualification or diagnostic ultrasound qualification. These additional roles along with advanced clinical reasoning skills have allowed the development of Advanced Practice Physiotherapy posts within Rheumatology.

There are specialist physiotherapists working throughout Scotland; from the Scottish Borders to the Highlands & Islands. Rheumatology Physiotherapy services can vary across the country, and are often linked with MSK services with some of a therapist's time allocated to Rheumatology, but some are stand alone within larger teams working in specialist Rheumatology units. Recent development of the Rheumatology Physiotherapy Capabilities Framework in conjunction with the British Society of Rheumatology and Chartered Society of Physiotherapy has provided an evidence-based and specific national framework across the spectrum of screening, assessment and specialist management of Rheumatology conditions. This ensures that, regardless of working within a larger team or lone-working, our practice is evidence-based, up-to -date, measureable and of a high quality. It also highlights the involvement of Research and Development within physiotherapy.

Aimee Urquhart, Specialist Rheumatology Physiotherapist

Alison Knight, Advanced Practice Rheumatology Physiotherapist/Rheumatology AHP Lead

Podiatry has an important role to play in the management of patients with inflammatory arthropathy and we are a key member of the multidisciplinary team (MDT). Clinical symptoms of inflammatory arthritis can regularly present in the foot and ankle and it is often the podiatrist who is initiating the referral for further investigations to rule out or confirm the presence of systemic disease. Once systemic disease has been confirmed, part of our role in the MDT is to try and establish if the issues reported by the patient are more mechanical in nature or are they systemically driven – that is to say, are the patient's symptoms independent of the inflammatory systemic condition, or at least not being solely driven by it.

A huge part of our management plans with the patient are education around the potential reasons for the symptoms, exploring their current beliefs and fears. This shared decision making in collaboration with the patient aims to improve their understanding in the hope that this increases compliance with whatever the plan is and subsequently, a decrease in symptoms which will improve their quality of life. The management of patients with inflammatory arthropathy almost always involves some element of rehabilitation of muscles that may not be a strong or as flexible as we would want. This will help to the patient to cope with the demand of activities of daily life dependent on their goals. Off the shelf or custom-made orthoses are also very useful and can be utilised short or long term to help with improving the way the foot and limb deal with the forces created by ground reaction force, along with discussions around footwear. Local steroid injections can also be helpful if and when required. Liaising with colleagues in Orthotics and Physiotherapy always helps when required to ensure all bases are being covered and the patient is receiving the best management possible from the most appropriate person and the right time.

John Tougher, Podiatry MSK Lead

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