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When to refer to physiotherapy

Referral to physiotherapy is common in children with established musculoskeletal disease. For children with rheumatic disease such as inflammatory arthritis, the management is multidisciplinary and the physiotherapist will work to optimise joint range of movement, muscle strength and function alongside medical treatments.

The physiotherapist will often work with an occupational therapist as part of the assessment and management plan.

They also play an important role in helping young people to adjust their routine to minimise fatigue and interruption into school, play or sports activities. 

For children who do not have an inflammatory rheumatic disease, referral to physiotherapy is also reasonable in the following situations; 

  • Concern about normal variants (bow legs, knock knees, flat feet) - these should not be painful and if so, consider referral to paediatric orthopaedics.
  • Limb pain consistent with anterior knee pain.
  • Functional problems (walking, clumsy) as part of the assessment to reach a diagnosis.
  • Chronic pain syndromes. 

The paediatric physiotherapy assessment may result in referral back to the GP to refer on for specialist opinion if there are concerns to suggest pathology. 

Access to paediatric physiotherapy is variable and may be from the local doctor,  paediatrician or paediatric specialist. 

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