Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.

The Development of a New Service for the Management of Non-Inflammatory Musculoskeletal Pain.

Maillard,  Susan, Bhagat,  Swati, Bernie,  Charmaine, Morgan,  Alice, Adkins,  David, Haggart,  Ellie, Pilkington,  Clarissa


Great Ormond Street Hospital Rheumatology Department recognised that 50% of the referrals that were received were for young people with non-inflammatory musculoskeletal pain (NIMP) but that the service was not able to provide adequate treatment after diagnosis. A business plan was proposed to the hospital management board and a new service was developed and subsequently reviewed.


The business plan was developed by senior multidisciplinary members of the Rheumatology team. The new service was set up and then specific outcome measures were followed after 1 year to monitor the success and effectiveness of the treatments and service.


The service was funded to employ a full time Physiotherapist (PT), Occupational Therapist (OT), Psychologist (Psych) and administrator. Out-patient appointments were established and patients were placed into the new service. The initial appointment was in a new-patient clinic and they were assessed by a Consultant paediatric Rheumatologist and a specialist physiotherapist. This initial assessment ensured that there was no other diagnosis other than a non-inflammatory condition such as hypermobility syndrome; the patient was then referred to PT, OT and Psych as appropriate. The treatments included individualised home muscle strength training programmes, life style advice, group patient and parent education programmes and individualised pain management interventions. Specific Outcome measures (OCM) were used to monitor the success of the treatments provided. The most significant OCM's were:

School attendance which increased from 75% missing at least 1 day a week due to pain to only 7%.

Loss of muscle strength was present in 98% of children and this was resolved in 100% of those who completed the programme given.

Participation in PE increased from only 25% participating to 75% joining in sport at school.

The cost of providing the staff and facilities was less than 50% of the revenue the service brought into the hospital and so the service made a significant profit.


The establishment of a dedicated service to the management of NIMPS has been shown to be both clinically and cost effective and has worked extremely well as an AHP led service enabling the medical staff to focus upon inflammatory diseases.

To cite this abstract, please use the following information:
Maillard, Susan, Bhagat, Swati, Bernie, Charmaine, Morgan, Alice, Adkins, David, Haggart, Ellie, et al; The Development of a New Service for the Management of Non-Inflammatory Musculoskeletal Pain. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :861

Abstract Supplement

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