Moving to the UK and continuing physical therapy?

Hello...
I am planning to move to the UK in about a month on a fiance visa. I have recently been diagnosed with a bulging disc in my lower back with sciatica in my leg. I just started physical therapy here in the US. I am signed up for a month, but I am half way through and I'm not making a lot of progress. I'm assuming my Dr. will approve another month for me(I've had PT before and this is what they did). Trouble is I will be on my way to England.

How will this work? I have no idea where to start. I have already had 3 sets of x-rays and 2 MRI's this year so I'm trying to avoid any more x-rays and testing for now. Should I start collecting my information to bring to the UK with me? The Dr's don't allow X-rays to leave their office but I do have 2 cd's with the MRI's on them with paperwork. Will the UK doctors accept this paperwork or will they want to do have their own testing and x-rays done?

I understand there can be waiting lists anywhere from weeks to months. I really don't want to have a large gap between my therapy because I don't think that its good for the treatment to be on and off.

Any ideas? Has anyone been in this situation?

Definitely bring as much documentation as you can. I think you have a right to get copies of your x-rays, though you may have to pay a small fee. Register with a GP as soon as you arrive and get advice. What will probably happen is that you'll have to see a private physio. Fortunately you can do this even without a referral from the GP, and it isn't outrageously expensive. I occasionally go to a physio who used to be the physio for the Scotland rugby team and the British & Irish Lions (sort of the British Isles VIP rugby team selected every 4 years), and it costs £45 per appointment. £35-55 seems to be a common range.

This is a good question, Jenny. I too have had sciatica off and on for a number of years. Planning on seeing my PCP in a couple weeks for an annual checkup but want to bring up the recurring pain I've had recently. So, what do I do if she recommends more physio -- will it be cleared up by the time I depart (Feb./March) -- will I be able to continue with physio in UK?? 
And, by the way, sitting on long flights across the Atlantic do not help this condition at all!!

Here are my recent experiences:

(2005) I had some lower back pain so I went to my GP, and they referred me to PT, without xrays or MRIs. I started PT about a week or two later. And this is without having a pre-existing injury. Physio determined it was muscular and luckily I didn't need any further messing about after the initial month.

(2011) This most recent time I moved over, I'd been in a series of PT sessions over the years for a rotator cuff injury here in the US, so I brought all my medical files (forgot to bring the MRI though) and when I went to my GP, she told me I could do a self assessment online and it would refer me to PT. She didn't even want to see the paperwork.

Now that might just be the Camden borough that has you do the self assessment, I can't speak for all PCTs (primary care trusts), but both times it was really easy. Perhaps they were being lazy for not x-raying/MRI first, however it took almost 3 years here in the US to get them to take it serious enough to send me to a specialist. 

Definitely bring as much as you can documentation wise. It can only help.

I would be prepared to pay for physiotherapy as there may be a waiting list where you register.

In terms of cost it might appear to be a lot for each individual session (I happen to think that 45 UK pounds is quite a lot of money for a one hour appointment), but it beats paying for health insurance that you might not use.

You can get physical therapy on the NHS, or you can pay privately for physio, however as someone with two bulging discs and sciatica, I will tell you these are two different kettles of fish. NHS Physio is basically someone giving you exercises and leaving you to independently do them. Private Physio is hands on, massage, electro therapy, exercise and a much more hands on experience.  Well this is what I have found, and when I have a flare up, like you probably, I can't wait to see an NHS Physio, so I run (okay, hobble) to my private guy. Worth every penny of thr £45 a session it costs. Good luck

Eta...when you get here spend £30 and buy yourself a TENS machine, helps greatly with pain management.

Definitely bring as much documentation as you can. I think you have a right to get copies of your x-rays, though you may have to pay a small fee. Register with a GP as soon as you arrive and get advice. What will probably happen is that you'll have to see a private physio. Fortunately you can do this even without a referral from the GP, and it isn't outrageously expensive. I occasionally go to a physio who used to be the physio for the Scotland rugby team and the British & Irish Lions (sort of the British Isles VIP rugby team selected every 4 years), and it costs £45 per appointment. £35-55 seems to be a common range.

I would be prepared to pay for physiotherapy as there may be a waiting list where you register.

In terms of cost it might appear to be a lot for each individual session (I happen to think that 45 UK pounds is quite a lot of money for a one hour appointment), but it beats paying for health insurance that you might not use.

You can get physical therapy on the NHS, or you can pay privately for physio, however as someone with two bulging discs and sciatica, I will tell you these are two different kettles of fish. NHS Physio is basically someone giving you exercises and leaving you to independently do them. Private Physio is hands on, massage, electro therapy, exercise and a much more hands on experience.  Well this is what I have found, and when I have a flare up, like you probably, I can't wait to see an NHS Physio, so I run (okay, hobble) to my private guy. Worth every penny of thr £45 a session it costs. Good luck

Eta...when you get here spend £30 and buy yourself a TENS machine, helps greatly with pain management.

Thanks for the information and advice, ladies. I guess its going to be tough to accept that I'm going to have to pay if I want some fast and decent treatment It's tough because here in the US my insurance completely covers PT. I'm not sure if we can afford to pay £45 a session, it would add up to £360/month and we have a wedding and more visas coming up, we really can't afford it, even if it was half that cost. Not sure what I am going to do, but I am 23 years old and the doctors here said I can fully recover without surgery because of my age. Though I'm not sure if it is going to help if I delay treatment or don't get good treatment :/ I'm in so much pain that everyday tasks are so difficult...walking, sitting, bending, lifting.

This is a good question, Jenny. I too have had sciatica off and on for a number of years. Planning on seeing my PCP in a couple weeks for an annual checkup but want to bring up the recurring pain I've had recently. So, what do I do if she recommends more physio -- will it be cleared up by the time I depart (Feb./March) -- will I be able to continue with physio in UK?? 
And, by the way, sitting on long flights across the Atlantic do not help this condition at all!!

I agree. Sitting for just 3 hours is horrible for me. On an 8 hr flight I have to sit near the isle because I have to get up so often to stretch my legs :/ I hope you can finish treatment and recover before you go to the UK, because it's not looking good for us.

Here are my recent experiences:

(2005) I had some lower back pain so I went to my GP, and they referred me to PT, without xrays or MRIs. I started PT about a week or two later. And this is without having a pre-existing injury. Physio determined it was muscular and luckily I didn't need any further messing about after the initial month.

(2011) This most recent time I moved over, I'd been in a series of PT sessions over the years for a rotator cuff injury here in the US, so I brought all my medical files (forgot to bring the MRI though) and when I went to my GP, she told me I could do a self assessment online and it would refer me to PT. She didn't even want to see the paperwork.

Now that might just be the Camden borough that has you do the self assessment, I can't speak for all PCTs (primary care trusts), but both times it was really easy. Perhaps they were being lazy for not x-raying/MRI first, however it took almost 3 years here in the US to get them to take it serious enough to send me to a specialist. 

Definitely bring as much as you can documentation wise. It can only help.

Thanks for sharing your stories. When you went to PT in the UK, what was it like? Did they show you exercises to do at home and send you off? Or did they sit down with you and have a full session? Here in the US, I go to 1 hr session, 2x a week. When I go in, I lay on a heating pad for 30 min and then do exercises with a therapist for 30 min, and they tell me I should be doing the same exercises at home that I do at therapy.

Just an update in case anyone is in my situation or is curious as to what happens.

I went to see a doctor here for the first time ever so I could just be registered with one and also get treatment for my bad back. I came prepared with my most recent bloodwork results, my vaccination history, medications, ect, and my MRI paper from the US which stated that I had a bulging disc. Needless to say the doctor wasn't interested in anything I brought. She basically said "why are you here?". So I showed her the MRI paper and she flat out said she would refer me to physical therapy, but they don't do surgery or shots for my condition. I was fine with starting PT again but not pleased to hear that they don't do anything for you if PT doesn't work. I have chronic back pain from my condition and she wouldn't even give me medication, just told me to keep taking over the counter painkillers. Anyway, the doctor said I would be on an 8 week waiting list, but thankfully I got seen within 2 weeks.

When I went to the PT appointment, it was very short, 30 mins tops. The physical therapist asked me questions about my previous treatment in the US, asked questions about my pain, and did a few strength tests with me. She was very nice, and showed me some exercises and then gave me a sheet explaining them and I have to do them at home everyday and report back in 4 weeks.

To be honest, I was pretty disappointed. When I went to PT in the US, I met with a physical therapist 2x a week, where they would put me on a heating pad, and I would do exercises there as well as them helping me stretch my back. I had been to PT before(for something else) and successfully recovered, and I feel that I wouldn't have recovered fully if I didn't have someone working with me. So I'm a bit upset that I am on my own now and don't have the luxury of working with a trainer.

We will see what happens, if I don't improve on my own, I will probably look into getting private healthcare.

That is disappointing, jenny. I agree, having to wait 4 weeks before the PT will see you again is not on.
I was sent for physio again in December and was scheduled for 10 sessions, 2 x a week and then the PT extended it because I had to miss a few sessions. I probably could have had another round of sessions but I felt she had taught me what I needed (besides the $15 co-pays each time were getting a bit much). The PT thought my problem might be spinal stenosis rather than disk and was going to recommend to PCP that I get an MRI. Heard nothing about it and it's getting a little close to the Move so I don't know ... I'm sure I wouldn't get it on NHS. 

That is disappointing, jenny. I agree, having to wait 4 weeks before the PT will see you again is not on.
I was sent for physio again in December and was scheduled for 10 sessions, 2 x a week and then the PT extended it because I had to miss a few sessions. I probably could have had another round of sessions but I felt she had taught me what I needed (besides the $15 co-pays each time were getting a bit much). The PT thought my problem might be spinal stenosis rather than disk and was going to recommend to PCP that I get an MRI. Heard nothing about it and it's getting a little close to the Move so I don't know ... I'm sure I wouldn't get it on NHS. 

Wow, I hope they can figure out what condition you have before you move! You don't have the MRI results yet? Make sure you get them printed before you leave so you can speak with a doctor here about it.

I am not lazy by any means but I'm not sure I can correct this problem all by myself. Sure, I can do the exercises at home, but in the US my trainer would physically stretch my legs and pull on my back, something obviously I cannot do myself and only a trained professional should be doing. They had a whole gym with weights, exercise balls, and equipment which I used during my sessions(I'm sure you had similar). I firmly believe that those things were very important for the recovery process. I'm probably going to go out and buy myself a heating pad and maybe an exercise ball and try to recreate my sessions a bit at home

I had already assumed I wouldn't get much treatment through the NHS for my pain but I'm just really upset by it all, and having a hard time adjusting to the healthcare system here and the approach used when treating people who are injured. My back has become very serious and is effecting every aspect of my life.

If you find yourself in the same situation as I am after you speak with an NHS doctor/PT, look into private care. I haven't looked into it myself yet but I'm certainly thinking about it, it sounds like it can be expensive but I'm thinking I may start after my wedding when we have more money.

When are you moving to the UK?

Both my husband and I had the same sort of back problems as you, and received similar provision of physical therapy. Following the exercises gave relief, and we were lucky not to need surgery. If the exercises don't provide relief you need a referral to a specialist which comes from the GP. If you don't like your GP then perhaps there is an alternative Dr. within the practice, or another surgery in the area? You're not tied to the GP you saw.

But, and it's a big but, you must remember that the NHS is not private health care. Moving country means changing your perspective, and sometimes things really aren't the same. You were lucky that physio was free on your particular US plan, on many plans there's a $$ copay for limited sessions.

Private healthcare isn't going to help you. Amost all British private health care plans will not cover treatment for pre-existing conditions.

We will see what happens, if I don't improve on my own, I will probably look into getting private healthcare.

No, I haven't had an MRI -- just meant haven't heard whether the doc. would order it (doubt it at this point -- will be moving by March at the latest).

My PT would sit on my feet and pull my legs and it actually felt good  She also tried me on this creepy machine that pulled on you. Didn't like that at all -- too much like the rack! She also recommended the pool -- just walking in the water. Thought I could try that when I get there. Maybe there are even some kind of classes (?)  She also had me on the stationery bike and we do have a cheapo one in UK. Could probably get another balance ball there -- or even deflate this one and bring it. I have the stretchy bands she gave me which will be easy to bring.

I just found this: http://www.backcare.org.uk which looks like it might be helpful.

Buy yourself a TENS Machine....I promise you won't regret it.