Musculoskeletal
Musculoskeletal pain refers to discomfort or pain originating from muscles, bones, tendons, ligaments, or joints.
Musculoskeletal injury or pain is generally caused by trauma, inflammation or aging (living life). These different paths finally lead to an injury to your muscle, bone, tendons, ligaments or joints. This can be acute or chronic in nature. The majority of minor injuries heal adequately in 6-12 weeks.
Some injuries within areas of poor blood flow heal much more slowly. Continued recurrent inflammation due to ongoing repetitive injury or stress may also fail to heal. Examples include large muscle tears, fasciitis, tendonitis and bursitis. In some cases it is clear that these treatments offer the best chance of a pain-free long term outcome such as in plantar fascitits and elbow tendonitis, for example.
This healing process may be accelerated and potentially improved with the use of Biologics, thus avoiding the need for surgery. This explains why athletes seek such treatment.
After an evaluation for an underlying source of pain and treatment of systemic inflammation, musculoskeletal pain is typically treated to achieve healing of the damaged tissue. Then, to preserve and maintain function, corrective exercise or therapy is pursued with the goal of restoring muscle strength and balance at affected joints in an effort to correct disuse or abnormal postures used to control pain.
Steroids are commonly used and do work in the short term. Unfortunately, they also break down tissue, result in accelerated wear, and prevent the cell signaling required for your body’s normal full healing response. This can result in premature failure of a a joint or tendon and increased risk of re-injury in athletic pursuits. This can be avoided with the use of Biologics which fully harness your own healing with mounting evidence of more durable and stronger outcomes.
Hyaluronic acid is successfully used for injection into large joints with relief of pain and improvement of function. Unfortunately the outcome is not healing and the limited durability does not achieve enough benefit to dependably avoid progression of arthritis requiring surgery.
An attitude of persistence is necessary both for the patient and clinician, as all therapies don’t uniformly work equally for each patient and it’s usually through a combination of therapies unique to each patient that we achieve our best outcomes.
Understanding the musculoskeletal system
The musculoskeletal system comprises bones, muscles, tendons, ligaments, and joints, working together to support movement and protect the body.
Here’s an overview of the components and functions of the musculoskeletal system:
- Bones: The skeletal system consists of more than 200 individual bones that form the body’s framework. Bones provide support, protect vital organs, and serve as reservoirs for minerals like calcium and phosphorus. They are also responsible for the production of blood cells in the bone marrow.
- Muscles: Muscles are responsible for generating movement through contraction and relaxation. There are over 600 muscles in the human body, and they come in three main types: skeletal (voluntary muscles that move limbs), smooth (involuntary muscles found in organs), and cardiac (the heart muscle).
- Tendons: Tendons are fibrous tissues that connect muscles to bones. They transmit the force generated by muscles to the bones, allowing for controlled and precise movements.
- Ligaments: Ligaments are tough, elastic connective tissues that link bones together at joints. They provide stability and limit excessive joint movement, preventing dislocations and injuries.
- Joints: Joints are the points where two or more bones meet and can move relative to each other. They come in various types, including hinge joints (e.g., elbow), ball-and-socket joints (e.g., hip), and pivot joints (e.g., the radius and ulna in the forearm).
The musculoskeletal system’s functions encompass not only movement but also maintaining posture, protecting internal organs, and supporting the body’s weight. It is integral to activities of daily living, from walking and running to more complex tasks like lifting and carrying objects. Additionally, the musculoskeletal system plays a crucial role in maintaining overall health and well-being, as it houses the bone marrow, where blood cells, including red and white blood cells and platelets, are produced by your stem cells.
Caring for the musculoskeletal system is vital for maintaining mobility, preventing injuries, and addressing various musculoskeletal conditions and disorders, such as arthritis, fractures, sprains, and musculoskeletal pain.
Common causes of musculoskeletal pain
Musculoskeletal pain can result from a variety of causes, including:
- Injuries: Strains, sprains, fractures, and dislocations can lead to acute musculoskeletal pain.
- Overuse: Repetitive motions or excessive use of specific muscle groups or joints can cause overuse injuries and pain.
- Arthritis: Various types of arthritis, such as osteoarthritis and rheumatoid arthritis, can lead to chronic joint pain and inflammation.
- Tendinitis: Inflammation of tendons, often due to overuse or repetitive movements, can result in localized pain.
- Ligament Injuries: Ligament sprains, such as those in the knee (e.g., ACL tear), can cause significant pain and instability.
- Muscle Tears: Tears or ruptures of muscle fibers can result from sudden trauma or overexertion.
- Nerve Compression: Conditions like carpal tunnel syndrome and sciatica involve nerve compression, leading to pain and discomfort.
- Spinal Disorders: Disc herniation, spinal stenosis, and other spinal conditions can result in back or neck pain.
- Poor Posture: Prolonged poor posture can lead to muscle imbalances and discomfort, particularly in the neck and lower back.
- Age-Related Changes: As people age, natural wear and tear on joints, muscles, and bones can lead to musculoskeletal pain.
It’s important to note that the specific causes of musculoskeletal pain can vary from person to person and often, multiple factors may contribute to the pain experienced. More recent evidence shows that an injury to a myofascial unit may result in central sensitization and neurogenic inflammation, resulting in pain that is much more widespread than the original injury. Accurate diagnosis and appropriate treatment are crucial to addressing musculoskeletal pain effectively. If you’re experiencing persistent or severe musculoskeletal pain, it’s advisable to consult with a healthcare provider for a proper evaluation and treatment plan.
Every patient is unique, which is why everyone’s musculoskeletal pain symptoms are unique as well. You may experience a constant, dull, lingering pain that isn’t unbearable but is a constant discomfort. At other times, you may have a “flare-up” in which your pain comes on suddenly. Other symptoms include:
- Deep aching, throbbing, tight, or stiff pain in your affected muscles
- Trigger points, like a small bump, nodule, or knot in a muscle that triggers pain when touched, or even when it’s not touched
- Tender or sore muscles or joints
- Weakness in the affected muscle(s)
- Reduced range of motion in affected areas
There are other issues that may coincide with myofascial pain syndrome:
- Headaches
- Poor sleep
- Stress, anxiety, and depression
- Fatigue
The diagnosis process for musculoskeletal pain typically involves several steps to identify the underlying cause and to develop an effective treatment plan. Here is an overview of the common diagnostic process for musculoskeletal pain:
- Medical History: We’ll begin by taking a detailed medical history, which includes questions about the onset, duration, and characteristics of the pain. We will discuss any recent injuries, activities, or medical conditions that may be related to the pain.
- Physical Examination: A physical examination is conducted to assess the affected area and the range of motion, strength, and any signs of inflammation or deformity. Palpation of the area is often performed to identify tender points or areas of pain.
- Imaging Studies: X-rays, MRI, or CT scans may be ordered to visualize the bones, joints, and soft tissues. These imaging tests can help identify fractures, structural abnormalities, and degenerative changes in the musculoskeletal system.
- Blood Tests: Blood tests may be used to check for markers of inflammation or specific autoimmune conditions that could contribute to musculoskeletal pain.
- Ultrasound: Musculoskeletal ultrasound can provide real-time images of soft tissues like tendons and ligaments, helping to diagnose conditions like tendinitis or tears.
- Bone Scans: In some cases, nuclear medicine bone scans may be used to identify areas of increased bone activity, which can indicate conditions like stress fractures or infections.
- Specialized Testing: Depending on the patient’s symptoms and medical history, additional tests or consultations with specialists such as rheumatologists, orthopedic surgeons, or neurologists may be recommended.
- Review of Medications: It’s important to review any medications or supplements you are taking, as certain medications or interactions can contribute to musculoskeletal pain.
Once the underlying cause of musculoskeletal pain is identified, we can work with you to develop an appropriate treatment. Accurate diagnosis is essential to address the root cause of the pain and tailor treatment to your specific condition.