Musculoskeletal Guidelines
Musculoskeletal disorders are conditions that affect the muscles, bones, and joints in the human body. These disorders are often difficult to treat simply because their affects can be so wide-reaching that they can affect the entire body. An injury in the neck can cause pain to radiate down the leg. Musculoskeletal disorders affect the body's movement because of how the entire body interacts with itself as a whole. Muscles are connected by ligaments, nerves, and living tissues that interact with one another, so injury to one can produce pain throughout other, seemingly unrelated, areas of the body. Those who suffer from musculoskeletal pain and injury are often severely limited in movement and daily function. Proper treatment of musculoskeletal disorders and pain is imperative to a patient's quality of life.
As with all treatment, a related history should be taken of each patient. Impertinent information includes:
- Determine if a specific injury occurred to cause the musculoskeletal disorder
- Determine and evaluate current symptoms (their duration, frequency, intensity, and how they impair or effect daily living)
- What type of treatment has been used to date and the response of the treatment
- Physical activities: both occupational and recreational
- Additional medical history
- Family history
- Psychosocial factors that may delay recovery
- A physical examination to observe range of motion and reflexes
The musculoskeletal system includes bones, muscles, tendons, ligaments, and nerves – which make up the majority of the human body. Pain, numbness, and loss of function are all common complaints of those suffering from musculoskeletal disorders simply because of how the body is created. This intertwining of bones with muscles, muscles with tendons and ligaments, and all of these connected with the nervous system makes musculoskeletal disorders unbearable for many patients.
Management of chronic musculoskeletal disorder must be seen from the view that this disorder is a degenerative disorder. Musculoskeletal disorder is most often not expected to completely resolve through treatment, but patients can achieve successful results in functional improvement, stabilization, pain management, and the slowing of progressive degenerative changes.
Musculoskeletal disorders have become a global healthcare issue, being the second leading cause of disability. These disorders prevent many individuals from being able to work, and the total cost for treating musculoskeletal disorders is estimated to be more than $125 billion annually. Disability caused by musculoskeletal disorders is the third leading reason for early retirement in the United States. These statistics prove how far-reaching the effects of these disorders are. Physicians are responsible for helping to improve the quality of life for those suffering with musculoskeletal disorders, yet it is no easy task.
From "tunnel syndromes," to back and neck issues, to the functionality of the entire body, musculoskeletal disorders are disruptive to life. Physicians must base much of their information on self-reports from patients regarding their pain and symptoms. They must rely on medical history, recreational and occupational injuries, intensity of pain, physical examinations to locate the source of pain, lab tests, X-rays, and MRI screenings to find specific criteria to diagnose different musculoskeletal disorders. Pain is usually best relieved by treating its cause; therefore, identifying the specific causes is imperative. From there, medications, physical therapy, and surgery can be recommended.
Musculoskeletal disorders, like most chronic conditions, have multiple risk factors that are both occupational and non-occupational. Physicians must take the time to identify the source before treating the pain.
- American Academy of Orthopedic Surgeons
- European Society of Musculoskeletal Radiology
- Royal Australian College of General Practitioners
- Occupational Safety and Health Administration
- 2020 VA/DoD clinical practice guideline for the non-surgical management of hip & knee osteoarthritis
- 2020 Endocrine Society Guideline Pharmacological Management of Osteoporosis in Postmenopausal Women
- 2019 Osteoarthritis Guideline Early View
- 2019 Comparative Effectiveness Research Long Term Drug Therapy and Drug Holidays for Osteoporosis Fracture Prevention Systematic Review
- 2018 European League Against Rheumatism, Physical Activity in Adults with Arthritis
- 2018 Europran League Against Rheumatism Evidence Based Statement on Gout
- American College of Physicians 2017 Treatment of Low Bone Density or Osteoarthritis to Prevent Fracture in Men and Women Clinical Practice Guideline
- AHRQ 2017 Treatment of Osteoarthritis of the Knee
- AHRQ 2017 Lower Extremity Injury Medical Guideline