Musculoskeletal pain – the number one reason for doctor visits

Muscle-and-Joint-Pain

Have you ever lifted a heavy bag too quickly and hurt your back? Or gone for a run and twisted your ankle? If so, you will know the lingering pain that such injuries can inflict – and also that feeling of reluctance to seek medical treatment.

Because they often occur in mundane, everyday circumstances, we tend to dismiss joint and muscle injuries as minor and don’t want to trouble anybody with having to treat them.

The rest, it seems, just grit their teeth.

But pain is your body’s natural warning system. Disregard it at your peril. Early treatment will not only curtail your suffering, it can also prevent chronic symptoms from setting in. Physical therapy applied early on can make investigations, surgery, pain medications, injections and additional medical appointments at a later date all less necessary.

The message is clear: where joint and muscle pain are concerned, it pays to be proactive. 

Have I got musculoskeletal pain?

Musculoskeletal pain is any pain that affects the muscles, bones, ligaments, tendons and nerves. It is commonly – but not always – caused by physical injury. A recent study in Korea suggests that a person’s risk of muscle and joint injury can be increased by normal daily activities, including prolonged sitting, holding an awkward posture or reaching overhead.

Overuse of specific muscles or joints can also lead to a type of musculoskeletal pain known as repetitive strain injury (RSI). Often seen in athletes, manual workers and others with jobs and hobbies that require the same movement to be made over and over again, RSI is caused by microscopic tissue damage that worsens with repeated movement.

Age is another risk factor for musculoskeletal pain. Osteoarthritis, for example, is a painful degenerative joint condition that’s caused by the wearing away of protective cartilage where two bones meet to create a joint. Because cartilage wear and tear happens every time we move, by the time we reach later life, many of us have completely worn through the cartilage in commonly used joints like the hip and knee. Osteoarthritis is the most common cause of disability in older adults, affecting 10% to 15% of those over the age of 60. 

Musculoskeletal pain as a symptom of illness

A case in point is fibromyalgia, a condition whereby sufferers experience chronic body pain lasting for months on end. The pain is often widespread throughout the body and accompanied by unexplained tiredness. According to research, it affects 3-6% of the world’s population and, while there is currently no known cure, early diagnosis allows patients to make lifestyle changes that can make the condition easier to live with.

Moreover, research suggests that early treatment can prevent short-term pain from becoming chronic. According to a 2012 review in the US, failure to correctly treat pain from injury early on can lead to chronic symptoms because persistent pain signals can alter the way the nervous system responds to pain. Therefore, while pinpointing and self-treating pain from injury or overuse is often straightforward, it’s always worth seeking medical advice for musculoskeletal pain. 

According to a 2012 review in the US, failure to correctly treat pain from injury early on can lead to chronic symptoms because persistent pain signals can alter the way the nervous system responds to pain.

Effective treatment of musculoskeletal pain

While painkillers are often the first resort for the treatment of musculoskeletal pain, effective pain management goes a lot further than popping pills. True, an acute injury like a muscle sprain can be effectively treated with rest and anti-inflammatory painkillers, but in many cases there is more intervention required, and chronic pain requires a completely different approach altogether – one that tackles physical, psychological and social factors.

What we’re talking about here is a multidisciplinary team that works under one roof that might consist of health professionals such as manual therapy or physical therapy experts, osteopaths, chiropractors, anaesthesiologists who specialise in pain management, naturopathic medicine practitioners, nurses, psychologists, social workers, and home care nurses. As always, the best first step is early assessment by your primary physician. Once he or she has diagnosed the most likely cause of your pain, you can then be referred to other specialists for appropriate care or further investigation.

Remember that pain is sometimes a sign of another condition and, therefore, it is not uncommon for what seems like a simple injury to require input from specialists, such as rheumatologists, endocrinologists or orthopaedic surgeons. If there is no identifiable cause and a chronic pain syndrome is suspected, it is likely that you will undergo several tests.

Remember that pain is sometimes a sign of another condition and, therefore, it is not uncommon for what seems like a simple injury to require input from specialists, such as rheumatologists, endocrinologists or orthopaedic surgeons.

You may find yourself having to undergo a ‘diagnosis of exclusion’ – whereby, in the absence of objective proof, the most likely cause of your pain is diagnosed by ruling out all provable explanations for your symptoms. Chronic pain conditions like fibromyalgia are called ‘diagnoses of exclusion’. Doctors will often run many tests (including blood tests and imaging) before giving you a chronic pain syndrome diagnosis.

It sounds alarming but even if you do fall into the category of having a chronic pain syndrome, this need not consign you to a lifetime of discomfort. There is a wide variety of medications available (including muscle relaxants and stronger painkillers), as well as physical therapy and electrical nerve stimulators that are all effective tools for managing long-term pain. Recent studies also suggest that more innovative therapies like injecting injured joints with numbing medicine under precise ultrasound guidance or with a natural blood component, called platelet-rich plasma (PRP), or with stem cells derived from fat from your own body may have a role to play in treating acute or chronic musculoskeletal pain without resorting to surgery. 

Do not ignore pain

US Government statistics from 2015 show that musculoskeletal complaints accounted for nearly one third of all days absent from work. This figure could be greatly reduced if people were more inclined to seek treatment for what they perceive as a ‘normal’ ailment. Rather than hobbling along and hoping the pain will go away, there is plenty you can do to keep the debilitating effects of musculoskeletal pain to a minimum.

Rather than hobbling along and hoping the pain will go away, there is plenty you can do to keep the debilitating effects of musculoskeletal pain to a minimum.

If the cause of your pain is an injury, you can treat it at home with painkillers, ice, rest and elevation, but take the precaution of seeking medical help. What seems like a straightforward injury could well be the symptom of a more serious condition and early intervention is the secret to preventing a straightforward injury from developing into a long-term problem.

As with any warning system, once you know the cause of the alarm you can take the appropriate course of action. But put up a resilience to pain before you know where it’s coming from and you run the risk of it becoming a nagging feature for life.

Surely it’s better to be safe than sorry.

Dr. Gustavo Rydberg

About Dr. Gustavo Rydberg

With over 15 years of experience in musculoskeletal and sports medicine, ‘Dr. Gus’ is qualified in general practice, osteopathic medicine, pain medicine, sports medicine and MSK ultrasound diagnostics/interventions. His speciality is in the management of musculoskeletal pain, including back pain, and he has a special interest in combining treatment modalities like manual-osteopathic approaches with allopathic medical pain management and minimally invasive procedures. These range from image-guided injections with platelet rich plasma (PRP), steroids, high-volume injections, hydro-dissection and fat transfer to joints which possess stem cell properties. Dr. Gus has been the Medical Director of the Andalusian Karate Federation and a medical staff of the Spanish Karate Federation for over 10 years, and prior to moving to Dubai he successfully managed a number of private clinics in Spain. As an experienced lecturer, Dr. Gus frequently speaks on MSK interventional pain management as a faculty member of the International Pain Diploma offered by the University of Montpellier in France.

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