Pain in muscles and bones (musculoskeletal pain)

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What is it about ?
Musculoskeletal pain is an umbrella term for pain in muscles, bones, tendons, ligaments, and joints, including their nerves, cartilage, and bursae. Musculoskeletal pain is a very common complaint that can have all kinds of causes. It can occur acutely or gradually and take a chronic form. The possible causes are injuries related to overwork, sports trauma, accident, improper positioning or the use of unsuitable equipment in the workplace. Pain can also be related to conditions like osteoarthritis, rheumatism, fibromyalgia, etc. Very often, pain in the muscles or bones occurs for no reason and goes away on its own.

What is its frequency?
Musculoskeletal pain is a very common reason for consulting a general practitioner. Thus, muscle pain is the complaint justifying 5.5 consultations out of 1000 each year.

How to recognize it?
Musculoskeletal pain can be detected when you have pain in your muscles and joints. Often it is not just the pain, but also itching, irritation, heat, cramping and / or stiffness. The nature of the complaints depends on the cause of the problem. For example, in the event of a sports injury, the pain appears suddenly. In osteoarthritis, on the other hand, it increases rather gradually, with complaints of nocturnal pain and morning stiffness. In rheumatism, one or more joints are red, hot, swollen, and painful. In tendonitis, the pain is usually related to a long-lasting load, such as when you always perform the same movements at sport or at work.

How is the diagnosis made?
The doctor will ask you questions about the type of pain you feel, when it started, and whether the intensity of the pain is decreasing or increasing. Then he will examine you. Sometimes he thinks it is appropriate to do additional tests, such as a blood test or x-rays.

What can you do ?
In the presence of normal muscle pain, a visit to the general practitioner is usually not necessary. Usually, these pains are short-lived and go away on their own. Most cases of normal muscle pain can be resolved without a doctor’s help, by applying ice packs to the painful area, with rest, and by taking paracetamol medications. If the pain is the result of an accident (trauma) or overload (eg tendonitis), rest is very important.

In the presence of certain forms of musculoskeletal pain, such as osteoarthritis of the knee, exercise may be beneficial. More physical exercise as well as exercises that improve muscle strength can also be helpful in treating neck pain and lower back pain. Exercises to improve endurance are helpful in the treatment of fibromyalgia. These exercises are performed under the supervision of an experienced physiotherapist. In the treatment of musculoskeletal pain, the effect of “passive physiotherapeutic treatments”, such as massage, is limited.

What can your doctor do?
If medication is needed, the doctor will first prescribe paracetamol medication or an anti-inflammatory drug. Muscle ointment based on anti-inflammatory drugs is also beneficial in relieving muscle and bone pain.

Taking anti-inflammatory drugs rarely makes sense. In addition, they can cause serious side effects, such as stomach ulcers, increased blood pressure, adverse effects on the heart and kidneys. This is why it is recommended to administer them with caution, especially in cases of chronic pain. In many cases, paracetamol remains the safest choice.

It is also ideal to avoid muscle relaxants. They can cause side effects like dizziness or drowsiness, and can be addictive.

In some cases of chronic pain and fibromyalgia, antidepressants can provide pain relief.

It happens that cortisone injections are necessary, especially in cases of tendonitis and bursitis and in cases of osteoarthritis or arthritis.

Adaptations can be made in the workplace, such as adapting tables, office chairs, mouse, keyboard, etc.

In the event of chronic pain, the doctor can refer you to a multidisciplinary team of specialists.

Want to know more?

Source

Foreign clinical practice guide ‘Musculoskeletal pain’ (2006), updated on 02/28/2017 and adapted to the Belgian context on 08/16/2018 – ebpracticenet

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