Muscolosketal System Disorders

Unit 8: Muscolosketal system Disorders

Arthritis (Osteoarthritis) – Arthritis occurs as we age, and our joint tissues become less and less resilient to the wear and tear. The joint begins to degenerate and begins to swell, pain occurs and a lot of the time, the loss of mobility of joints. Changes happen in both the soft joint tissues and the bones opposite. This a condition known as osteoarthritis. This is known as the most common type of arthritis in the UK which is affecting over 8 million people. It mainly develops in adults who are in their late 40’s or older. It can occur at any age because of an injury or be associated with other joint related conditions. Osteoarthritis begins to affect the smooth cartilage lining of the joint. This makes movement more difficult than usual, which will then lead to pain and stiffness. Whenever the cartilage lining starts to roughen and begin to thin out, the tendons and ligaments must work harder. This can then cause swelling and the development of bony spurs which is called osteophytes. Severe loss of cartilage can lead to bone rubbing on bone which will lead to the altering the shape of the joint. This forces the bones out of their normal position.

The most commonly affected joints are those in the:

• Spine
• Hips
• Hands
• Knees

There is no set cure for osteoarthritis, but the condition doesn’t necessarily get any worse over time and several treatments are available to help relive the symptoms.

The main treatments for osteoarthritis include:

• Lifestyle measures can include maintaining a healthy weight as well as regular exercise. Your physical activity should include a combination of exercises to strengthen your muscles. Even though you may think that exercise will make your symptoms worse due to the pain and stiffness this isn’t the case. With regular exercise
• Medication – to relive any serious pain. This will include painkillers, paracetamol or Non-steroidal anti-inflammatory drugs. If you have pain because of osteoarthritis, then your GP might suggest taking paracetamol first. You can take this without a prescription. Its best to take it regularly rather than waiting until your pain becomes unbearable. Painkillers that you take will be down to the severity of the pain and what your GP recommends. If paracetamol doesn’t control the pain of your osteoarthritis effectively, then your GP may prescribe a stronger painkiller. This may be a non-steroidal anti-inflammatory drug or NSAID. These are painkillers that work by reducing the inflammation. There are two types of NSAID and the both work in slightly different ways:

• Traditional NSAIDs – This includes medication such as ibuprofen, diclofenac or naproxen.
• COX-2 inhibitors – which is often called coxibs – such as etoricoxib and celecoxib.

Some of these NSAIDs can be available as creams that you apply directly to the affected joints. They can be very effective if you have osteoarthritis in your knees or hands. This can reduce the swelling as well as to help ease the pain. Another form that NSAIDs can take are tablets however they may not be suitable for people with certain conditions, such as peptic ulcers, asthma or if you have had a heart a hear attack or stroke at a previous stage of your life.

• Supportive therapies – to help make normal everyday activities easier. These can include using hot or cold packs which are applied to the joints to relive pain, manual therapy which consist of stretching out your joints to keep them as flexible as possible or using something simple like a walking aid, using different kind of foot wear if your osteoarthritis is located at the joints of your feet.

If these treatments fail and haven’t been helpful then surgery may be considered to repair, strengthen or to replace any damaged joints. Surgery for osteoarthritis is only needed in a small number of cases where other treatments haven’t been effective or where one of your joints is severely damaged. Having surgery may greatly improve your mobility and your as well as your symptoms. It is important to note that surgery can’t be guaranteed to get rid of symptoms altogether and you may still experience pain as well as stiffness from your condition. Types of surgery include:

• Arthroplasty – This is joint replacement therapy which is the most commonly carried out surgery to replace hip and kneed joints. During an arthroplasty, your surgeon will remove your affected joint and replace it with an artificial joint made of very special plastics and metal. An artificial joint can last up for 20 years however it might to be replaced at some point. There’s also a newer type of joint replacement surgery called resurfacing. This joint replacement surgery uses only metal components an may be more suitable for the younger patients.
• Osteotomy – This form of surgery is knee replacement surgery which consists of removing a small section of bone either below or above your knee joint. This is done to help realign your knee, so your weight is no longer focused on the damaged part of the knee. An osteotomy can relive your symptoms of osteoarthritis however you might still need knee replacement surgery eventually.

Tendonitis/Tendinitis – A tendon is a tissue that attaches muscle to the bone. It is stretchy, tough and fibrous and it can endure a lot of strain. A ligament extends from bone to bone at a joint, while a tendon extends form muscle to bone. Muscles and tendons work together and exert a pulling force. Tendons and ligaments are tough and fibrous, but they are known as a soft tissue, since they are softer compared to bone. If the sheath around the tendon becomes inflamed, rather than the tendon itself, the condition is known as tenosynovitis. Tendinitis and tenosynovitis can occur together.            

Tendonitis occurs when a person overuses or injures a tendon. It is normally linked to an acute injury with inflammation. Tendinitis can occur at any age however its more common among adults who do a lot of sport in their time. Older people are a lot more susceptible to this than the younger generation due to their tendons losing elasticity and becoming weaker with age.

• Elbow
• thigh
• fingers
• wrist

As well as other parts of the body.

Treatment – Treatment aims to relieve pain as well as reducing the inflammation. Treatment can include:

• Resting the joint
• Hot and Cold treatments
• Splinting the affected joint
• Over-the-counter pain relievers

Rest – Resting will allow the inflammation time to decrease in severity. If a certain sporting activity or typing was the cause for the tendinitis, the person will need to rest from this activity, or reduce the amount of time spent on the activity. A brace, bandage or splint may be used to help reduce movement. If you do not rest it can cause a lot more complications in the future.

Hot and cold – An ice pack or a warm towel may be used to reduce the pain felt as well as reducing the swelling in the area affected. Ice should only be applied from 10 – 15 minutes on the affected area once or twicer per day. Its also important to note that you should wrap the ice in a towel and not apply directly on the skin. Relief may also come from taking a warm bath, applying cream and other soothing ointments to the area and applying hot towels.

Pain relivers –

Physical therapy such as manipulating and massaging the affected area may provide relief and speed up the healing process.             Over the counter drugs such as ibuprofen and other non-steroidal anti-inflammatory drugs. These have been proven to reduce tendon pain. Corticosteroid injections which is used around the tendon and can alleviate the symptoms. It’s important to note that if repeated injections are taken around the area affected, the tendon may be weakened and have the increased possibility of a rupture. A physical therapist may also recommend very specific stretching exercises which are designed to stretch and strengthen the tendon and muscle that is affected.

Shock wave therapy – If tendinitis continues to persist, something called extracorporeal shock wave therapy (ESWT) may be taken. How it works is a shock wave is passed through the skin which breaks up the calcium deposits around the tendon. These deposits may also be removed surgically.      

Carpal tunnel syndrome – Carpal tunnel syndrome is pressure on a nerve in your wrist. This nerve passes over the carpal bones through a passage way at the front of the wrist. CTS happens whenever the carpal tunnel inside your wrist swells and squeezes one of your nerves. You’re at a greater risk of getting CTS if:

• You’re over-weight.
• Pregnant.
• Normally do work or hobbies that force you to bend your wrist or grip vibrating tools.
• From another illness, such as diabetes or arthritis.
• Passed down from parent or runs in the family.
• Previous injury around your wrist.

Carpal tunnel syndrome can cause numbness, tingling and pain in your fingers and hands. Most of the time you can treat yourself, however it can take up to several months fully recover and get better. Symptoms of carpal tunnel syndrome include:

• An ache or pain located in your fingers, arm or hand.
• Hands feeling numb
• Pins and needles
• Having difficulty gripping and a weak thumb

These symptoms often begin slowly, and they tend to come and go. Sometimes, CTS can clear up itself in just a few months. Most of the time people will have it because of pregnancy.

Treatment –

Wrist splint – This is something you would wear on your hand to keep your wrist as straight as possible. It aids to reduce the pressure on the nerve in your wrist. You would wear it at night while you sleep, and you will need to wear this splint for a minimum of 4 weeks before you begin to feel any difference. Your bale to buy wrist splints online or from your local pharmacies.