The burden of musculoskeletal disorders

Musculoskeletal disorders are disorders or injuries that affect structures of movement. These biomechanical structures include bone, muscle, tendon, ligament, cartilage, and other connective tissues.

Examples of Musculoskeletal disorders include back pain, neck tension, tendonitis, strains or sprains of muscle/tendon/ligament, degenerative disc disease, carpal tunnel syndrome, osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus, scleroderma, polymyalgia rheumatica, gout, fibromyalgia…the list exceeds 100 conditions! It’s not surprising that some of us have experienced at least one of these once in our life time.¹ They are extremely common and the risk is increased with age.

“Musculoskeletal disorders are one of the most prevalent and costly disorders globally.”¹

The Australian Institute of Health and Welfare reported:

“Musculoskeletal conditions contributed 12% of the total burden of disease and injury in Australia in 2011.” ²

“[Musculoskeletal disorders] were ranked as the fourth leading contributor to total burden after cancer, cardiovascular diseases, and mental and substance use disorders.“ ¹

Treatment

Treatment for chronic musculoskeletal pain and disorders should be focused with the aim to ‘load’ and provide ‘resistance’ to the affected joints and/or movements. However, controlled articular loading or resistance to these affected areas may temporarily reproduce and aggravate the pain or symptoms.³ The rehabilitation process should be prescribed under supervision from a trained physical therapist such as chiropractor, physiotherapist, exercise physiologist, etc. Prescribed loading and resistance will address the fear avoidance and catastrophising belief, which occurs after long-term musculoskeletal pain or discomfort.

A study published in the British Journal of Sports Medicine reported:

There is moderate quality of evidence that suggests that rehabilitation “protocols using painful exercises offer a small but significant benefit over pain-free exercises in the short term.

Conclusion

 “Pain during therapeutic exercise for chronic musculoskeletal pain need not be a barrier to successful outcomes.”¹

Future research is warranted to fully evaluate the effectiveness of exercise prescription into pain for chronic musculoskeletal disorders.

1.Smith, BE, Hendrick P, Smith TO, Bateman M, Moffatt F, Rathleff MS, Selfe J, Logan P (2017). Should exercises be painful in the management of chronic musculoskeletal pain? A systematic review and meta-analysis. British Journal of Sports Medicine.
2.Australian Institute of Health and Welfare. 2017. Burden of disease. [ONLINE] Available at: http://www.aihw.gov.au/burden-of-disease/. [Accessed 15 August 2017].
3.Nijs J, Roussel N, Paul van Wilgen C, et al. (2013). Thinking beyond muscles and joints: therapists’ and patients’ attitudes and beliefs regarding chronic musculoskeletal pain are key to applying effective treatment. Man Ther;18:96–102.