What are musculoskeletal disorders?
Musculoskeletal disorders are abnormalities of the bones, muscles, or connective tissue of the body. Musculoskeletal disorders are anomalies of the bones, muscles, or connective tissue of the body. They can be in the form of disease, deformity from birth or the result of injury. Learning the terminology is the first step in gaining insight into these conditions.
Ankylosing spondylitis – Is a chronic inflammatory disease affecting the spine, the joints between the spine and the pelvis and various other joints of the body. The most common symptoms are pain and stiffness throughout the spine from the neck down to the lower back. The vertebrae may fuse, causing a stooped posture and the classic bamboo spine seen on x-ray. Inflammation of the joints between the ribs and the spine and the ribs and the sternum can cause restricted breathing. Less common symptoms of ankylosing spondylitis are pain in the heels, ankles, hips, shoulders and knees. Because it is a systemic disease it can also cause non-musculoskeletal symptoms including fatigue, fever, weight loss, decreased appetite and shortness of breath if it affects the lungs or heart. Medical science does not know the cause of ankylosing spondylitis but genes predispose to it. The genetic link is based on the fact that individuals with the HLA B 27 antigen detected on the surface of their white blood cells have a higher incidence of the disease. The peak age of onset is between 15 and 25 years of age. It is 3 times more common in males and females. Marie-Strumpell disease is a synonym.
Arthritis – arthritic – adj. – Is inflammation, deterioration of cartilage, and/or abnormal bone formation in a joint. There are various types of arthritis. The most common forms are osteoarthritis, rheumatoid arthritis and gout.
Avascular necrosis – Is a condition in which there is death of bone tissue in an area of interrupted blood flow. The most commonly involved areas are bone in or around the hip, knee, upper arm, shoulder and ankle. Joint pain on weight-bearing or use of the muscles that move the bones of the affected joint is the most common symptom. Trauma is the most common cause. But it can be associated with chronic use of corticosteroids, sickle cell anemia, excessive alcohol use, HIV infection, radiation treatment, chemotherapy, autoimmune disease and decompression sickness. Osteonecrosis, aseptic necrosis and ischemic bone necrosis are alternate terms.
Bursitis – Is painful inflammation of a bursa. Repetitive motion is a common cause. Acute or chronic infections are other causes. It has also been associated with rheumatoid arthritis and gout.
Cervical spondylosis – Is a degenerative disease of the cervical spine. In addition to the formation of bone spurs from the vertebrae, there is loss of fluid from the intervertebral discs. The most common symptoms it causes are neck pain and neck stiffness. It is a disease of aging and generally begins around the age of 55. Typical findings on x-ray of the cervical spine are bone spurs and a decrease in the spaces between the vertebrae resulting from shrinkage of the discs due to the loss of fluid from them.
Chondromalacia patellae (chondromalacia patella) – Is a condition in which there is abnormal softening or wear and tear changes of the cartilage that coats the back of the kneecap. It forms part of the patellofemoral joint which is where the back of the kneecap and front of the thigh bone meet. It is one of the many causes of knee pain. Plain x-rays don’t usually yield the diagnosis but an MRI scan does. Arthroscopy – visualization of the inside of a joint via a device inserted through a skin incision – can also make the diagnosis.
Degenerative arthritis – Is a chronic progressive degenerative disease of a joint or joints. Loss of cartilage and overgrowth of bone at the joint margins are the characteristic pathology. Cyst formation may also occur at the joint margins. Pain in the affected joint or joints is the most common symptom. It most commonly affects the knees, hips, fingers joints, thumb joints and spine. The shoulders, elbows, wrists, ankles and toe joints or less commonly affected. It might develop secondary to prior joint injury or might be a primary disease. Conventional wisdom is that wear and tear is the cause. Research suggests though that several other not well understood factors are also involved. Osteoarthritis, degenerative joint disease and DJD are synonymous terms.
Degenerative disc disease (DDD) – Is the changes in the discs between the vertebrae which occur as a consequence of aging. Because of fluid loss from the discs they lose their sponginess and become less effective as shock absorbers between the vertebrae. The changes can occur throughout the spine, but most commonly in the neck and lower back. The changes can cause back pain and neck pain.
Dislocation – Is the displacement of a bone from its respective joint.
Fracture – Breakage of bone. A horizontal breakage is a transverse fracture. A diagonal breakage resulting from torque (a twisting motion) applied to the long axis of the bone when the fracture occurs, is a spiral fracture. A comminuted fracture is one in which the bone is splintered or crushed or broken into several pieces. A compound fracture is one in which a fragment of broken bone is protruding through the skin. A greenstick fracture is one in which the bone cracks and bends rather than breaks completely. A compression fracture is one in which part of the bone collapses. It most commonly refers to a vertebra.
Fibromyalgia – Is a disorder associated with fatigue and muscle pain throughout various portions of the upper and lower body. Suffers usually have areas of point tenderness when pressure is applied. Other symptoms that can occur with it are headaches, trouble sleeping, problems thinking and remembering, morning stiffness, tingling or numbness in the hands and feet, and painful menstrual periods. Its cause is unknown.
Gout – Is a form of arthritis in which acute attacks of severe pain, swelling, redness, heat and stiffness occur in a joint as a result of the deposition of uric acid crystals in the affected joint. It most commonly involves the MTP joint of the big toe, but can also affect various other joints. They include joints of the knee, ankle, foot, hand, wrist, fingers and elbow. An acute gout attack usually affects only one joint at a time unless it involves the hand or foot. The cause of the uric acid buildup is the body’s breakdown of foods containing chemical substances known as purines. Some of the foods high in purines are liver, dried beans, peas and anchovies, sardines, gravies and sweet breads.
Legg-Calvé-Perthes disease (Perthes disease) – This is a form of avascular necrosis of the hip that occurs in children, typically before the age of 10 years. The primary problem is temporary disruption of blood supply to the head of the femur. The result can be damage to the growth plate and/or flattening of that part of the bone. The cause is unknown. The most common symptoms are a limp and/or pain in the knee, thigh, and/or groin. It may follow different courses depending upon the age of onset, the severity of the blood flow disruption and the timeliness and appropriateness of treatment. Depending upon these factors, there can be full recovery; shortening of the involved limb because damage to the growth plate; or secondary osteoarthritis.
Neural foraminal stenosis – Is the narrowing of the opening between the vertebrae through which a spinal nerve at its respective level travels in route to other parts of the body. It can cause compression of the spinal nerve resulting in lower back pain and symptoms of radiculopathy. It is a common consequence of degenerative disc disease. It can also result from arthritis of the spine, particularly in the region of the facet joints, herniated or bulging discs, spondylolisthesis, or spondylosis.
Osgood-Schlatter disease – Is inflammation of the tibial tuberosity. The tibial tuberosity – also call the tibial tubercle – is the bony prominence or bump near the top of the shin bone where the tendon of the kneecap attaches. It most commonly occurs in children between the ages of 10 and 15. The cause is unknown but theories suggest that repeated stress to the bone from extending the leg is involved. The pain in the area usually occurs during running, jumping and participating in other sports related activities. The tubercle is also tender to touch. The pain usually subsides without treatment after a child completes the growth spurt of adolescence but the prominence of the tubercle persists. Sometimes pain in the area on kneeling is a complication in adulthood. The condition oftentimes goes undiagnosed, but the prominent bump below the kneecap is a clue. Oftentimes when asked, patients with a large bump will remember a period of time during childhood when they experienced pain in the area.
Osteoporosis – osteoporotic – adj. – Is decreased bone density due to a reduction in its protein and mineral content. Because of the resulting weakness, involved bones are more susceptible to fractures. There are many causes. They include low estrogen in women following menopause, low testosterone in men, aging, low calcium, a shortage of vitamin D, hormone imbalances, sedentary lifestyle and certain medications.
Rheumatoid arthritis (RA) – Is a chronic inflammatory disease involving the joints, surrounding tissues of the joints, and other organs. It is an autoimmune disease which means the body produces antibodies against its own tissue. That immune response causes inflammation and damage to tissues including joint tissue. RA can cause deformities sometimes referred to as crippling changes, particularly in the hands and fingers. The most commonly affected joints are the wrists, fingers, hands, shoulders, knees, ankles and toes. It affects the hips, elbows, neck, and joints of the spine less commonly. In addition to pain, sufferers oftentimes experience stiffness and/or swelling of the affected joints. Because rheumatoid arthritis is a systemic illness it can be associated with many other symptoms than those involving the joints. They include poor appetite, fatigue and low grade fever.
Rotator cuff injury – A complete or partial tear in one of more of the tendons of the four muscles in the shoulder that govern arm rotation and moving of the arm sideways at the shoulder joint (abduction).
Scleroderma – Is an autoimmune connective tissue disease that can involve various tissues of the body. Most commonly it affects the skin and causes hardening and thickening. Some of the other tissues that it can also affect are the lungs, joints, heart, blood vessels and esophagus. One of the classic features often associated with it is Raynaud’s phenomenon. It is the color changes in the fingers and toes in response to spasm of the arteries and reduced blood flow caused by exposure to cold or stress. The digits first turn white, then blue. Upon rewarming they might turn red. Other autoimmune diseases can also cause the phenomenon. When the cause is unknown it is termed Raynaud’s disease.
Shoulder impingement syndrome – Is a common condition causing shoulder pain during overhead motion of the shoulder. The cause of the pain is pressure applied to the tendons or bursa of the shoulder by bones of the shoulder. A physical examination usually establishes the diagnosis. Over time, the repetitive trauma to the shoulder tendons can result in a rotator cuff tear.
Sjogren syndrome (sicca syndrome) – Is an autoimmune disorder which causes destruction of the glands which produce saliva and tears. The result is dry mouth and dry eyes. It can also affect other parts of the body including joints, lungs, and kidneys. It can be a primary disease or can accompany other autoimmune diseases such as rheumatoid arthritis and lupus.
Spina bifida – Is a birth defect in which there is incomplete formation of bone in a part of the posterior spinal canal. As a result a portion of the spinal cord in the area of the defect lacks a full bony enclosure. Most individuals with spina bifida have only a mild defect and do not experience any problems. More severe degrees of spina bifida can cause neurological problems though if a meningocele or myelomeningocele forms.
Spinal stenosis – Is narrowing of the spinal canal through which the spinal cord passes. It appears to be a part of the aging process in some people. Other causes include excessive bon buildup which occurs with spondylosis, thickening of the spinal ligaments and congenital narrowing present at birth. The neck and lower back regions are most commonly affected. It can cause symptoms of neural foraminal stenosis but usually more marked. Additionally, it can cause bladder or bowel dysfunction. Decompression surgery may be required to relieve severe symptoms not controllable with conservative measures. Some use the term to mean narrowing of either the spinal canal or neural foramen (foramina Pl.). In its truest sense though, spinal stenosis refers to narrowing of the spinal canal and narrowing of the openings through which the spinal cords exit is neural foraminal stenosis. The ICD coding system makes this distinction.
Spondylolisthesis – Forward displacement of a vertebra in relationship to the vertebra beneath it. It is the result of a developmental defect in the region where the two vertebrae connect. The name of the region is the pars interarticularis. It most commonly involves the fourth and fifth vertebra of the lumbar spine, which is the region of the spine in the lower back.
Spondylolysis – A defect in the pars interarticularis. It can cause low back pain. It can also progress to spondylolisthesis if slippage between the two vertebrae at the point of the defect occurs.
Spondylosis – spondylotic – adj. – Is degeneration and arthritis of the spine. Accompanying osteophyte formation (excessive bone growth) can press against nerve roots or the spinal cord itself and cause typical symptoms. It can involve any of the three portions of the spine, but most commonly the cervical and lumbar spine.
Subluxation – Is a partial or incomplete dislocation of a joint.
Systemic lupus erythematosus (SLE) – An autoimmune disease affecting many parts of the body including the joints, other musculoskeletal tissues, skin, kidneys and brain, lungs and other organs. It is a result of the body producing antibodies against its own tissues. The wrists, hands, elbows, knees and ankles are commonly affected joints. The joint symptoms consist of pain, stiffness, and/or swelling. It is far more common in females than males. Lupus is its shortened name.
Tendinitis – Is inflammation of a tendon or the tissue which connects a muscle to its supporting bone.
Tenosynovitis – Inflammation of a tendon and the membranous sheath covering it.