What is musculoskeletal pain?

Musculoskeletal Pain: Definition and Understanding

Musculoskeletal pain is pain that affects bones, joints, ligaments, tendons, or muscles throughout the body. 1 This type of pain is extremely common, affecting approximately 20-30% of adults in Europe at any given time, and represents one of the leading causes of disability worldwide. 1

Types and Causes of Musculoskeletal Pain

Musculoskeletal pain can arise from various causes:

• Mechanical problems - structural issues affecting joints and supporting tissues
• Injuries - work or leisure-related trauma
• Age-associated changes - degenerative processes
• Inflammatory diseases - conditions causing tissue inflammation
• Overuse - repetitive strain on muscles and joints

Common musculoskeletal pain conditions include:

• Spinal pain (lumbar, thoracic, cervical)
• Osteoarthritis - particularly affecting hip and knee joints
• Rheumatoid arthritis - inflammatory joint disease
• Back pain - the leading cause of work incapacity in many regions
• Soft tissue rheumatism - affecting muscles and connective tissues
• Regional and widespread pain syndromes

Impact and Burden

Musculoskeletal pain has significant impacts:

• Most common cause of severe long-term physical disability 1
• Significantly affects psychosocial status of individuals, families, and carers 1
• Major burden on health and social care systems 1
• Two in five people with musculoskeletal problems are limited in everyday activities 1
• Represents nearly 25% of total illness costs in European countries 1
• Second most common reason for consulting a doctor (10-20% of primary care practice) 1

Characteristics of Musculoskeletal Pain

Musculoskeletal pain conditions share several important characteristics:

• Can be self-limiting, recurrent, or chronic
• Some conditions can be life-threatening
• Often affects quality of life significantly
• May involve multiple body systems beyond the musculoskeletal system
• Enormous socioeconomic costs, with most costs being indirect (social care, pensions, workers' compensation) 1

Management Principles

The effective management of musculoskeletal pain requires:

1. Integrated, coordinated approach - multidisciplinary and multiprofessional care focused on individual needs 1
2. Early identification and management - identifying those at high risk or with earliest features 1
3. Appropriate specialist involvement - many patients need diagnostic and management expertise from specialists 1
4. Evidence-based interventions - including exercise therapy and psychosocial interventions which have moderate to strong evidence of effectiveness 2

Key Recommendations for Musculoskeletal Pain Care

High-quality clinical practice guidelines consistently recommend: 1

• Patient-centered care
• Screening for red flag conditions
• Assessment of psychosocial factors
• Selective use of imaging
• Thorough physical examination
• Monitoring patient progress
• Providing education and information
• Addressing physical activity and exercise
• Using manual therapy only as an adjunct to other treatments
• Offering high-quality non-surgical care prior to surgery
• Trying to keep patients at work

Understanding musculoskeletal pain and its proper management is crucial for reducing its burden on individuals and society. The most effective approach involves early intervention, appropriate specialist referral when needed, and evidence-based treatments focusing on exercise, education, and addressing psychosocial factors.