Injuries or pathology related to muscles, bones, nerves, tendons ligaments and other structural tissue comes in the category of musculoskeletal disorders.
According to a recent report, more than 12% of the Worlds elderly population lives in India. The demographic trends suggest that between the years 2000 and 2050, the Indian population in their 60s and above will increase by 326% while those in the age group of 80+ will increase by 700%. Aging populations result in increased numbers of people suffering from musculoskeletal conditions. On the contrary in the workforce population, ergonomic hazards account for more than 50% of all MSDs.
Causes of Musculoskeletal Disorders:
- Ageing like in case of Osteoarthritis
- Wear and Tear due to ageing – Deformities in case of Rheumatoid Arthritis
- Sudden jerky movement – Spasm, Strain, and Sprain
- Heavy lifting – Backache, Slip disc, Spondylitis
- Repetitive motion – Carpal tunnel syndrome
- Vibrations
- Awkward posture
- Trauma or injury due to a road traffic accident- Fracture
- Monotonous posture
Mechanism of Musculoskeletal Disorders:
Biomechanically speaking while pursuing a task an external force at a joint in space is applied which is counterbalanced by a force of your muscles. In case an unbalanced force in the form of trauma or repetitive movement is applied on the joint and your muscle do not have the ability to counterbalance the force, it results in a musculoskeletal disorder.
Women have reported having a higher incidence of musculoskeletal disorders. Repetitive motion, vibrations, etc. are attributed to an occupational hazard. Unnatural postures like twisting, back extension, overhead movements may be one of the reasons for musculoskeletal disorders.
Symptoms of Musculoskeletal Disorders:
- Pain
- Stiffness
- Loss of range of motion
- Loss of function
- Inability to walk
- Weakness
- Swelling
- Redness
- Warmth in and around the area
Diagnosis of Musculoskeletal Disorders:
- Physical Examination
- History
- Assessment of occupational hazard
- X-Ray
- MRI
- Blood tests in case of rheumatic disease
Treatment for Musculoskeletal Disorders:
- RICE Therapy
- Rest – Restricting the range of motion and resting can help subside metabolites of inflammation
- Ice – Cold packs help with inflammation reduction
- Compression – Compression through crepe or stocking to remove swelling
- Elevation – help remove swelling
- Medication Management
- Anti-inflammatory drugs
- Pain killers
- Muscle relaxants
- Surgical Management – In cases where both above doesn’t work like
- Total or partial hip replacement in osteoarthritis of the knee
- Nailing, plating, etc. in case of trauma or accident
- Movement Restriction is practiced in various musculoskeletal disorders with the help of:
1. Corsets
2. Splints
3. Collars
- Walking or weight redistribution aids:
- Calipers
- Ankle foot orthosis
- Walkers
- Sticks
Prevention for Musculoskeletal Disorders:
- Healthy Lifestyle
- Regular strengthening exercises
- Warm-up and cool down before and after exercises
- Stretching can be a good cool-down activity
- Ergonomics at work
- Practice safe occupational posture
- Weight should be carried close to the body
- Avoid repetitive movements like headsets instead of neck bending in case of frequent phone calls
- Physical selection procedures
- Maintaining neutral postures
- The computer should be in arms reach of you, in the same horizontal plane where the neck stays neutral
- Practice Relaxation movements for eyes, neck, and hands
Prognosis:
Most cases with musculoskeletal disorders are managed by exercise, physiotherapy, and over the counter drugs. Prognosis depends on age and other factors. Most people at a young age may reach functional independence while the elderly may begin treatment to target pain as their prime enemy.
According to the estimates from WHO, if musculoskeletal disorders estimated for the two-target population is 40 and 50 percent, the burden of morbidity would be much higher and will be increased immensely in the near future. In India, with speedy demographic change pertaining to epidemiological transitions of disease resulting in a rising share of disease burden routing from Non-Communicable Diseases; the importance of musculoskeletal disorders burden has been neglected.
The main purpose of this write up was to enforce the magnitude of the problems caused by musculoskeletal disorders and aware you about the other important aspects of disease management and prevention.
Dr. Rajesh Verma | Director & Senior Consultant – Orthopaedics, Spine Surgery | Dharamshila Narayana Superspeciality Hospital, Delhi & Narayana Superspeciality Hospital, Gurugram