How to Deal with Musculoskeletal Pain

The human musculoskeletal system can be plagued by different types of pain. Injuries aside, in your experience as a personal physician, what are some of the most common?
‍Accidents aside, acute inflammatory joint pain and chronic pain, particularly affecting the spine and large joints, are the most frequent problems we see in our office. Musculoskeletal disorders affecting tendons, tendon attachments, bursae and tendon sheaths, which are not directly caused by injury and manifest mainly as pain, are also frequently encountered.

Can we look at the different types of common problems and zoom in on the things that usually cause them?
‍The causes of musculoskeletal pain can generally be divided into two basic groups. In the first are inflammatory diseases, which include infectious arthritis, rheumatic and autoimmune diseases. The second group includes non-inflammatory diseases – birth defects, post-traumatic conditions, a large group of degenerative diseases (arthrosis and spondylarthrosis), metabolic diseases (osteoporosis, gout), functional disorders from overload or uneven loading, nervous diseases and also oncological conditions. When diagnosing musculoskeletal pain, we should not forget that after the age of 40, aging (degeneration) of muscles, tendons and ligaments occurs and overloading is more frequent even in people who load the musculoskeletal system with the same intensity.

Can you recommend any general methods of prevention that are effective against the onset and development of the most common musculoskeletal pains? What should we look out for?
‍The basic ways of preventing common functional pain disorders are the principles of a healthy lifestyle. This means avoiding extreme strain on the spine and joints and monotonous work or sports that overload a particular muscle group or joint. Adequate rest after work or sport and an appropriate form of recovery are also important. Not only for metabolic reasons, dietary changes and weight reduction are important. Psychological factors, especially stress, anxiety or depression can also contribute to the onset and intensity of pain.

How can one tell which musculoskeletal pains are common and can be relieved with analgesics in the short term until the body has dealt with the problem itself, and in which cases should people definitely consult a doctor about their condition?
‍If we know the underlying cause of the pain, it is possible to try rest, avoid the underlying cause, opt for massage or physiotherapy and suppress the pain with medication for a short period of time. It is important to consult a doctor whenever the pain is unusual in intensity, without a clear trigger, when it is accompanied by temperature or other physical symptoms (weight loss, shortness of breath, abdominal pain, etc.) and when the pain lasts for more than a few weeks.

What diagnostic options do personal physicians at Health+ have when a client complains of specific musculoskeletal pain? What is the usual procedure and how does the first stage of the diagnostic examination work?
‍When a client presents to a personal physician's office with a painful musculoskeletal condition, the first stage of the examination is to determine whether the condition is acute or chronic. Through a detailed interview with the client and a clinical examination, we always try to find the triggering cause of the pain. To refine the diagnosis, we perform laboratory tests to determine inflammatory activity and to identify other possible causes such as metabolic, autoimmune or rheumatic diseases. In terms of imaging, we have the ability to perform x-rays or schedule the client for computed tomography (CT) or magnetic resonance imaging (MRI).

Musculoskeletal pain can be related to a variety of medical areas. What specialists can personal physicians refer clients to for further testing? And in what cases does this usually happen?
‍Non-traumatic and especially chronic musculoskeletal pain can have multiple triggering causes. Their diagnosis and follow-up care therefore often require the collaboration of specialists from different specialties. Diagnosis and treatment may involve a personal physician, orthopedic surgeon, neurologist, internist, rheumatologist, physiotherapist, endocrinologist, nutritionist or psychologist. A great advantage for Health+ clients is the fact that we have all the specialists under one roof, so to speak. The documentation with the results of all examinations is shared, and there is no problem consulting complicated cases with each other at any time. The personal physician also has an important role in monitoring possible side effects of treatment, catching a rise in disease activity or the development of extra-articular complications. Collaboration with other specialists is also essential in providing and coordinating multidisciplinary care, including rehabilitation and spa treatment.

‍Why should people definitely not downplay prolonged musculoskeletal pain and what problems can it bring to a person if the causes of pain are not addressed?
‍Pain is a clear signal that something is wrong in the body. If this information is ignored over a long period of time, it can lead to permanent changes and organ damage or a late diagnosis of a serious illness.

Many individuals try to eliminate physical pain with painkillers, but they cannot eliminate the cause. How does the long-term use of these drugs affect the body, what are the risks?
‍Painkillers are abundant on the market and are among the most widely used drugs. In the case of chronic diseases accompanied by pain, it is often impossible to do without them. When taking them repeatedly, it is important to know that they can have a number of side effects. The most common are digestive problems, which can lead to stomach ulcers. Caution should be exercised when prescribing them, especially in the elderly, where associated diseases slow the elimination of the drug from the body and may lead to its accumulation in the body. Chronic use of higher doses can then lead to liver and kidney damage. Injectable preparations designed to inject collagen directly into affected connective tissue structures as part of the treatment of degenerative connective tissue diseases such as osteoarthritis have the fewest adverse effects.

Are there non-pharmaceutical remedies that can effectively help with acute musculoskeletal pain? Or is it always best to seek medical advice?
‍Physiotherapy, massage, acupuncture or, in some cases, psychosomatic medicine can be used, depending on the cause of the problem, especially in the case of functional disorders. However, if the cause of the problem is not obvious and the pain does not improve, then a visit to the doctor is definitely in order.

Can you recommend any suitable products for prevention?
‍In addition to general preventive recommendations such as a healthy diet, active exercise, maintaining a healthy weight, not overloading the musculoskeletal system or limiting stress, we can recommend specific preventive measures especially in cases where we know the underlying cause or metabolic disorder. For example, in gout, adherence to a purine-free diet, adequate drinking and, in some cases, the administration of drugs for lowering uric acid can achieve a significant reduction in the risk of acute gout attacks and chronic gouty arthritis. Also in the prevention of osteoporosis, regular physical activity, calcium and vitamin D supplementation can delay the onset of osteoporosis and osteoporotic fractures.

Thank you for the interview.