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Musculoskeletal pain (pain affecting the joints, bones or muscles) lasting more than 3 months is referred to as chronic musculoskeletal pain.
Chronic musculoskeletal pain is not just a physical problem but can also have significant impact on wellbeing and mental health. This can vary between patients but in some individuals can lead to complete loss of independence. Almost half of those with chronic pain also suffer with depression.
It is a common problem affecting up to 30% of UK adults at any time.
The symptoms associated with chronic musculoskeletal pain will depend on the underlying cause for the pain. The pain may be mild or severe and continuous or sporadic.
The most common pain locations are back, hips and knees.
Many types of musculoskeletal pain are associated with reduced range of movement of affected body structures resulting in limited function and restriction in activities.
Chronic pain is not only a physical problem; it often has severe effects on psychological, social and economic health.
There are over 200 different causes of chronic musculoskeletal pain but these can be organized according to whether they affect joints, bones or muscles (and tendons). Some examples of specific conditions are found below.
Joints
Bones
Muscles (and tendons)
Chronic musculoskeletal pain is usually diagnosed by taking a thorough history and examination to identify the type of pain, severity, functional impact and context.
Some patients may benefit from X-Rays, ultrasound scans or MRI scans of the affected areas.
A clinician may make recommendations for other investigations, such as blood tests or joint aspiration, depending on the underlying cause of the pain.
Musculoskeletal Pain Treatment
A holistic approach is often needed to treat chronic musculoskeletal pain. Physiotherapy, modifications to work and home environment and psychological therapies are important aspects of patient care. It is also important to try and continue exercising as tolerated.
Medical therapy is dependent on the underlying cause of pain, as addressing the underlying cause is an important component of treatment.
For muscle and connective tissue pain simple painkillers are often first line treatment with stronger painkillers (e.g. codeine, tramadol and morphine) used in conjunction in severe pain. For those with inflammatory arthritis they may be started on specialist medications that regulate their immune system by a rheumatologist.
Some conditions such as osteoarthritis of the hip or knees may benefit from an operation when severe.
Medicinal cannabis can be considered when first line therapies have not achieved adequate symptom control for their pain.
