musculoskeletal pain
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Introduction
Pain originating from the musculoskeletal system, affecting muscle, ligaments, tendons, & bones.
See more specific terms: myalgia, myofascial pain, bone pain.
Etiology
- trauma
- jerking movements
- accidents, auto accidents
- falls
- fractures
- sprains
- dislocations
- blunt muscle trauma
- postural strain
- repetitive movements, overuse
- prolonged immobilization
- poor body mechanics
- medications (see myalgia)
Clinical manifestations
- variable
- most common
- pain
- fatigue
- sleep disturbance
Laboratory
see specific etiology
Radiology
see specific radiology
Differential diagnosis
Management
- see specific etiology
- general
- RICED: rest, ice, compression, elevation, drugs (analgesics, NSAIDS)
- topical NSAIDs, with or without menthol 1st-line treatment for acute pain from musculoskeletal injury (excepting low-back pain)[5]
- acetaminophen noninferior to diclofenac alone or to diclofenac plus acetaminophen in reducing acute minor musculoskeletal pain[3]
- ibuprofen & opioids similarly effective for short-term relief of acute extremity pain when combined with acetaminophen[4]
- muscle strengthening & stretching
- physical therapy or occupational therapy
- acupuncture or acupressure[5]
- transcutaneous electrical nerve stimulation (TENS) to reduce pain[5]
- relaxation/biofeedback techniques
- steopathic manipulation
- chiropractic care
- therapeutic massage
- RICED: rest, ice, compression, elevation, drugs (analgesics, NSAIDS)
- walking may be beneficial but long-term effectiveness is uncertain[2]
- SNRI of marginal benefit for musculoskeletal pain, other antidepressants less useful[6]
- treatment of insomnia[7]
More general terms
More specific terms
Additional terms
References
- ↑ WebMD: Pain Management: Musculoskeletal Pain http://www.webmd.com/pain-management/guide/musculoskeletal-pain
- ↑ 2.0 2.1 O'Connor SR, Tully MA, Ryan B, et al. Walking exercise for chronic musculoskeletal pain: systematic review and meta-analysis. Arch Phys Med Rehabil. 2015;96:724-734 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25529265
- ↑ 3.0 3.1 Ridderikhof ML, Lirk P, Goddijn H et al. Acetaminophen or nonsteroidal anti-inflammatory drugs in acute musculoskeletal trauma: A multicenter, double-blind, randomized, clinical trial. Ann Emerg Med 2017 Oct 13 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29033294 <Internet> http://www.annemergmed.com/article/S0196-0644(17)31506-8/fulltext
- ↑ 4.0 4.1 Chang AK, Bijur PE, Esses D et al Effect of a Single Dose of Oral Opioid and Nonopioid Analgesics on Acute Extremity Pain in the Emergency Department. A Randomized Clinical Trial. JAMA. 2017;318(17):1661-1667 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29114833 https://jamanetwork.com/journals/jama/article-abstract/2661581
Kyriacou DN Opioid vs Nonopioid Acute Pain Management in the Emergency Department. JAMA. 2017;318(17):1655-1656 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29114813 https://jamanetwork.com/journals/jama/article-abstract/2661559 - ↑ 5.0 5.1 5.2 5.3 Qaseem A, McLean RM, O'Gurek D et al Nonpharmacologic and Pharmacologic Management of Acute Pain From Non-Low Back, Musculoskeletal Injuries in Adults: A Clinical Guideline From the American College of Physicians and American Academy of Family Physicians. Ann Intern Med. August 18, 2020 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32805126 https://www.acpjournals.org/doi/10.7326/M19-3602
Busse JW, Sadeghirad B et al Management of Acute Pain From Non-Low Back Musculoskeletal Injuries A Systematic Review and Network Meta-analysis of Randomized Trials. Ann Intern Med. August 18, 2020 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32805127 https://www.acpjournals.org/doi/10.7326/M19-3601 - ↑ 6.0 6.1 Anderson P Little Help, Possible Harm of Antidepressants for Musculoskeletal Pain. Medscape - Jan 22, 2021. https://www.medscape.com/viewarticle/944532
Ferreira GE, McLachlan AJ, Lin CWC et al Efficacy and safety of antidepressants for the treatment of back pain and osteoarthritis: systematic review and meta-analysis. BMJ 2021;372:m4825 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33472813 Free article https://www.bmj.com/content/372/bmj.m4825 - ↑ 7.0 7.1 Adogwa O, Reid MC, Chilakapati S, Makris UE Clin-STAR corner: 2021 update in musculoskeletal pain in older adults with a focus on osteoarthritis-related pain. J Am Geriatr Soc. 2023 Aug;71(8):2373-2380 PMID: https://www.ncbi.nlm.nih.gov/pubmed/37186060 https://agsjournals.onlinelibrary.wiley.com/doi/full/10.1111/jgs.18369