Musculoskeletal Disorder Treatment Pune

At Sancheti Hospital, we provide specialised care for age-related joint, bone, and muscle problems, helping seniors regain mobility and confidence.

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Overview

Musculoskeletal disorders (MSDs) are conditions that affect your muscles, bones, and joints. They can also impact connective tissue. MSDs can be present from birth or develop as a result of injury or disease. These conditions are extremely common, especially in people older than 50.

Musculoskeletal disorders (MSDs) are disabling conditions that can greatly affect a person’s health, especially in older adults. They can cause pain, stiffness, and inflammation.

The severity of MSDs can vary, sometimes causing pain and discomfort that interferes with everyday activities. Early diagnosis and treatment are important as they may help ease symptoms and improve long-term outlook.

Key examples of MSDs include tendinitis, carpal tunnel syndrome, osteoarthritis, rheumatoid arthritis, fibromyalgia, and bone fractures. Arthritis and osteoporosis are two particularly prevalent musculoskeletal conditions among the elderly.

Symptoms

Musculoskeletal disorders (MSDs) can cause ongoing pain, stiff joints, swelling, and dull aches. These symptoms can happen in many parts of the body, like the neck, shoulders, wrists, back, hips, legs, knees, and feet. Sometimes, they can make daily activities like walking or typing harder to do. You might also notice weaker muscles or muscle loss.

Arthritis mostly causes problems in the joints. Common symptoms can include pain, stiffness, swelling, redness, and trouble moving the joint, depending on the type of arthritis.

Osteoporosis, however, is often referred to as a “silent” disease because it weakens your bones without obvious symptoms until a bone fracture (broken bone) occurs.

Symptoms associated with fractures due to osteoporosis can include intense pain, inability to move a body part, a noticeable deformity, seeing bone through the skin, swelling, and new bruising appearing at the same time as these other symptoms.

Causes

Several factors can contribute to the development of MSDs. Your risk is affected by age, occupation, activity level, lifestyle, and family history.

In elderly subjects, a pathological triad of inter-related disorders is highly prevalent: sarcopenia (loss of skeletal muscle mass and function), tendinopathies (persistent tendon pain and loss of function), and arthritis (persistent joint pain and stiffness). This combination is referred to as the “STAR” triad. These three disorders share common pathophysiological and clinical characteristics.

A common denominator is the progressive loss of neuromuscular performance, which increases the risk of adverse outcomes such as pain, mobility disorders, falls and fractures, and impaired ability to perform daily activities.

Age-related tendinopathies can be viewed as a degenerative process influenced by local and systemic factors. Metabolic alterations related to aging, such as obesity and type 2 diabetes, can amplify the negative effects of stress on tendons.

Osteoarthritis is a common type of arthritis, and its development is linked to aging. Factors like genetics and systemic conditions such as obesity and type 2 diabetes are risk factors for osteoarthritis. In the elderly, osteoarthritis is a key disease of musculoskeletal aging.

Osteoporosis, which weakens bones, is also closely linked to aging. About 85-90 percent of adult bone mass is acquired by early adulthood, and maintaining strong bones throughout life is important.

Risk Factors

As mentioned, age is a significant risk factor for developing MSDs, including arthritis and osteoporosis. Other risk factors for MSDs generally include occupation, activity level, lifestyle, and family history.

For the STAR triad (sarcopenia, tendinopathies, arthritis) prevalent in the elderly, common pathophysiological factors contribute to the risk of pain, mobility issues, falls, fractures, and impaired daily activities.

Systemic factors such as obesity and type 2 diabetes are noted as amplifying factors for age-related tendinopathies. Weight gain and diabetes were highlighted in a clinical case example of a 70-year-old woman presenting with symptoms related to this triad.

Specific risk factors for osteoarthritis include genetics, obesity, and type 2 diabetes . For osteoporosis, reaching peak bone mass in youth is crucial for bone health later in life, implying that factors affecting this can be considered risk factors. Aging itself is a primary risk factor for decreased bone density.

Diagnosis

Diagnosing MSDs involves a physical examination by a doctor, who may check for tenderness, swelling, redness, muscle weakness, and unusual reflexes. Unusual reflexes could indicate nerve damage.

Imaging tests are commonly used to help diagnose MSDs, allowing doctors to examine bones and soft tissues. These tests may include X-rays, MRI scans, CT scans, and ultrasound. Specific imaging tests like bone density tests are crucial for diagnosing osteoporosis.

Blood tests may also be ordered to check for rheumatic diseases, such as rheumatoid arthritis.

Types

Musculoskeletal disorders encompass a wide range of conditions. Some specific types are:

Tendinitis
Carpal tunnel syndrome
Fibromyalgia
Bone fractures

Arthritis itself has many different types such as:

Ankylosing spondylitis
Gout
Juvenile idiopathic arthritis
Osteoarthritis
Psoriatic arthritis
Reactive arthritis
Rheumatoid arthritis
Septic arthritis
Thumb arthritis

Osteoarthritis and Rheumatoid arthritis are the common types of arthritis and common MSDs.

Treatment

General Musculoskeletal Disorders (MSDs): Treatment depends on the specific diagnosis and how severe the symptoms are. For mild, occasional pain, doctors may suggest moderate exercise and over-the-counter pain medicine.

If symptoms are worse, prescription drugs to reduce pain and swelling might be needed, along with physical or occupational therapy. Severe arthritis may require joint replacement surgery.

STAR Triad Disorders (Sarcopenia, Tendinopathies, Arthritis): Physical exercise, sometimes with nutrition support, is recommended as the main treatment. For sarcopenia, high-intensity resistance training helps build muscle strength and size, and regular endurance and strength exercises are best for weak or older adults.

Other therapies like neuromuscular electrical stimulation and whole body vibration may help, but more research is needed. There are no approved drugs for sarcopenia, but Vitamin D may help older women and testosterone may help older men who have weakness and low hormone levels.

Tendinopathies: Treatment includes exercise therapy, certain injections (like corticosteroids or platelet-rich plasma), physical therapy methods (such as shockwave therapies), and topical glyceryl nitrate.

The exercise program often starts with isometric exercises for pain, then progresses to slowly strengthening the tendon. Reducing stress on the tendon is also important.

Osteoarthritis: Treatment focuses on patient education, self-management skills, weight loss, and exercise to make joints and muscles stronger. Psychological support may help people with long-term pain. Losing weight (5-10% of body weight) can improve symptoms.

Exercise should include both cardio and strength training, starting under supervision if possible and then at home. Water-based exercises are good for those with too much pain to exercise on land.

Supports like canes and braces may help. Medicines include glucosamine and chondroitin (slow-acting), paracetamol, and NSAIDs for pain and swelling. High-quality glucosamine and chondroitin may work better. Painkillers and NSAIDs need to be used carefully, especially in elderly people, due to possible side effects.

Osteoporosis: Treatment aims to stop bones from getting weaker. Exercise plays an important role in managing osteoporosis.

Rehabilitation

Rehabilitation through physical therapy is a key component of managing musculoskeletal disorders, with physical therapy and supervised, progressive exercise programs being encouraged, especially for conditions like osteoarthritis, with the aim of transitioning to a self-administered home program.
For sarcopenia, physical exercise, including resistance training, is a primary recommended intervention, often guided by professional recommendations, while exercise therapy is a core part of managing tendinopathies, progressing from isometric exercises to more functional movements, potentially under supervision.

In the context of the STAR triad, physical exercise, alone or with nutritional interventions, is the recommended primary treatment for all three components. Supervised exercise by a physical therapist may be particularly beneficial in the oldest to improve strength. The minimum effort for strengthening should feel moderately hard, performed 3 or more sessions per week with rest days. This approach can lead to significant pain reduction in knee osteoarthritis.

Complications

Severe musculoskeletal disorders can lead to significant complications that impact quality of life. Severe arthritis, especially affecting hands or arms, can make daily tasks difficult. Arthritis in weight-bearing joints can hinder comfortable walking or sitting upright. In some cases, joints can slowly lose their normal shape and position.

For osteoporosis, the primary complication is an increased risk of bone fractures (broken bones), and these fractures can cause intense pain and significantly impair mobility.
The pathological triad of sarcopenia, tendinopathies, and arthritis can lead to severe adverse outcomes in the elderly, including pain, mobility disorders, an increased risk of falls and fractures, and impaired ability or disability to perform activities of daily living.

These complications highlight the interconnected nature of these conditions and their significant impact on independence and quality of life.

Prevention

Preventing musculoskeletal disorders involves addressing risk factors throughout life, with building high peak bone mass by early adulthood (age 18 in girls and 20 in boys) being crucial for long-term bone health and osteoporosis prevention.
Maintaining a healthy lifestyle, which includes exercise and managing conditions like obesity and diabetes, can help lower the risk of MSDs, while exercise specifically helps prevent bone density loss associated with osteoporosis.

For sarcopenia, physical exercise and adequate nutrition are recommended interventions, suggesting they play a role in prevention and management. For tendinopathies, managing mechanical loads and addressing systemic factors like obesity and diabetes are important.

Living With Musculoskeletal Disorders

Living with musculoskeletal disorders, particularly for older adults dealing with conditions like arthritis and osteoporosis, often involves managing chronic pain, stiffness, and reduced mobility. These symptoms can make performing everyday activities challenging.

Effective management strategies are key to maintaining independence and quality of life, including following prescribed treatment plans, which may involve medication, physical therapy, exercise programs, and assistive devices.
Weight management, if applicable, can also significantly ease the burden on joints, while understanding the relationship between conditions like sarcopenia, tendinopathies, and arthritis (the STAR triad) is important.

Addressing each component through targeted interventions, such as tailored exercise and nutrition, can help improve overall musculoskeletal health and performance. Adapting activities, listening to your body, and seeking support from healthcare providers and potentially support groups can help individuals live more comfortably and actively despite the challenges posed by MSDs.

Key Takeaways

Musculoskeletal disorders (MSDs), including arthritis and osteoporosis, are very common conditions affecting muscles, bones, joints, and connective tissue, with risk increasing significantly with age.
Common symptoms of MSDs include pain, stiffness, swelling, and reduced range of motion, which can impact daily activities. Osteoporosis often presents silently until a fracture occurs.
Risk factors for MSDs include age, lifestyle, activity level, and family history. In the elderly, the combination of sarcopenia, tendinopathies, and arthritis (the STAR triad) is highly prevalent and contributes to pain, mobility issues, and increased fall/fracture risk.
Diagnosis involves physical examination, imaging tests like X-rays and MRIs, and potentially blood tests or bone density tests.
Treatment approaches for MSDs vary but commonly include exercise, medication for pain and inflammation, and physical or occupational therapy. Joint replacement is an option for severe arthritis. Exercise, often combined with nutrition, is a primary recommended treatment for the STAR triad components.
Severe MSDs can lead to complications like difficulty performing daily tasks, impaired mobility, and increased fracture risk.
Prevention includes building strong bones in youth, maintaining a healthy lifestyle, and managing risk factors.
Living with MSDs involves managing symptoms through tailored treatment plans, exercise, and potentially assistive devices to maintain independence and quality of life.

For individuals seeking specialized orthopedic care, especially for severe musculoskeletal conditions like complex fractures, joint pain, arthritis, or the need for joint replacement, institutions like Sancheti Hospital in Pune, India, are noted as premier institutions. Sancheti Hospital is described as the best orthopedic hospital in India, renowned for its advanced medical facilities, team of expert orthopedic surgeons specializing in areas like joint replacement and spine surgery, patient-centric approach, and state-of-the-art infrastructure. They offer comprehensive treatment and have established a legacy of excellence, catering to patients from all walks of life.

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Patient Stories & Experiences

The pain in my left knee left me feeling helpless for years. After my treatment here, I can finally say I'm pain-free.

Vinita Singh

The nerves were swollen, and the body went numb. But thanks to Sancheti Hospital, I got a second life!

Parvati

I finally could walk again, a relief I've only felt after the hip pain surgery. I thank the doctors at Sancheti Hospital for their help.

Balaji Kharat

I'm a police officer, and I'm extremely thankful to Sancheti Hospital for treating my fracture without surgery.

Shantilal

My life has completely changed after the knee replacement surgery at Sancheti Hospital. It's like I can finally live again!

Kalpana Lepcha

The knee pain I've carried for years finally went away with the help of Sancheti Hospital.

Karuna

I can't believe that I get to finally live a normal and happy life, all thanks to the knee surgery I had at Sancheti Hospital.

Kishore Bhosle

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Frequently Asked Questions

Can exercise make my arthritis pain worse, or should I avoid it completely?

Exercise is actually beneficial for arthritis, but start with low-impact activities like water-based exercises if land exercises cause too much pain. Begin under professional supervision and gradually progress to a home program. The key is finding the right balance between activity and rest.

How do I know if my bone pain is from osteoporosis or just normal aging?

Osteoporosis is often “silent” until a fracture occurs. Normal aging typically causes muscle aches and joint stiffness, while osteoporosis-related pain is usually intense and associated with fractures. A bone density test is the only way to definitively diagnose osteoporosis before fractures happen.

What's the difference between taking glucosamine pills from the pharmacy versus prescribed medications?

High-quality glucosamine and chondroitin supplements may be more effective than standard pharmacy versions. However, these are slow-acting treatments that take time to show results. Prescribed NSAIDs work faster for pain and inflammation but require careful monitoring, especially in elderly patients due to potential side effects.

At what age should I start worrying about building bone strength for osteoporosis prevention?

Peak bone mass is achieved by age 18 in girls and 20 in boys, making the teenage years crucial for bone health. However, it’s never too late to start – maintaining bone density through exercise and proper nutrition is important at any age to prevent further bone loss.

If I have multiple conditions like weak muscles, joint pain, and tendon problems, do I need separate treatments?

These conditions often occur together (called the STAR triad) and can be managed with a combined approach. Physical exercise with nutritional support is the primary treatment for all three components, making it more efficient than treating each condition separately.

Musculoskeletal Disorders