Other MSK conditions

Osteoarthritis (OA) or degenerative joint disease (DJD)

• Chronic degenerative joint disease that causes the breakdown of cartilage, the protective tissue that cushions the ends of bones in joints
  • Characterized by articular cartilage with hypertrophy of subchondral bone and joint capsule of weight-bearing joints
  • Most common form of arthritis
  • Most common joints are cervical spine, lumbar spine, hips, knees, and great toe- weight-bearing joints

Rheumatoid conditions

Rheumatoid arthritis (RA)

• Chronic autoimmune disease that causes inflammation and damage to the joints due to the overproduction of antibodies
  • Etiology is unknown, but it is thought to have genetic links
• Disease is characterized by times of exacerbation and remission
• Most common areas are hands, feet, cervical spine

Psoriatic arthritis

• Chronic, inflammatory arthritis that often, but not always, occurs in people with the skin condition psoriasis
  • Autoimmune disorder
• Typically occurring in the axial skeleton and joints of the digits

Ankylosing spondylitis

• An autoimmune disease that causes inflammation and stiffness, primarily in the spine, and is notably more common in men. Men typically develop AS in early adulthood. It causes inflammation of the joints (vertebrae) and ligaments in the spine, leading to stiffness, pain, eventual fusion of the bones, and development of osteoporosis

Gout

• Primary gout is a male genetic disorder in which uric acid changes into crystals and deposits in the peripheral joints

• Secondary gout affects all ages and genders with elevated uric acid in the blood secondary to other disease processes, primarily of the kidneys.

  • Characterized by elevated serum uric acid due to a disorder of purine metabolism

• Typically occurring in the knees and great toes

Tendonosis/tendopathy

• Tendon dysfunction caused by overuse or repetitive motions that put excessive stress on the tendon
  • Can also be caused by sudden trauma or age-related degeneration

Bursitis

• Inflammation of bursae due to overuse, trauma, gout, or infection

Myofascial pain syndrome

• Chronic pain condition that affects muscles and the tissue that surrounds them. Characterized by trigger points in muscles that cause pain when pressed
  • Can be caused by sudden overload, overstretching, and increased repetition
  • Types of trigger points
    • Active trigger points are tender to palpation and can cause referred pain
    • Latent trigger points are taut bands that can be transitioned to active trigger points

Complex regional pain syndrome (CRPS)

• Chronic pain condition characterized by persistent, severe pain; presentation of symptoms is disproportionate to the initial injury, thought to be caused by an abnormal response of the sympathetic nervous system to an injury.
  • Results in dysfunction of the sympathetic nervous system
  • Can be caused by trauma or have an unknown etiology
  • Types of complex pain syndrome
    • CRPS I- tissue injury with no nerve involvement
    • CRPS II- tissue injury with known nerve involvement

Muscle strains

• Injury to the muscle or tendon, the fibrous tissue that connects muscles to bones, causing an inflammatory response
  • Typically due to overuse or overstretching caused by forceful movement

Myositis ossificans

• Abnormal calcification within the muscle belly
  • Can be caused by direct trauma- hematoma causes calcification
  • Frequently located in the quadriceps or biceps

Paget’s disease

• Chronic bone disorder characterized by abnormal bone remodeling
  • May be linked to viral infections

Osteoporosis

• ​​Bones become brittle and fragile from loss of tissue due to metabolic changes, resulting in bone mineral density loss
  • Affects women ten times more than men
    • Can be related to menopause (reduction in estrogen)
  • Common sites are the thoracic and lumbar spine, the proximal humerus, the proximal tibia, the pelvis, distal radius

Osteomyelitis

• Inflammation of the bone caused by infection

Somatic dysfunction

Somatic dysfunction is an impaired or altered function of the body’s framework, including muscles, joints, and fascia. It is commonly associated with pain, restricted movement, and abnormal tissue texture.

Diagnosed using the TART criteria

• Tissue texture changes
• Asymmetry
• Restriction of motion
• Tenderness

Below is a description of somatic dysfunction within each segment type:

Cervical somatic dysfunction

• Location: Affects the neck (C1-C7).
• Common causes:
  • Poor posture, whiplash, prolonged screen time, stress-related muscle tension.
• Symptoms:
  • Neck pain, stiffness, headaches, dizziness, reduced range of motion, and possible radiating pain to the shoulders or arms.
• Treatment:
  • Soft tissue mobilization, cervical manipulation, stretching, and postural correction exercises.

Thoracic somatic dysfunction

• Location: Affects the mid-back (T1-T12).
• Common causes:
  • Poor posture, kyphotic spine patterns, prolonged sitting, rib dysfunction, and respiratory issues.
• Symptoms:
  • Mid-back stiffness, difficulty taking deep breaths, rib pain, referred pain to the chest or upper back, and limited spinal rotation.
• Treatment:
  • Thoracic mobilization, rib articulation techniques, breathing exercises, and spinal extension exercises.

Lumbar somatic dysfunction

• Location: Affects the lower back (L1-L5).
• Common causes:
  • Heavy lifting, poor body mechanics, prolonged sitting, muscle imbalances, disc pathology.
• Symptoms:
  • Lower back pain, stiffness, restricted forward bending, muscle spasms, pain radiating to the hips or legs, and possible sciatic nerve involvement.
• Treatment:
  • Lumbar manipulation, core strengthening, stretching, and movement retraining.