Globally, musculoskeletal pain is a common reason for disability and seeking medical advice. It may be localized to one area or present as a widespread/ multisite pain. Musculoskeletal symptoms may be a consequence of orthopedic, neurologic or rheumatologic processes and hence a comprehensive history and examination are required. Based on the findings further tests and imaging are requested to confirm the diagnosis or rule out other serious conditions.
This section focuses on minimally invasive nonsurgical interventions available via pain clinic for joint pain and some other common musculoskeletal conditions. The interventions listed below are most often used as a part of multi-disciplinary management in combination with medications, physiotherapy, complementary therapy and psychology input as required.
Shoulder Pain
Shoulder pain may be an isolated problem localized to the shoulder or be a part of widespread pain as in rheumatoid arthritis. A combination of history, examination and diagnostic investigations is utilized to identify the pathology and guide further management. Diagnostic ultrasound scan is an effective bedside tool as it can reliably identify common shoulder pathologies and reduce the requirement of additional investigations. I routinely perform ultrasound scans at the time of the initial assessment.
Hip Pain
Hip pain is a common condition and can be quite disabling because of the impact on walking. Pain may be localised to the front, side or back of the hip joint. Common cause for anterior hip pain is joint problems such as arthritis, that on the outer side of hip is greater trochanteric pain syndrome whereas posterior hip pain may arise from multiple sources such as sacroiliac joint, lumbar spine, piriformis muscle etc. It is important to evaluate lumbar spine as spine pathology commonly coexists and can be responsible for producing/ exacerbating hip pain.
Knee Pain
Knee pain can be a source of significant disability in all age groups as it limits mobility. It can be classified into traumatic or non traumatic and based on the site of pain into anterior, medial, lateral and posterior. The common reasons for knee pain vary with age group and pain site .Pain from other sites such as hip and lumbar spine can also present knee pain.
Other Common Musculoskeletal Conditions
These are common problems involving staining/overuse of forearm tendons which attach to the bony prominences on the upper arm bone close to the elbow joint. Tennis elbow involves the tendons attaching to the outer side of elbow and repetitive activities involving gripping or twisting of forearm makes this pain worse. It may affect one or more tendons and it’s not uncommon for the pain to radiate down further into the forearm.
Dr. Amod Manocha is a Senior Consultant and Head of Pain Management Services at Max Multispecialty Hospital, Saket. He is trained as a Pain Management Specialist and an Anaesthetist in the UK. He has over 13 years of work experience in the UK including working as a Chronic Pain Consultant in many UK hospitals.
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