Mechanical Joint and Muscle Pain
This can involve the joint, capsule around the joint, ligaments, tendons and tendon insertions. The symptoms can be localised to one joint, multiple joints or be more generalised affecting the whole body. Examples are:
This is due to wear and tear of the joint and is also known as degenerative joint disease. It can also be associated with locking or sticking of the joint. It occurs as people get older but other factors may also increase the chance of developing this condition. These include genetic factors, previous trauma, obesity in weight bearing joints and inflammatory conditions affecting the joint such as gout or Rheumatoid Arthritis.
Pain affecting the heel which is much worse in the morning and is caused by damage or tears in the plantar fascia which is a band of tissue that runs under the sole of the foot and inserts into the heel.
This occurs when the joint capsule becomes thickened and rigid and the joint becomes acutely painful and movement is reduced in all directions. The commonest joint to be affected is the shoulder and another name for this is a frozen shoulder.
Tennis or Golfer’s Elbow
Pain on the inside or outside of the elbow that is due to inflammation of the tendons that move the elbow at the point of insertion into the bone (also known as the enthesis.)
The rotator cuff is a group of four muscles that move the shoulder. Sometimes one or more of the muscle tendons can become inflamed or worn and this causes pain in the shoulder in a distribution that reflects the tendon involved. Movement of the muscle and affected tendon reproduces the pain and sometimes the tendon can catch on the bone (impingement.)
The commonest causes of pain at the base of the thumb are either osteoarthritis of the thumb joint or inflammation of the tendons that move the thumb.
Fibromyalgia (FM) is a common cause of chronic, generalised musculoskeletal pain. It affect muscles and soft tissues and the cause of the pain is not known. It can be associated with other symptoms such as fatigue, sleep disturbance, bowel and bladder problems, numbness and tingling, depression and anxiety. One of the hallmarks of the disease is marked tenderness in multiple soft tissue locations (trigger points.) Laboratory testing is normal and it is important to exclude other conditions that may also cause widespread pain such as thyroid disease, vitamin deficiencies, inflammatory conditions, infections and malignancy.
Treatment of mechanical pain can involve:
-Exercise, muscle stretches
-Medications – pain killers, anti-depressants, muscle relaxants
-Therapy - physiotherapy, occupational therapy, podiatry