I.    GENERAL APPROACH. In medical school and residency, clinicians are taught to focus on preventing life-threatening events such as myocardial infarctions, stroke, and cancer. When a patient comes in with a mere musculoskeletal complaint, clinicians are often unprepared. We find that students and young clinicians who see patients with musculoskeletal complaints downplay the patient’s symptoms. A patient’s complaint of “my knee bothers me when I run more than three miles” may be met with the clinician thinking, “Well then don’t run more than three miles.” Physician downplaying of musculoskeletal complaints may be especially frequent when the patient with the knee pain also has an elevated risk for cardiovascular disease or diabetes.

However, it is our job to listen to and assist patients with musculoskeletal pain. First and foremost, it is the patient’s concern! Furthermore, although the pain may not be life-threatening in the immediate future, it may in fact pose a tremendous threat to their long-term health. It is clear that higher levels of physical activity are associated with lower risk for cardiovascular morbidity and mortality.^1–3 If musculoskeletal pain is prohibiting the patient from maintaining his or her desirable amount of physical activity, it may be predisposing them to obesity, type 2 diabetes, hypertension, and hypercholesterolemia. In this manner, musculoskeletal pain may be considered a cardiovascular risk factor. Given that we now live in an age of diseases of sedentary lifestyles, it is the clinician’s job to help patients maintain a physically active lifestyle. Telling the patient who has knee pain with running to simply “rest” is like telling a patient who says he or she does not like the taste of broccoli to simply “eat cookies.” If the problem is such that running in the short term makes symptoms worse, then encourage other activities (i.e., help them to discover strategies to cross-train). Also, we need to be wary of using the term “overuse” when describing the cause of a patient’s musculoskeletal pain. Although it is true that some repetitive motions in specific areas can cause soft tissue stress, individuals who are more active often have less musculoskeletal pain.^4,5 Our focus needs to be on making a proper diagnosis and encouraging the patient to remain active in ways that will not prolong the injury. Realize that rest is often detrimental to injury healing (e.g. with tendinopathies).

II.

Related posts:

Nonacute Shoulder Disorders Overuse and Miscellaneous Conditions of the Foot and Ankle The Diagnosis and Management of Musculoskeletal Trauma Fractures of the Tibia Aspiration and Injection of Upper and Lower Extremities Operating Room Equipment and Techniques

Stay updated, free articles. Join our Telegram channel

Join