A primer on musculoskeletal pain
Musculoskeletal pain (MSK) is one of the most common reasons for primary care visits with almost 50% – 85% of the population experiencing MSK pain in their lives.
It is the leading cause of disability worldwide with low back pain being the most common area of complaint. MSK conditions can lead to an early retirement and a reduced ability to accumulate wealth. There’s also a strong correlation between mental health and MSK pain (WHO, 2019). It’s safe to assume that MSK conditions influence all aspects of life.
The use of imaging (x-ray, CT, Ultra Sound and MRI) in atraumatic musculoskeletal diagnosis and pain complaints
Unless indicated, the use of imaging for common atraumatic musculoskeletal complaints often leads to neutral or negative outcomes for patients and in many cases doesn’t provide helpful information.
According to Brinjikji et al’s study (2015) up to 88% of people over the age of 60 had disk degeneration with no symptoms or pain, 30% of 20 year olds had an asymptomatic disc bulge and 50% of 60 year olds had degeneration of the spinal joints with no corresponding pain.
Does this mean imaging is useless?
Absolutely not. Imaging is essential in investigating more serious causes of pain which can often mimic common musculoskeletal ailments such as infection or fractures.
There are certain guidelines which practitioners abide by when choosing whether to have their patient undergo imaging or not. You could say that there is a time and place for imaging. However, routine imaging in most cases is unnecessary.
What causes musculoskeletal pain if I can’t see it on imaging?
It can be caused by a variety of things such as aberrant movement patterns, learnt behaviours and changes in muscle activity post injury. A physical and functional assessment is key here once more serious causes of pain have been ruled out.
He uses a variety of functional assessments and treatments to manage his patients such as dry needling, rehabilitation, therapeutic massage and practitioner assisted stretching.
He’s also available for consultation. He is a Melbourne based chiropractor who consults from Medical clinics in Croydon. For more information please contact Michael on 0430 300 257. Chiropractic care is covered by Private Health Insurance (depending on your plan) and some patients may be eligible for a Medicare EPC referral.