Musculoskeletal diseases and conditions affect half of Americans, or nearly 128 million people. This number is only growing as the population ages. The musculoskeletal system consists of bones, muscles, cartilage, ligaments, tendons, and joints. Many chronic and degenerative conditions, as well as injuries, can affect those areas.
We’ll look at the ten most common orthopedic conditions, how to get diagnosed, and common treatments for each.
Osteoarthritis (OA) is the most common type of arthritis. This degenerative joint condition causes mild to severe pain and discomfort. This usually occurs in the hands, hips, knees, or back, although it can affect any joint. OA is caused by the breakdown of cartilage (the cushion) in the joints and affects over 33 million people in the United States. It’s more common in people who are overweight or over the age of 55.
OA can be caused by age, obesity, overuse, stress, injury to the joints, genetics, and metabolic conditions like diabetes or high blood pressure.
General symptoms of OA include:
- Pain, especially when moving a joint
- Stiffness
- Swelling
- Tenderness
- Decreased range of motion
- Popping or cracking sounds (especially in the knees)
- Joint deformity (knee OA can cause or exacerbate “bow-legged” or “knock-kneed” leg alignment)
Pain and stiffness are usually the first symptoms that people notice, and that is when you should see your doctor.
You can treat symptoms of OA with anti-inflammatory medications, injections, weight loss and exercise or physical therapy.
Keeping your joints flexible and mobile with range-of- motion exercises is very important. Strengthening and stretching the muscles next to the joint also improves pain related to OA. Regular low-impact physical activity (walking, swimming or cycling) can help to keep your joints healthy.
If symptoms are severe or don’t go away after a course of non-surgical therapies, you may be advised to see an orthopedic surgeon.
“Joint replacement surgery, when performed for advanced stage arthritis of the hip or knee is a very successful operation that reliably alleviates joint pain and restores function,” says Ayesha Abdeen, MD, an orthopedic surgeon and BMC’s chief of hip and knee replacement surgery.
Fractures are breaks in the bones of the extremities, spine, or pelvis area. Fractures have many potential causes, from falls to motor vehicle accidents. Fractures can be open or closed. Open fractures are where the bone is out of the skin and exposed to the outside environment. This type of fracture is an emergency.
Symptoms of fractures include:
- Swelling
- Bruising
- Deformity
- Inability to use the extremity
- Loss of pulses
- Numbness
Fractures require tests, such as X-rays, CT scans, or an MRI, to determine the type and severity of the fracture. Treatment depends on what these tests tell your doctor. Fractures can be treated in many ways, both with and without surgery.
Potential treatments include:
- Casting and splinting
- Plates and screws
- Intramedullary implants
- Surgery for nonunion and malunion fractures
- Bone grafting
Carpal tunnel syndrome (CTS) is a collection of symptoms that include numbness in certain fingers in the hand. The numbness is due to compression of one of the major nerves that provides sensation and strength to the hand. If left untreated, the hand can also become weak.
The common symptoms of carpal tunnel include:
- Numbness
- Tingling
- Burning
- Weakness
There are many potential causes of carpal tunnel syndrome, though in most cases the cause is never discovered. Certain medical conditions can also cause CTS symptoms or make them worse.
If your primary care physician suspects carpal tunnel syndrome, initial treatment recommendations may include splints, hand therapy, and medications. The diagnosis is confirmed by both clinical examination and electrical testing, which is done by a neurologist. Injections or surgery may be recommended based on the severity of symptoms or nerve damage.
Plantar fasciitis is a common inflammatory condition that causes heel pain. You’ll feel stabbing pain in your foot, usually first thing in the morning or after standing or sitting for a long time. It usually improves with movement.
It is common in people over 40 years old. Doing certain types of exercise that put stress on your feet, like running, dancing, or playing tennis, can cause plantar fasciitis, as can working on your feet. Obesity can also contribute to plantar fasciitis.
Treatment usually includes rest, stretching, and icing with the use of a soft shoe insert. For severe pain, they may recommend anti-inflammatory medications or wearing a night splint.
Surgery is not commonly recommended for plantar fasciitis as most cases resolve over time, however it may take up to a year. You may be referred to an orthopaedic foot specialist for non-surgical treatments like extracorporeal shock wave therapy (ESWT) or ultrasonic tissue repair.
Osteoporosis is the “brittle bones” disease. As people age, we all experience a decrease in bone density and bone mass. This is especially common in women who have gone through menopause. Osteoporosis is called a “silent disease” because there generally aren’t any symptoms until you break a bone.
Bone is a living tissue made of protein and minerals. Bones break down and are recreated throughout our life, but osteoporosis occurs when bone loss outweighs new bone growth. This is mainly due to loss of minerals like calcium, but also hormones like estrogen.
Once bone loss becomes significant, you may experience the following symptoms:
- Back pain
- Bone breaks
- Loss of height (losing an inch or so)
- Bent over, or “stooped” posture from a weakened spine
- Falling
The risk of osteoporosis increases with age. It can also be caused by certain medications like cortisone and medical conditions like cancer, kidney disease, inflammatory bowel disease, or celiac disease. Excess alcohol consumption can also interfere with mineral absorption. You should get a bone density test if you’re over the age of 65 or a family history of osteoporosis.
You can do things to decrease your risk of osteoporosis including:
- Increase calcium intake either from calcium-rich foods or taking a supplement
- Exercise
- Get enough vitamin D, which increases calcium absorption
- Quit smoking
- Reduce alcohol intake
- Stay at a healthy weight
Osteoporosis is preventable. Speak with your physician about any concerns you may have, especially if you have a family history of bone breaks or have a medical condition. They may recommend medication that can help rebuild bone.
If you do have a break, you may be referred to an orthopedist.
Back and neck pain affects millions of people in the United States. Eight percent of adults experience chronic back or neck pain at some point of their life and seek the care of a physician.
The most common cause of back or neck pain, other than injury, include:
- Degenerative conditions like arthritis or osteoporosis
- Poor posture
- Inflammation
- Sprains or strains
- Compression fractures
- Muscle weakness
- Bulging disc
Talk to your doctor if you have pain that either won’t go away or returns frequently, especially if you’re also experiencing bladder or bowel problems, numbness, fever, or unexplained weight loss. They may refer you to an orthopedic spine specialist who can provide treatments such as medications, physical therapy, and if necessary, surgery.
Bursitis is an inflammatory condition that causes pain in the shoulder, elbow, hip, knee, heel, or big toe. The bursae are fluid-filled sacs that cushion bones, joints, and tendons. When they get inflamed, they cause the severe pain of bursitis.
Common symptoms include:
- Dull or achy pain that worsens when touched
- Decreased range of motion
- Redness or swelling
- Fever or chills, which may indicate infection
Bursitis is caused by poor posture, repetitive movement, not properly stretching before exercise, and injury.
Because bursitis is an inflammation of the joints, you may be referred to an orthopedist. They can diagnose your bursitis through x-rays, MRI, or fluid sample, and may do a blood test to rule out an infection.
They may recommend rest, alternating ice and heat, elevating the area, wearing a splint, pain medication, or a steroid injection. Surgery may be an option if other treatments are not successful.
Hip fractures are common, especially in older adults and women. Hip fractures, or a “broken hip” can be caused by degenerative conditions like osteoporosis, falling, certain medications, nutritional deficiencies, or an injury.
Symptoms usually include pain in the area and the inability to walk or move your hip or leg. You may also see swelling or bruising.
An orthopedist will diagnose a hip fracture with an x-ray or MRI. You may need surgery to either repair your hip, with screws that may or may not be removed after healing, or a partial or total hip replacement. It can take several months to heal from a hip replacement.
Tendonitis is the swelling or inflammation of tendons, which connect muscles to bones. It is most common in the shoulder, elbow, wrist, knee, or heel, and can be caused by injury, overuse, or repetitive motion.
Common symptoms include:
- Achiness in the joint
- Swelling
- Tenderness
If the pain persists or gets worse, keeps you from activities, or you see symptoms that would indicate an infection like a fever or warmth at the area, then you should see an orthopedist. These symptoms will only get worse if left untreated.
Your doctor may recommend physical therapy or steroid injections, and if necessary, surgery.
Sports injuries are common for those who participate in any sport, exercise, or other activity that puts stress on the body or includes repetitive motion in the bones, joints, or connective tissues. Sport injuries can be acute or chronic.
Many injuries occur by not warming up or cooling down after exercise, not staying hydrated, being out of shape, or not wearing protective gear for your sport.
Best practices to prevent sports injuries include:
- Stretching
- Drinking plenty of water
- Wearing properly functioning safety equipment
- Avoiding sudden increases in physical activity
- Wearing the proper shoes
Injuries can vary from the minor scrape or sprain to a break or torn ligament. Symptoms also vary depending on the type of injury, but the most common include:
- Pain
- Achiness
- Tenderness
- Stiffness
- Swelling
- Bruising
- Deformity
- Grinding or popping
- Inability to move or decreased range of motion
Your doctor will perform a physical exam and potentially x-rays or an MRI to figure out the type of injury you have.
Some injuries only require immobilizing the area with a splint or cast, pain or anti-inflammatory medications, and physical therapy. For more serious injuries you may need to see an orthopedist for an evaluation and, possibly, surgery.