ANAT1081 Human Anatomy And Physiology : Solution Essays

Question:

Learning Aim

Understand the impact of disorders of the musculoskeletal system and their associated corrective treatments

Title: Musculoskeletal Disorders

Scenario

You are employed by a large sports and fitness company as a trainee Health Care Assistant within their Occupational Health Department (OHD). Your employers are concerned that a significant number of working days are lost due to employee absence through musculoskeletal disorders. They hope that by liaising with other Health Care professionals, the OHD will be able to create support programmes that offer employees education and guidance regarding the structure and function of the musculoskeletal system, the treatments available for disorders of the system and the effective clinical management of common musculoskeletal disorders. The company’s management team hope that this initiative will reduce absences by expediting employees return to work in the shortest possible time. Your role is to carry out research in order to produce information that will be used to educate the employees.

Task 

Using relevant scientific terminology and labelled images, produce a set of written reports and information leaflets that include the following:

  • An explanation of the structures and functions of the human musculoskeletal system to include its role in:

-Support, leverage and movement, protection of body organs, production of blood cells and storage of minerals.

  • An outline of the normal anatomy and physiology of six major joints. You must explain the importance of their structure and role in enabling normal movement. You must include bones, muscle groups and associated ligaments and tendons involved in bringing about normal movement.
  • A description and comparison of three disorders that affect different aspects of the musculoskeletal system (e.g. shoulder dislocation in joint hypermobility, rheumatoid arthritis and anterior cruciate ligament injury). You must include:
  • A detailed explanation using scientific knowledge of the anatomy and physiology of affected bones, joints and muscle groups.
  • Detailed evidence describing how normal movement (flexion/extension, adduction/abduction, internal/external, rotation, circumduction) is compromised in each of the three conditions you have researched.
  • A description and comparison of the available corrective treatments health care professionals might utilise to alleviate the symptoms of each disorder you have chosen to research. In each case, you must include the scientific rationale behind choosing one treatment in preference to others. For example, you could consider:

-Why non-steroidal anti-inflammatory drugs (NSAIDs) might be prescribed instead of steroid treatment

-What factors might influence a Doctor’s choice of analgesic medications

-Why alternative or complementary therapy may be used in conjunction with conventional treatments

  • Choose one of the musculoskeletal disorders that you have researched above to produce an evaluation that demonstrates how this condition affects normal movement and functioning of the musculoskeletal system and the corrective treatments associated with it. You must include evaluation of the effectiveness, limitations, strengths and weaknesses of different forms of corrective action and alternative treatment methods offered by medical professionals for this disorder.
 

Answer:

Effects of corrective treatments associated with musculoskeletal disorders

The underlying effects of musculoskeletal disorder corrective treatments have not been anticipated by plenty of researchers across the globe.  For instance, when an individual undergoes treatment by physical therapist, orthopedist and chiropractor for pain management, it is important to acknowledge the fact that the recommended treatment addresses the underlying cause of the problem. More often than not, most healthcare professionals who manage the condition tend to cover up the underlying pain rather than treating the cause of the condition (Babatunde et al., 2017). In other words, most of the practitioners employ treatment methods that address the diagnosis of the musculoskeletal disorder.it is not difficult to ask a patient who is undergoing a severe back pain to bend over to touch his/her toes and prescribe anti-inflammatory medications or muscle relaxers. It is also very easy to make cortisone shot just to cover up for the pain presented by patients. The use of such medications not only puts the patient at underlying potential risks but also fail to treat the underlying cause of the condition. On the same note, orthopedic surgery may be significant to repair torn ligaments or tendon or to replace completely degenerated knee or hip (Magee et al., 2015).  However, most of the surgical approaches fail to handle the underlying problems that led to the development of degeneration and pain in the original place of the start of the condition.

Following the treat the diagnosis approach in correcting musculoskeletal disorders, a physician or doctor is likely to implement a pre-packaged treatment program and pre-packaged exercises based on the diagnosis of the patient. In such a case, all patients with a rotator cuff syndrome are likely to receive a similar shoulder exercises and treatment programs.  At the end, there is a great likelihood that the approach will fail due to the varying causes of the condition among patients with the same rotator cuff syndrome. For instance, one patient may have a may have a postural misalignment of the neck and shoulders which calls for adjustments of the spinal for the restoration of the normal alignment. On the other hand, the other patient may be having abnormal muscle (motor) control of their scapular and abdominal (shoulder blade) stabilizing strategies that call upon some primary shoulder and core stabilizing exercises (Dean, and Söderlund, 2015). Therefore, a treat the diagnosis approach in the management of musculoskeletal disorders does not work out for most patients because the underlying cause of the condition is not managed. There is a great probability that the pain and condition of the patients remain unresolved in the case here the treat the diagnosis approach has been utilized.

 

Following the negative impacts of the treat the diagnosis program; it is significant to apply the treat the cause approach in the correction of musculoskeletal disorders. This approach serves a significant role in the treatment process because of not only considering the movement patterns of each and every patient but also basing on the misalignment of the patients. It is currently clear that misalignment, muscle inhibition, and abnormal motor control are the primary causes of musculoskeletal disorders and pain. Therefore, the best treatment method to promote good patient outcomes includes reprogramming and resetting the musculoskeletal system in terms of movement, motor control and alignment.

There are plenty treatment methods employed on pain and inflammation management. These treatment methods include ice, ultrasound, natural anti-inflammatory supplements and high concentrated fish oil (Frontera, Silver, and Rizzo, 2014). Ice treatment has plenty of side effects to the normal wellbeing of the patient. Some of the primary side effects of the approach include decrease in blood circulation in the body, numbs to the skin, inflammation and metabolic activity. Prolonged use of ice may also lead to the frostbite (Cunningham, and Kashikar-Zuck, 2013). The beneficial effects of the ice include pain reduction, reduced swelling, reduced inflammation, and decreased muscle spasm/cramping. No adverse side effects have been identified on the use of natural anti-inflammatory medications in the management of pain and inflammation. However, there exist potential side effects on the use of steroid based medications in the management of inflammation and  pain. Such side effects include but not limited to increased risk for infections like impaired wound healing, fluid retention edema, dermatitis, mood change, stomach ulcers, osteoporosis, cushingoid –like state and hypertension. Steroid-based medications are also likely to lead to fat deposits in face, stomach, upper back and chest. The medications have a great link to hyperglycemia, cataracts, adrenal suppression and crisis, depression, worsening of previously acquired medical conditions, eight gain and increases appetite.

 

Spinal manipulation especially hence performing upper spine is often linked to mild and moderate impacts to the wellbeing of the patient (Van et al., 2016). However, the operation may also lead to development of adverse complications such as artery dissection followed by stroke. Often, spinal manipulation is used to treat low back and other musculoskeletal pain (Frontera, Silver, and Rizzo, 2014). The approach encompasses a high velocity thrust whereby joints are adjusted rapidly together with popping sounds. This leads to the transient stretching of joint capsules which, according to chiropractic belief, repositions the spinal cord and nerves hence promoting optimal functioning of the nerves system hence promoting the efficiency of the biochemical activities in the human body. Even though spinal manipulation has been found to be an effective method in management of back pain among patients, most of the researchers tend to find no evidence of the effectiveness of the approach in the management of other conditions other than back pain. Furthermore, several authors have raised queries regarding the strategy. Most significantly, stroke is a huge concern regarding the upper spinal manipulation. The approach also leads to dissection of the vertebral arteries. Other complications associated with spinal manipulation include disc herniation, nerve injury, haematoma, oedema, bone fracture and dural tear. The symptoms of such complications are life threatening. However, a higher chance of full patient recovery exists. Therefore, spinal manipulation is an ultimate cause of the underlying adverse conditions among the victim patients.

For patients ho present abnormal alignment of the spinal, the displaced position of their spine becomes the custom (Harrison, and Oakley, 2017). This problem has underlying effects that spread throughout the human body. In curbing the crisis, mirror image adjustments overcompensate in the opposite to result into progression back towards the normal condition. Mirror image adjustments focus all forms of misalignment at once to develop a cohesive motion back to normal. As opposed to handling a single problem at a time, mirror imaging handles the entire issue.  This serves a significant role in ensuring everything is back to normal at once rather than handling a single problem at a time. Finally, mirror image adjustments not only adjust the position of the pine but also strengthen the spine. Through mirror image adjustments, the bodies of patients are recalibrated to operate normally (Taljanovic et al., 2014). For instance, correction of the translation to the left serves a significant role in preparing the right side muscles to support the spine. Mirror imaging serves a significant role in progressively promoting buildup of strength during the translation process. In the end the corrected spine is also strongly supported.

 

How musculoskeletal disorders hinder the movement of muscles

Musculoskeletal disorders prevent muscle movement through the pain associated with them. Pain is the most common symptom of most musculoskeletal disorders. Pain may range from mild, to moderate to severe. Also, pain may be categorized depending on the lifespan. In this case, pain may be short lived or chronic. Furthermore, the pain may be either diffuse (widespread) or local depending on the extend of the affected area. Musculoskeletal pain may arise from joints, bones, ligaments, muscle or a combination of both. Bone pain is often deep, penetrating or dull. Bone pain can either result from bone infections like osteomyelitis or injury. Bone pain may prevent an individual from moving the body muscles normally. Muscle pain is also a huge hindrance to the normal movement of body muscles. Even though muscle pain is less intense hen compared to the bone pain, it is unpleasant when it occurs. A typical example of a muscle pain is the muscle spasm or cramp (a sustained painful muscle contraction) in the calf is an intense that is often identified as a charley horse. Muscle pain may originate from either tumors, infection, inadequate or lack of blood flow to the muscle or general injury. Such pain makes an individual to impose restrictions to the normal movement of the muscles as a pain management strategy. Tendon pain and ligament pain worsens when the respective ligament or tendon is stretched or moved. On the same note, the pain is relieved at rest. Therefore, an individual ill prefer restricting the movement of the muscles of the respective painful ligaments and tendons hence impacting the overall movement of the body muscles.

Similarly, bursae pain lowers with rest and worsens with movement involving the bursa (Darwish, and Al-Zuhair, 2013). Bursae pain can be caused by gout, infection, overuse and trauma. Bursae are often small fluid filled sacs that provide a protective cushion around the joints.  Bursa pain may limit an individual to rest thus restricting the normal movement of muscles.

Apart from causing pain that in turn impact the normal movement of the body muscles, musculoskeletal disorders result into swelling which affects the normal movement of muscles. An affected bursa for instance swells thus impacting the normal movement of muscles. Similarly, arthritis is a joint inflammation condition that affects the normal movement of muscles. Arthritis not only cause swelling but also pain. Arthritis is caused by different musculoskeletal disorders. Some of these conditions include inflammatory arthritis like rheumatoid arthritis, gout, infectious arthritis and osteoarthritis (Baraliakos, Coates, and Braun, 2015). Other complications include autoimmune disorders like systemic lupus erythematosus, oestenecrosis and vasculitic disorders such as immunoglobulin A-associated vasculitis (Storheim, and Zwart, 2014). Such complications have a significant inflammation impact that hinders the normal movement of muscles.

 

Musculoskeletal disorders may cause joint stiffness which in turn interferes with the normal motion (Hamill, Gruber, and Derrick, 2014).  The feeling is not brought about by weakness or reluctance to move the joint due to pain. Some individuals with joint stiffness tend to move their joint through full range of motion, however, this requires application of force. Joint stiffness due to inflammation often occurs after awakening or prolonged duration of rest. Joint stiffness is popular among patients with arthritis (Perretti et al., 2017). Morning stiffness on the other hand mostly occurs among patients with inflammatory arthritis and rheumatoid arthritis. However, the stiffness lowers with activity within a period of approximately five hours. However, not all stiffness is caused by inflammation. Some stiffness, particularly the one which worsens as the day progresses is not caused by inflammation (McGinnis, K., Snyder-Mackler, Flowers, and Zeni, 2013). Therefore, it is important for the clinicians to contact physical examinations in investigating / assessing the cause of the condition (Davis, and Kotowski, 2015). Stiffness has a fundamental impact to the normal functioning of the joint and muscle movement among the victim patients.

Musculoskeletal disorders may result into development of tremors that impact the normal movement of muscles. Tremors often occur when the muscles repeatedly relax and contract. In definition, tremors refers to the involuntary , rhythmic shaking movement of part f the body like vocal cords, legs, hands, head or trunk. Tremors may be normal hence termed as physiological in nature. However, in most cases, tremors are abnormal hence termed as pathological. Pathological tremors occur mostly as a result of musculoskeletal disorders.

Apart from the above means through which musculoskeletal disorders lead to the interference of the normal movement of the body muscles, the interference may be caused due to a previous joint injury leading to significant scar tissue (Bhattacharya, 2014). Also, the abnormality may result from prolonged joint immobilization (for instance, when an individual’s arm, is paralyzed by a stroke or placed in a sling) resulting into the shortening of tendons). Also, the abnormality may arise from fluid accumulation in a joint resulting from either an acute injury or arthritis hence providing a sensation that the joint is locked. Lastly, a piece of torn cartilage originating from injury, especially in the knee, may block joint movement.

 

References

Babatunde, O.O., Jordan, J.L., Van der Windt, D.A., Hill, J.C., Foster, N.E. and Protheroe, J., 2017. Effective treatment options for musculoskeletal pain in primary care: A systematic overview of current evidence. PloS one, 12(6), p.e0178621.

Baraliakos, X., Coates, L.C. and Braun, J., 2015. The involvement of the spine in psoriatic arthritis. Clin Exp Rheumatol, 33(5 Suppl 93), pp.S31-5.

Bhattacharya, A., 2014. Costs of occupational musculoskeletal disorders (MSDs) in the United States. International Journal of Industrial Ergonomics, 44(3), pp.448-454.

Cunningham, N.R. and Kashikar-Zuck, S., 2013. Nonpharmacological treatment of pain in rheumatic diseases and other musculoskeletal pain conditions. Current rheumatology reports, 15(2), p.306.

Darwish, M.A. and Al-Zuhair, S.Z., 2013. Musculoskeletal pain disorders among secondary school Saudi female teachers. Pain research and treatment, 2013.

Davis, K.G. and Kotowski, S.E., 2015. Prevalence of musculoskeletal disorders for nurses in hospitals, long-term care facilities, and home health care: a comprehensive review. Human factors, 57(5), pp.754-792.

Dean, E. and Söderlund, A., 2015. What is the role of lifestyle behaviour change associated with non-communicable disease risk in managing musculoskeletal health conditions with special reference to chronic pain?. BMC musculoskeletal disorders, 16(1), p.87.

Frontera, W.R., Silver, J.K. and Rizzo, T.D., 2014. Essentials of Physical Medicine and Rehabilitation E-Book: Musculoskeletal Disorders, Pain, and Rehabilitation. Elsevier Health Sciences.

Frontera, W.R., Silver, J.K. and Rizzo, T.D., 2014. Essentials of Physical Medicine and Rehabilitation E-Book: Musculoskeletal Disorders, Pain, and Rehabilitation. Elsevier Health Sciences.

Hamill, J., Gruber, A.H. and Derrick, T.R., 2014. Lower extremity joint stiffness characteristics during running with different footfall patterns. European journal of sport science, 14(2), pp.130-136.

Harrison, D.E. and Oakley, P.A., 2017. Scoliosis deformity reduction in adults: a CBP® Mirror Image® case series incorporating the ‘non-commutative property of finite rotation angles under addition’in five patients with lumbar and thoraco-lumbar scoliosis. Journal of physical therapy science, 29(11), pp.2044-2050.

Magee, D.J., Zachazewski, J.E., Quillen, W.S. and Manske, R.C., 2015. Pathology and intervention in musculoskeletal rehabilitation (Vol. 3). Elsevier Health Sciences.

McGinnis, K., Snyder-Mackler, L., Flowers, P. and Zeni, J., 2013. Dynamic joint stiffness and co-contraction in subjects after total knee arthroplasty. Clinical biomechanics, 28(2), pp.205-210.

Perretti, M., Cooper, D., Dalli, J. and Norling, L.V., 2017. Immune resolution mechanisms in inflammatory arthritis. Nature Reviews Rheumatology, 13(2), p.87.

Storheim, K. and Zwart, J.A., 2014. Musculoskeletal disorders and the Global Burden of Disease study.

Taljanovic, M.S., Melville, D.M., Scalcione, L.R., Gimber, L.H., Lorenz, E.J. and Witte, R.S., 2014, February. Artifacts in musculoskeletal ultrasonography. In Seminars in musculoskeletal radiology (Vol. 18, No. 01, pp. 003-011). Thieme Medical Publishers.

Van Eerd, D., Munhall, C., Irvin, E., Rempel, D., Brewer, S., Van Der Beek, A.J., Dennerlein, J.T., Tullar, J., Skivington, K., Pinion, C. and Amick, B., 2016. Effectiveness of workplace interventions in the prevention of upper extremity musculoskeletal disorders and symptoms: an update of the evidence. Occup Environ Med, 73(1), pp.62-70.

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