Musculoskeletal - Back pain, Neck pain, Shoulder pain, Lumps and bumps Flashcards
OA Knee Patellofemoral pain syndrome Plantar fasciitis Lower back pain Carpal tunnel syndrome neck pain shoulder pain shoulder impingement frozen shoulder rotator cuff syndrome tennis and golfers elbow de quervains trigger finger mallet finger Cervical spondylosis Lumbar spondylosis Cervical/ lumbar radiculopathy
General management of common MSK problems
Components of exercise prescription
Advantages of exercise prescription
Common types of exercise prescription
Types of physiotherapy for common MSK problems
Ice vs heat therapy
Application
Timing
Occupational therapy modalities
ADL, Occupation, Leisure
Injury on duty
Payment
Reporting
Role of doctor
Common prescriptions for MSK problems
OA knee
Risk factors
OA knee
S/S
OA knee
Typical Ix
OA Knee
Management options
+ RICE
+ Sitting knee extension +/- ankle weight
+ sit to stand exercise
+ walking aid/ walking frame/ wheelchair of the correct height, width, depth, angles
+ stair walking technique: good leg up first, bad leg down first, sideways approach for both knee pain
+ Home environment modifications for fall risk
+ knee orthosis: valgus knee brace to apply 3 point force, medial arch support (lateral wedge insole NOT recommended)
Patellofemoral Pain Syndrome
Pathogenesis
Patellofemoral Pain Syndrome
Clinical presentation
Patellofemoral pain syndrome
Management
Clinical dx by clarke’s test
Plantar Fasciitis
Risk factors
Plantar fasciitis
Clinical presentation
Plantar fasciitis
Management
Lower back pain
Red flag S/S
Lower back pain
Causes
Lower back pain
General advice and management
Carpal tunnel syndrome
Common risk factors
Carpal tunnel syndrome
S/S
Carpal tunnel syndrome
Special tests
Carpal tunnel syndrome
Investigation
Carpal tunnel syndrome
Conservative management
Carpal tunnel syndrome
Surgical management
Neck pain
Causes
Neck pain
Investigations
Management
Shoulder pain
Causes
Approach to shoulder pain
Shoulder impingement syndrome
Pathogenesis
Shoulder impingement syndrome
Phases
Shoulder impingement syndrome
Signs, Special tests
Shoulder impingement syndrome
Diagnosis
Management
Frozen shoulder
Causes
Frozen shoulder
Pathogenesis
Frozen shoulder
Clinical presentation
Diagnosis
Frozen shoulder
Conservative and surgical management
Frozen shoulder
Treatment according to stages of disease
Rotator cuff tear
Risk factors
Rotator cuff tear
Pathogenesis
Rotator cuff tear
Clinical presentation
Rotator cuff tear
Special tests
Rotator cuff tear
Complications
Diagnosis
Rotator cuff tear
Management
Prognosis
Tennis elbow
Pathogenesis
Tennis elbow
Clinical presentation
Tennis elbow
Ddx
Diagnosis
Tennis elbow
Management
Golfer’s elbow
Pathogenesis
Golfer’s elbow
Clinical presentation
Compare to tennis elbow
Olecranon bursitis
Clinical presentation
Ddx
Management
Acromioclavicular joint arthritis
Clinical presentation
Management
de Quervain’s disease
risk factors
Pathogenesis
de Quervain’s disease
Clinical presentation
de Quervain’s disease
Management
Trigger finger
Risk factors A
Trigger finger
Pathogenesis
Trigger finger
Clinical presentation
Trigger finger
Management
Mallet finger
Cause
Pathogenesis
Mallet finger
Clinical presentation
Mallet finger
Management
Cervical spondylosis
Causes
Cervical spondylosis
Clinical presentation
Cervical spondylosis
Investigation
Cervical spondylosis
Management
Cervical radiculopathy
Causes
Cervical radiculopathy
Clinical presentation
Ddx
Prognosis of Cervical Radiculopathy
- ~80% self-limiting and affect sensory only
- Progression is uncommon
-
Cervical radiculopathy
Management
Conservative Treatment:
* Rest and activity modification: Avoiding activities that aggravate symptoms and allowing the affected nerve to heal.
* Physical therapy: Exercises and manual therapy techniques to improve posture, mobility, and strength.
Medications:
* Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation.
* Gabapentin or pregabalin for neuropathic pain.
* Muscle relaxants to alleviate muscle spasms.
* Cervical traction: Using a device to gently stretch the neck and relieve pressure on the nerve.
Interventional Treatments:
* Epidural steroid injections: Injections of corticosteroids into the epidural space around the affected nerve root to reduce inflammation.
* Nerve root blocks: Targeted injections of local anesthetics and/or steroids around the specific nerve root.
Surgical Treatment:
* Surgical decompression: Removing a portion of a vertebra or disc material to relieve pressure on the affected nerve root.
* Discectomy: Removal of a herniated or bulging disc that is compressing the nerve root.
* Fusion: Fusing two or more vertebrae to stabilize the spine and prevent further nerve compression.
Cervical myelpathy
Causes
Cervical myelopathy
Clinical presentation
Cervical myelopathy
Clinical signs
Cervical myelopathy
Investigations
Cervical myelopathy
Management
Conservative Treatment:
* Activity modification: Avoiding activities that exacerbate symptoms and may further damage the spinal cord.
* Physical therapy: Exercises and manual therapy techniques to improve posture, neck mobility, and strength.
* Neck bracing: Use of a cervical collar or brace to provide support and limit neck movement.
Medications:
* Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation.
* Gabapentin or pregabalin for neuropathic pain.
Surgical Treatment:
* Decompressive surgery: Procedures to remove bone, disc, or other tissues that are compressing the spinal cord, such as:
* Anterior cervical discectomy and fusion (ACDF): Removing a disc and fusing the adjacent vertebrae.
* Laminectomy: Removing the back part of the vertebra (lamina) to create more space for the spinal cord.
* Laminoplasty: Expanding the space for the spinal cord by opening up the back part of the vertebrae.
* Stabilization procedures: In cases of spinal instability, fusion surgery may be performed to stabilize the spine.
Monitoring and Follow-up:
* Neurological assessment: Regular evaluations to monitor the progression of symptoms and neurological function.
* Imaging studies: Periodic MRI or CT scans to assess the degree of spinal cord compression and any changes over time.
* Timing of intervention: The decision to proceed with surgery is based on the severity of symptoms, the degree of spinal cord compression, and the rate of progression.
Lower back pain
Red flags
(Lumbar spine diseases)
