An Overview of MSK Management by Most Common Conditions

Global Pathologies Osteoarthritis

Education regarding weight reduction and exercise;

The provision of appropriate simple orthoses, aids and appliances to alleviate distress and disability

Rheumatoid Arthritis Screen for those at greatest risk of loss of function, self-efficacy, physical and psychological status and pain;

A co-ordinated management programme, including patient education, joint protection training, exercise therapy, and appropriate provision of orthoses, mobility aids and environmental adaptations

Intensive co-ordinated in or day patient rehabilitation for people with active or severe RA

Other secondary health problems associated with poor mobility, such as thrombo-embolic disease and pressure sores, need to be considered and appropriate preventative strategies introduced

Fibromyalgia and CRPS In both fibromyalgia and CRPS, the severity of the disabling pain needs to be acknowledged

In CRPS, strategies to alleviate pain are seldom effective long-term, but the use of local treatments eg regional nerve blocks, protective and/or off-loading orthoses, may facilitate commencing rehabilitation.

Cognitive behavioural therapy (CBT) combined with rehabilitation to promote independence and return to normal lifestyle are the mainstays of treatment.

For fibromyalgia, initial management should include patient education supplemented by physiotherapy, particularly graded aerobic exercise programmes, but CBT again plays a crucial role