Musculoskeletal problems (the bone and joint problems or the orthopaedic problems) are rising with increasing frequency in the society. In the previous years the problems were seen more in patients after 40-45 years of age and it was attributed to aging and thus treated accordingly. But in the recent past the problem has become more frequent and with alarming increase in the young. The conventional approach is directed towards finding a structural cause to the problem or finding a disease that is responsible for the pains. Thus, there are a whole lot of investigations and references undertaken just to find the cause or disease responsible for the pain. The problem has to be seen from the point of function as well. Functional approach involves making an effort to find some activity or activities through the day that are painful or are likely to be painful and address them. If there is a identifiable structural cause then modifications of the stressful activities will lead to joint protection and in the absence of a definite structural cause or disease, this will be the treatment! The problem the patients face is while undertaking one of his or her daily activities from morning to evening. The endeavour should be to identify the single or multiple activities (from history or by leading questions) that can contribute to pain in that particular body region. The patients history will tell us that some specific activities are painful and some are not. For example, a desk worker complaints of back pain while sitting only. In this scenario the first approach can be to correct the sitting posture by doing his or hers workstation analysis, suggesting appropriate ergonomic changes and advising desk discipline. In the event where the patient is unsure about a particular activity, then appropriate area specific probabilities need to be thought of. For example, an exam going student complaining of pain in the dominant wrist and forearm. In this case we need to ask leading questions to find the cause of the pain. This can include the amount of continuous writing that he is undertaking, the use of mobiles, the use of laptops, the grip with which he is holding the pen, the angle of his wrist while writing. By addressing all these dynamic activities we are able to achieve a prompt, immediate and long lasting relief. The patient is also educated about his problem and it helps this in the long run as well. We will begin a series of articles using this approach wherein we will look at the various problems any particular type of work can produce or impact of the use of gadgets one can have on the musculoskeletal system. This functional approach in addition to the structural approach helps in a long lasting pain free state. Please give me the valuable feedback, queries and suggestions.
Posted on: Fri, 14 Mar 2014 07:08:51 +0000
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