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What are musculoskeletal disorders?
Musculoskeletal disorders are injuries or disorders of the muscles, nerves, tendons, joints, cartilage, and spinal discs.¹
What are musculoskeletal disorders?
Musculoskeletal disorders are injuries or disorders of the muscles, nerves, tendons, joints, cartilage, and spinal discs.¹
Musculoskeletal Disorders are Common
1 of 2 Adults in the U.S. were diagnosed with musculoskeletal conditions in 2015. This is twice as many as any other medical condition back pain affects most people at some point in their lives.² Back pain is one of the most common musculoskeletal conditions.
Musculoskeletal Disorders are Common
1 of 2 Adults in the U.S. were diagnosed with musculoskeletal conditions in 2015. This is twice as many as any other medical condition back pain affects most people at some point in their lives.² Back pain is one of the most common musculoskeletal conditions.
Back pain affects most people at some point in their lives.
It is estimated that 60 to 80% of the general population will experience an episode of low back pain during their life time.Low back disorders are the most frequent problems presented to health care providers.³ In 2015, 72.3 million people age 18 and older reported they experienced chronic back pain in the previous year. This is nearly one in three adults.²
Back pain affects most people at some point in their lives.
It is estimated that 60 to 80% of the general population will experience an episode of low back pain during their life time.Low back disorders are the most frequent problems presented to health care providers.³ In 2015, 72.3 million people age 18 and older reported they experienced chronic back pain in the previous year. This is nearly one in three adults.²
Back Pain and Its Causes
Back pain is a symptom associated with many medical conditions, both mechanical and nonmechanical. Nonmechanical causes represent 3% of the causes of back pain and may include rheumatologic, vascular, gastrointestinal, renal, infectious, or oncologic causes. Mechanical causes of back pain represent 97% of cases.⁴
Back Pain and Its Causes
Back pain is a symptom associated with many medical conditions, both mechanical and nonmechanical. Nonmechanical causes represent 3% of the causes of back pain and may include rheumatologic, vascular, gastrointestinal, renal, infectious, or oncologic causes. Mechanical causes of back pain represent 97% of cases.⁴
What is mechanical pain?
Mechanical pain is a result of abnormal or unusual forces or mechanics occurring in the tissue. Further, it means that a position, movement or activity caused the pain to start. If a mechanical force caused the problem then it is logical that a mechanical force may be part of the solution.⁵
What is mechanical pain?
Mechanical pain is a result of abnormal or unusual forces or mechanics occurring in the tissue. Further, it means that a position, movement or activity caused the pain to start. If a mechanical force caused the problem then it is logical that a mechanical force may be part of the solution.⁵
How does VIRT address mechanical pain?
All VIRT therapists are specialized in the McKenzie Method of MDT. The McKenzie Method is a reliable assessment process intended for all musculoskeletal problems. MDT is designed to identify the mechanical problem and develop a plan to correct or improve the mechanics and thus decrease or eliminate the pain and functional problems.⁵
How does VIRT address mechanical pain?
All VIRT therapists are specialized in the McKenzie Method of MDT. The McKenzie Method is a reliable assessment process intended for all musculoskeletal problems. MDT is designed to identify the mechanical problem and develop a plan to correct or improve the mechanics and thus decrease or eliminate the pain and functional problems.⁵
What are examples of musculoskeletal problems?
Pain in the back, neck and extremities (i.e., shoulder, knee, ankle etc.), as well as issues associated with sciatica, sacroiliac joint pain, arthritis, degenerative disc disease, muscle spasms and intermittent numbness in hands or feet.⁵
What are examples of musculoskeletal problems?
Pain in the back, neck and extremities (i.e., shoulder, knee, ankle etc.), as well as issues associated with sciatica, sacroiliac joint pain, arthritis, degenerative disc disease, muscle spasms and intermittent numbness in hands or feet.⁵
Active treatment is more successful than passive
Research shows that an active treatment (exercises) was more successful in reducing pain and disability and in improving lumbar endurance than was the passive treatment (heat and massages).³ Passive approaches such as rest and medication are linked with worsening disability, whereas active strategies such as exercise are associated with reduced disability and less reliance on formal health care.⁶
Active treatment is more successful than passive
Research shows that an active treatment (exercises) was more successful in reducing pain and disability and in improving lumbar endurance than was the passive treatment (heat and massages).³ Passive approaches such as rest and medication are linked with worsening disability, whereas active strategies such as exercise are associated with reduced disability and less reliance on formal health care.⁶
Low Back Disorders Guideline
The American College of Occupational and Environmental Medicine published this Low Back Disorders Guideline in 2016.³ Here as some of their recommendations based on evidence:
Low Back Disorders Guideline
The American College of Occupational and Environmental Medicine published this Low Back Disorders Guideline in 2016.³ Here as some of their recommendations based on evidence:
- Lower back pain is normal
Lower back pain is normal, has an excellent prognosis and, in all but rates cases, is not debilitating on long-term basis.
- Return to work as soon as possible
Evidence suggests that patients should be encouraged to return to work as soon as possible, as this leads to the best outcomes.
- Imaging and other tests are not recommended
In the absence of red flags (i.e., fever or major trauma), imaging and other tests are not recommended in the first 4 to 6 weeks of low back symptoms as they are highly unlikely result in a meaningful change in clinical management.
- Non-specific stretching is not recommended
Non-specific stretching is not recommended as its not helpful for treatment of lower back pain. However, specific types of stretching exercises appear helpful (e.g., directional and slump stretching).
- Bed rest is not recommended for lower back pain
Unless unstable fractures or cauda equina syndrome, it was shown that maintaining ordinary activity as much as possible leads to the most rapid recovery
- Early mechanical evaluation
An early mechanical evaluation using repeated end-range test movements to determine the presence or absence of a directional preference and pain centralization has been shown to guide directional exercises treatments that are associated with better outcomes.
- “Abnormal“ findings on imaging exams are normal by age 40.
“Abnormal“ findings on r-rays, magnetic resonance images, and other diagnostic tests are so common they are normal by age 40.
- Accept responsibility for managing recovery
Patients should be encouraged to accept responsibility for managing their recovery rather than expecting the provider to provide an easy “cure“. This process promotes the use of activity and function rather than pain as a guide.
- Lower back pain is normal
Lower back pain is normal, has an excellent prognosis and, in all but rates cases, is not debilitating on long-term basis.
- Return to work as soon as possible
Evidence suggests that patients should be encouraged to return to work as soon as possible, as this leads to the best outcomes.
- Imaging and other tests are not recommended
In the absence of red flags (i.e., fever or major trauma), imaging and other tests are not recommended in the first 4 to 6 weeks of low back symptoms as they are highly unlikely result in a meaningful change in clinical management.
- Non-specific stretching is not recommended
Non-specific stretching is not recommended as its not helpful for treatment of lower back pain. However, specific types of stretching exercises appear helpful (e.g., directional and slump stretching).
- Bed rest is not recommended for lower back pain
Unless unstable fractures or cauda equina syndrome, it was shown that maintaining ordinary activity as much as possible leads to the most rapid recovery
- Early mechanical evaluation
An early mechanical evaluation using repeated end-range test movements to determine the presence or absence of a directional preference and pain centralization has been shown to guide directional exercises treatments that are associated with better outcomes.
- “Abnormal“ findings on imaging exams are normal by age 40.
“Abnormal“ findings on r-rays, magnetic resonance images, and other diagnostic tests are so common they are normal by age 40.
- Accept responsibility for managing recovery
Patients should be encouraged to accept responsibility for managing their recovery rather than expecting the provider to provide an easy “cure“. This process promotes the use of activity and function rather than pain as a guide.
1. Centers for Disease Control and Prevention (CDC), Work-Related Musculoskeletal Disorders & Ergonomics, Workplace Health Strategies. Available at https://www.cdc.gov/workplacehealthpromotion/health-strategies/musculoskeletal-disorders/index.html. Accessed on August 6th, 2020.
2. United States Bone and Joint Initiative: The Burden of Musculoskeletal Diseases in the United States (BMUS), Fourth Edition, 2020. Rosemont, IL. Available at http://www.boneandjointburden.org. Accessed on August 19th, 2020.
3. American College of Occupation and Environmental Medicine, Low Back Disorders; Elk Grove Village, IL:ACOEM, 2016.
http://www.dwc.ca.gov/dwc/MTUS/ACOEM_Guidelines/Low-Back-Disorders-Guideline.pdf
4. Chien, J. J & Bajwa, Z. H 2008, ` What is mechanical back pain and how best to treat it?` Curr Pain Headache Rep, vol. 12, no. 6, pp. 406-11.
https://pubmed.ncbi.nlm.nih.gov/18973732/
5. The McKenzie Institute® USA, The McKenzie Method. Available at https://www.mckenzieinstituteusa.org/method-patients.cfm. Accessed on August 3rd, 2020.
6. Buchbinder, R, Tulder, M. V, Oberg, B, Costa, L. M, Woolf, A, Schoene, M et al 2018, `Low back pain: a call for action`, The Lancet, vol. 391, no. 10137, pp. 2384-2388.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30488-4/fulltext
1. Centers for Disease Control and Prevention (CDC), Work-Related Musculoskeletal Disorders & Ergonomics, Workplace Health Strategies. Available at https://www.cdc.gov/workplacehealthpromotion/health-strategies/musculoskeletal-disorders/index.html. Accessed on August 6th, 2020.
2. United States Bone and Joint Initiative: The Burden of Musculoskeletal Diseases in the United States (BMUS), Fourth Edition, 2020. Rosemont, IL. Available at http://www.boneandjointburden.org. Accessed on August 19th, 2020.
3. American College of Occupation and Environmental Medicine, Low Back Disorders; Elk Grove Village, IL:ACOEM, 2016.
http://www.dwc.ca.gov/dwc/MTUS/ACOEM_Guidelines/Low-Back-Disorders-Guideline.pdf
4. Chien, J. J & Bajwa, Z. H 2008, ` What is mechanical back pain and how best to treat it?` Curr Pain Headache Rep, vol. 12, no. 6, pp. 406-11.
https://pubmed.ncbi.nlm.nih.gov/18973732/
5. The McKenzie Institute® USA, The McKenzie Method. Available at https://www.mckenzieinstituteusa.org/method-patients.cfm. Accessed on August 3rd, 2020.
6. Buchbinder, R, Tulder, M. V, Oberg, B, Costa, L. M, Woolf, A, Schoene, M et al 2018, `Low back pain: a call for action`, The Lancet, vol. 391, no. 10137, pp. 2384-2388.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30488-4/fulltext