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Musculoskeletal disorder (MSD)

What are Musculoskeletal Disorders?

a skeletal foot

Every day, you use your muscles, tendons, ligaments and joints to lift and carry objects, sit, stand, walk, move and work in a variety of ways. However, these tasks, or how you perform them, can sometimes require too much effort for your body, cause pain and result in a more serious injury called a musculoskeletal disorder (MSD).

Back pain, shoulder pain, lumbar sprain, tendonitis, bursitis, these are some of the MSDs that can progressively develop with constant overexertion. They may be related to work, daily life or age, and affect joints, muscles and tendons.

MSDs first manifest themselves as discomfort and pain and may worsen if they are not resolved and can affect your quality of life over the short and long term. There are several types of MSDs that can affect the upper and lower parts of your body. This section provides an overview of the most common types.

Musculoskeletal Disorder types

  • Bursitis

Inflammation of a synovial bursa, a kind of cushion that separates tendons or muscles from the bone surface and allows for smooth gliding.

  • Epicondylitis

Inflammation of the wrist extensor tendons where they attach to the elbow. Lower back pain Pain in the lower back.

  • Tendinitis

Inflammation of a tendon (an extension of a muscle that allows it to attach to the bone).

  • Carpal tunnel syndrome

Compression or pinching of a nerve in a channel formed by bones and a wrist ligament on the palm side of the hand. Compression causes numbness or pain in the thumb, index finger and middle finger.

  • Tenosynovitis

Tenosynovitis is the simultaneous inflammation of a tendon and the surrounding synovial sheath.

Regions of the body affected by Musculoskeletal disorders

Elbow pain

Neck

Neck pain, or cervicodynia, can have multiple origins. It can be a cervical sprain, torticollis (wry neck) or osteoarthritis, for example. Often, they are accompanied by stiffness that restricts neck movements.

Pain is sometimes felt throughout the upper body, especially in the upper back and shoulders. Symptoms vary depending on where vertebrae, tendons, ligaments, muscles or nerves are affected.

Shoulders

Tendinopathy of the rotator cuff is the MSD that most often affects the shoulder joint. It occurs when you overuse a tendon in your shoulder. When you repeat the same movements improperly, small injuries occur in the tendons that decrease their elasticity.

Wrist, Hand and Fingers

The wrist is part of the upper limbs affected by MSDs recognized as occupational diseases that arise from excessive, repetitive or brutal use. These kinds of trauma can result in: wrist tendonitis or Quervain's tenosynovitis, an inflammation of the wrist tendons, carpal tunnel syndrome, a problem caused by a compressed median nerve in the carpal tunnel, composed of the carpal bones, and manifests as tingling in the fingers and a loss of muscle strength, and Guyon’s canal syndrome, a compression of the cubital nerve in the wrist.

Elbow

Elbow pain can come from the joint itself, from the bones or tissues attached to the joint, such as tendons. The two most common injuries involving elbow tendons are tennis elbow and golfer’s elbow, but they do not affect just athletes:

  • Tennis elbow or lateral epicondylitis (epicondylitis): localized pain in the outer forearm, in the epicondyle area (small bone protrusion from the outer face of the humerus, near the elbow

  • Golfer’s elbow or medial epicondylitis (epicondylitis): pain in the inner forearm, in the medial epicondyle area (small bone protrusion on the internal side of the humerus

Knee

The knee is the largest joint in the body and plays an essential role in maintaining your mobility and stability. During certain movements (e.g. climbing stairs), your knees bear 4 to 5 times the weight of your body. They can therefore be easily damaged by different repetitive movements.

You can experience knee pain at any age, and in any situation, even if you are athletic and in excellent health. Some common symptoms include:

  • Acute pain while walking, standing for prolonged periods of time, climbing up or down stairs or when you are kneeling (functional pain)
  • Pain that wakes you up at night (inflammatory pain)
  • Pain or fatigue in the legs
  • Hip pain
  • Locking sensation
  • Poor balance

Types of Knee Disorders

Knee illustration

The knee is a complex joint between the tibia and the femur that includes many elements:

  • Cartilage (allows the femur and tibia to slide over each other)
  • Meniscus (crescent shaped, it absorbs shock and stabilizes the joint)
  • Capsule (fibrous shell covering the joint and lined with a membrane that produces synovial fluid)
  • Synovial bursa (membrane pockets filled with synovial fluid)
  • Lateral ligaments (stabilize the knee)
  • Muscles, bones and tendons

Knee MSDs encompass many problems:

  • Sprain: stretching of a ligament
  • Tendinopathy (or tendinitis) 
  • Lesions to the meniscus, two small crescent-shaped cartilages located between the tibia and the femur in each knee
  • Hygroma or bursitis of the knee – inflammation of “synovial bursa” (small pockets in the knee that facilitate the sliding of tendons)
  • Compression of the nerve that goes down the side of the calf (peroneal nerve)

Three Most Common Knee MSDs

The three most common musculoskeletal disorders of the knee are Femoral-Patellar Syndrome, Iliotibial Band Friction Syndrome and knee bursitis, caused by frequent and prolonged knee positions or direct trauma.

These three types of conditions are associated with overuse of the knee and manifest gradually. They are rarely the immediate result of accidental trauma or contact shock, which usually cause injuries to ligaments and the meniscus.

Femoral-Patellar Syndrome is characterized by irritation of the knee joint cartilage between the femur (thigh bone) and the patella. Iliotibial Band Friction Syndrome manifests over the long term as a result of repeated knee bends and extensions. Irritation and inflammation occur as a result of repeated rubbing between two structures in the knee, on the external part, i.e., the long fibrous band located on the external side of the thigh (iliotibial band) and a protrusion of the femur (thigh bone). Knee bursitis is an inflammation or thickening of a synovial bursa (small liquid-filled cushion that reduces rubbing between the bones, tendons and muscles inside the knee).

Low back pain is pain in the lower back, in the five lumbar vertebrae (L1–L5), in the pelvis, the sacrum or in the buttocks. Pain can even radiate to the buttocks and thighs. In Canada, four out of five adults will experience at least one form of back pain (pain and disability) during their lifetime.

Manifestations of Low Back Pain

Lumbar Sprain

The sprain is the result of a sudden stretch, rupture or micro-tear in the back muscles or ligaments. It occurs as a result of sudden, uncontrolled movement that results in abnormal joint movement (e.g., sprained ankle).

Disc Syndrome

The intervertebral disc, which gives the spine its flexibility, is sensitive to biomechanical disruptions. If the disc is constantly under abnormal pressure, the disc can begin to curve or fragment, resulting in significant pain. Neurological symptoms such as loss of strength or numbness can also occur.

Sacroiliac Joint Syndrome

Improver movement of the pelvic bones (sacroiliac) can create an overload for the lumbar spine resulting in tissue fatigue. Without any apparent reason, low back pain can therefore occur when the tissues are at their maximum adaptive capacity. This type of low back pain is aggravated by extreme or prolonged positions (sitting or standing).

Lumbar Facet Syndrome

The facet is a joint located just behind the intervertebral discs and surrounded by a capsule. When degeneration or inflammation occurs, both are the source of your pain. Pain generally increases at the end of the day due to excessive vertebral movements. Over the long term, low back pain can cause wear on the affected joints while increasing pain.

MSD Stages

Initially benign, MSD can progressively worsen, in stages: in stage 1, you experience pain and fatigue in the affected area which disappear in the evening; in stage 2, you feel pain and fatigue early in the morning which persist in the evening and, in stage 3, the pain, fatigue and weakness persist even during rest and disrupt your sleep.

Causes

MSDs often manifest themselves in the workplace, as they are the result of frequent and repeated movements that cause trauma to the muscular and skeletal structures. But they can also be linked to your daily activities at home or elsewhere.

Factors that could lead to MSDs include:

  • Repetitive movements, such as assembly line work
  • Over-exertion such as carrying loads that are too heavy
  • Work done under poor conditions (e.g., joints subjected to excessive tension, static work and work done for long periods)
  • Traumatic work (using a jackhammer)
  • Stress

If you are experiencing MSD pain which is affecting your health and quality of life, talk to your healthcare professional.

To learn more about MSDs:

Canadian Centre for Occupational Health and Safety

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