Musculoskeletal Disorders I

Ch. 39, 40

What are common causes of back pain?

Muscle strain, ligament strain, poor posture, injury, degenerative changes, and conditions affecting the spine

What are common manifestations of back pain?

Localized pain, stiffness, muscle spasms, limited movement, and possible pain that radiates into the legs

What symptoms with back pain require immediate evaluation?

New bowel or bladder dysfunction, saddle anesthesia, significant leg weakness, or severe neurological changes

What is an important nursing assessment for a patient with back pain?

Assess pain location, severity, onset, movement, neurological status, muscle strength, sensation, and mobility

What are common interventions for uncomplicated back pain?

Pain management, activity modification, proper body mechanics, appropriate exercise, and physical therapy

What should patients be taught about preventing back injuries?

Use proper body mechanics, maintain good posture, avoid excessive lifting, use appropriate lifting techniques, and maintain physical conditioning

What is bursitis?

Inflammation of a bursa, a fluid-filled sac that reduces friction around joints

What commonly causes bursitis?

Repetitive motion, prolonged pressure, overuse, trauma, or inflammation

What are common symptoms of bursitis?

Localized pain, tenderness, swelling, and decreased movement around the affected joint

What joints are commonly affected by bursitis?

Shoulder, elbow, hip, and knee

What is a major intervention for acute bursitis?

Rest the affected area and avoid activities that aggravate the condition

What other treatments may be used for bursitis?

Ice, NSAIDs, physical therapy, and corticosteroid injection when indicated

What is tendonitis?

Inflammation or irritation of a tendon

What commonly causes tendonitis?

Repetitive movement, overuse, injury, or excessive stress on a tendon

What are common symptoms of tendonitis?

Pain, tenderness, swelling, and pain that worsens with movement of the affected tendon

What is an important intervention for tendonitis?

Rest and avoidance of activities that aggravate the tendon

What other treatments may be used for tendonitis?

Ice, NSAIDs, physical therapy, stretching, and gradual strengthening

What is the rotator cuff?

A group of muscles and tendons that stabilize the shoulder and help with shoulder movement

What can cause a rotator cuff injury?

Overuse, repetitive overhead activity, trauma, or degenerative changes associated with aging

What are common manifestations of a rotator cuff injury?

Shoulder pain, weakness, decreased range of motion, and difficulty lifting the arm

What may cause rotator cuff pain to worsen?

Raising the arm or performing overhead activities

What is an important nursing intervention for a rotator cuff injury?

Manage pain, protect the shoulder, and follow prescribed physical therapy and range-of-motion exercises

What should the patient be taught about recovering from a rotator cuff injury?

Follow the prescribed rehabilitation program and avoid activities that place excessive stress on the shoulder

What is carpal tunnel syndrome?

Compression of the median nerve as it passes through the carpal tunnel of the wrist

What commonly causes or contributes to carpal tunnel syndrome?

Repetitive hand/wrist movements, wrist injury, inflammation, pregnancy, and certain medical conditions

What fingers are commonly affected by carpal tunnel syndrome?

The thumb, index finger, middle finger, and thumb-side of the ring finger

What are common symptoms of carpal tunnel syndrome?

Numbness, tingling, burning, pain, and weakness in the hand/fingers

When are carpal tunnel symptoms often worse?

At night or during activities involving repetitive wrist movements

What is a common conservative treatment for carpal tunnel syndrome?

A wrist splint, particularly at night, to keep the wrist in a neutral position

What other treatments may be used for carpal tunnel syndrome?

Activity modification, NSAIDs, corticosteroid injections, physical/occupational therapy, and surgery for severe or persistent cases

What is the purpose of a wrist splint for carpel tunnel syndrome?

To maintain the wrist in a neutral position and reduce pressure on the median nerve

What is a possible complication of untreated severe carpal tunnel syndrome?

Persistent nerve damage, weakness, and muscle atrophy of the hand

What is Dupuytren’s contracture?

Thickening and shortening of connective tissue in the palm that causes the fingers to become progressively flexed

Which fingers are commonly affected by Dupuytren’s contracture?

The ring and little fingers are commonly affected

What is a characteristic finding of Dupuytren’s contracture?

Thickened tissue or nodules in the palm with progressive inability to fully straighten affected fingers

What is an important functional problem caused by Dupuytren’s contracture?

Difficulty using the hand for grasping and performing daily activities

What treatments may be used fro Dupuytren’s contracture?

Stretching/therapy, injections, needle procedures, or surgery depending on severity

What is plantar fasciitis?

Inflammation/irritation of the plantar fascia on the bottom of the foot

What is the classic symptom of plantar fasciitis?

Heel pain that is often worst with the first steps after getting out of bed or after rest

What can contribute to plantar fasciitis?

Overuse, prolonged standing, improper footwear, obesity, and repetitive stress on the foot

What are common interventions for plantar fasciitis?

Rest, stretching, supportive footwear, orthotics, ice, and pain medications as prescribed

What should a patient with plantar fasciitis be taught about footwear?

Wear supportive shoes with appropriate arch and heel support and avoid unsupportive footwear

What is hallux valgus?

A deformity in which the great toe deviates toward the other toes, producing a prominence at the base of the great toe

What is a common name for hallux valgus?

A bunion

What can contribute to bunions?

Genetic factors, abnormal foot mechanics, and poorly fitting or narrow footwear

What are common symptoms of a bunion?

Pain, swelling, redness, tenderness, and difficulty wearing shoes

What should be taught to a patient with a bunion?

What properly fitting shoes with a wide toe box and avoid tight or narrow shoes

What conservative treatments may help with bunions?

Proper footwear, padding, orthotics, activity modification, and pain management

When may surgery be considered for a bunion?

When pain and functional problems persist despite conservative treatment

What medications are commonly used or musculoskeletal pain and inflammation?

NSAIDs, acetaminophen, and sometimes corticosteroids depending on the condition

What is an important adverse effect of NSAIDs?

Gastrointestinal irritation/bleeding and kidney injury

What should patients taking NSAIDs be taught to report?

Black/tarry stools, vomiting blood, severe stomach pain, or signs of kidney problems

What is an important safety concern with acetaminophen?

Excessive doses can cause liver toxicity

What should patients taking acetaminophen be taught?

Do not exceed the recommended dose and check combination medications to avoid taking multiple products containing acetaminophen