Case Study Evaluation: Musculoskeletal Disorders

Analysis of Musculoskeletal Disorders (MSDs)

Pathophysiology

Varied body tissues have diverse capacities for withstanding pressure without getting injured or inflamed. Muscular and skeletal tissues become inflamed when there are mismatches between the body’s capacity for withstanding given loads and the pressure exerted on it by the loads. Ideally, when the tissues are relieved of the loads, they recover. When the pressures exerted by the loads are excessive and prolonged, the tissues become inflamed and painful and their activities may be impaired (Gatchel & Kishino, 2011). Over time, the inflamed muscular and skeletal tissues may become rather stiff and their movement limited. They may be typified by local swelling, numbness, and sensory loss.

Signs/Symptoms

Persons with MSDs may suffer, fatigue, numbness, sensory loss, local swelling, ischemic pain, movements, loss of limb mobility, body stiffness, muscle weakness, and tissue inflammation. They may suffer painful, as well as rather strong, muscle spasms or contractions. Others suffer muscle soreness (Hertling & Kessler, 2006).

Read also Pneumatic Impact Wrenches And Work-related Musculoskeletal Disorders (WMSDs)

Progression Trajectory

Inflammation is essentially a biological process via which tissues react to physical pressures, damage to given cells, pathogenic microbes, or harmful agents. Inflammation safeguards tissues, including muscular and skeletal tissues, from continued damage and helps repair them. If the inflammation goes on or becomes chronic, the tissues suffer varied pathological changes. In some cases, the inflammation of the muscular and skeletal tissues causes them to develop excessive fibrosis, or connective fibers, which disrupt the tissues’ functions. That limits the movement of the tendons or joints that have the fibers (Gatchel & Kishino, 2011).

Diagnostic Testing

Given that MSDs affect soft tissues, often there are no visible injury signs. Consequently, the commonest diagnostic test for MSD is based on individual self-reports on the pain they may be experiencing. The individuals fill up the NQ (Nordic Questionnaire), a popular MSD measure. The NQ has a diagram of a human body with diverse parts labeled (Marcus, 1998). Those filling it indicate the parts in which they suffer or whose typical functioning has been affected by the pain.

Treatment Options

MSDs are treated through the manual mobilization, or therapy, of affected skeletal parts, especially the ones that are misaligned. Those with MSDs are also treated using various medications, including NSAIDs (nonsteroidal anti-inflammatories), which reduce pain or inflammation, anesthetics or neurotransmitters (Hertling & Kessler, 2006). MSDs are as well treated through exercises, occupational therapy, acupuncture, biofeedback methods, osteopathic manipulation, therapeutic massage or chiropractic care.

Differences between Musculoskeletal Disorders and Normal Development

Unlike in those with MSDS, in those whose development is normal peripheral hyperalgesia causes localized pain inhibition shortly. Nerve fibers grow receptors rapidly. The receptors are encephalin-sensitive and helps make inflammation reaction less and less intense. Unlike those with MSDS, those whose development is normal have the muscle pains or soreness that they get disappearing in a few days. Those with normal development have normal blood supplies to their skeletal cells and muscle cells (Marcus, 1998). The cells undergo division normally and thus help replace damaged skeletal or muscular tissues. Unlike those with MSDS, those whose development is normal do not suffer atrophy and joints move freely (Gatchel & Kishino, 2011).

Demands Placed by Musculoskeletal Disorders on Family and Patient

Persons who have MSDs suffer limited physical mobility. Consequently, they have to take longer than usual in executing particular physical tasks like bathing, eating, and lifting given loads. At times, the persons are assisted by their families to execute the tasks. The patients along with the families are supposed to ensure that the former follow the prescribed treatment regimes. At times, that may involve driving the patients to healthcare facilities (Hertling & Kessler, 2006). The psychological demands placed by the patients along with own families by MSDs relate to doing work for which no one is compensated and lack of enough to attend to other essential tasks in addition to offering care to the patients. Other psychological demands relate to the patients’ low decision latitudes.

Key Concepts for Sharing With Family and Patient to Optimize Disorder Management

Various concepts should be shared with persons with MSDs, the patients, and their families to optimize MSD management plus the related outcomes. First, caregivers should share with the patients and the families the concept that the development of MSDs in persons suffering from given mental illnesses may exacerbate their disorders and their functioning may deteriorate further. Second, the caregivers should inform the patients and the families that the patients’ capacity for declining, as well as accepting, treatment may deteriorate over time. Third, the caregivers should inform the patients and the families that given the patients’ limited mobility, there may need assistance in going through the prescribed treatment regimens (Marcus, 1998).

Interdisciplinary Team Personnel

An interdisciplinary team is required in providing care to persons with MSDs (Marcus, 1998). Various professionals should be in the team to optimize MSD management along with the related outcomes. The team should comprise of a physiatrist, a nurse, an occupational therapist, a physiotherapist, a clinical nutritionist, a clinical pharmacist, a social work, and a language and speech pathologist. Each of the professionals would offer the care related to his or her specialty to the patients or their patients accordingly. The team would ensure the optimization of the management and the outcomes since the professionals would work together in managing the different facets of MSD concurrently (Gatchel & Kishino, 2011).

Facilitators and Barriers

There are various barriers that would hamper the team’s efforts towards the patients’ management. The barriers include time restrictions, the patients’ poor physical conditions, and socio-cultural impediments. The patients are burdened by time demands that are competing and that may leave them with limited time for engaging in prescribed exercises or taking the prescribed medications. The demands can be reduced by having family members undertake particular tasks on behalf of the patients to free up their time. The patients’ physical conditions may force them to keep away from prescribed exercises (Marcus, 1998). Notably, the patients can be afforded appropriate physical supports to help them carry out the exercises. Lastly, the patients may be dissuaded by given cultural or social realities from engaging in prescribed exercises or taking the prescribed medications. Such socio-cultural impediments may be resolved by counseling the patients suitably.

On the other hand, there are various facilitators that would help the team in its efforts towards the patients’ management. The facilitators would include the patients’ enhanced health states and behavioral, social, as well as emotional, supports. Others include access to environments where one can engage in the prescribed exercises, physical activity opportunities, and availability of exercising time.

Care Plan

Recognition and Planning for MSDs

Those giving care to persons with MSDs should work together in developing standards to guide how they recognize possible MSD cases and how they put together plans for caring for those diagnosed with MSDs (Hertling & Kessler, 2006). Ideally, the programs developed in relation to the recognition OF MSDs and planning for the relevant care should be implemented jointly as a campaign, or package. The persons who should be recommended for MSD diagnostic testing are those who report to be suffering sleep disturbances, fatigue, and pain.

Diagnostic Testing

Given that MSDs affect soft tissues, often there are no visible injury signs. Consequently, the commonest diagnostic test for MSD is based on individual self-reports on the pain they may be experiencing. The individuals fill up the NQ (Nordic Questionnaire), a popular MSD measure. The NQ has a diagram of a human body with diverse parts labeled. Those filling it indicate the parts in which they suffer or whose typical functioning has been affected by the pain (Marcus, 1998).

Treatment Options

MSDs are treated through the manual mobilization, or therapy, of affected skeletal parts, especially the ones that are misaligned. Those with MSDs are also treated using various medications, including NSAIDs (nonsteroidal anti-inflammatories), which reduce pain or inflammation, anesthetics or neurotransmitters. MSDs are as well treated through exercises, occupational therapy, acupuncture, biofeedback methods, osteopathic manipulation, therapeutic massage or chiropractic care.

Facilitators and Barriers

Facilitators

There are various facilitators that help the teams caring for patients with MSD in their efforts towards the patients’ management (Hertling & Kessler, 2006). The facilitators include the patients’ enhanced health states and behavioral, social, as well as emotional, supports. Others include access to environments where one can engage in the prescribed exercises, interdisciplinary care teams, physical activity opportunities, and availability of exercising time (Hadler, 2005).

Interdisciplinary teams are required in providing care to persons with MSDs.  Various professionals should be in the teams to optimize MSD management along with the related outcomes. Each of the teams should comprise of a physiatrist, a nurse, an occupational therapist, a physiotherapist, a clinical nutritionist, a clinical pharmacist, a social work, and a language and speech pathologist (Gatchel & Kishino, 2011).

Barriers

There are various barriers that hamper the patients’ management: time restrictions, the patients’ poor physical conditions, and socio-cultural impediments. The restrictions can be addressed by having family members undertake particular tasks on behalf of the patients to free up their time. The patients should be afforded appropriate physical supports to help them carry out the exercises (Marcus, 1998).

Patients with MSDs may be dissuaded by given cultural or social realities from engaging in prescribed exercises or taking the prescribed medications. The realities may dissuade patients from partaking in the exercises and adversely affect how they report the states of their bodies, possibly delaying the onset of the appropriate treatments. The patients’ responses to pain are largely shaped by their cultures. Some cultures teach persons to bear pains stoically, expressing them in a very limited ways where possible. Such socio-cultural impediments to the proper prompt and proper management of persons with Musculoskeletal Disorders may be resolved by counseling them properly.

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