Musculoskeletal (MSK) conditions are among the most common causes of pain and disability, and their prevalence continues to rise. This increase is driven by an ageing population, sedentary lifestyles, poor ergonomic environments, and long hours in physically or mentally demanding jobs. For general practitioners, effectively managing these complex presentations is critical to improving patient outcomes and preventing chronic disability.
MSK conditions do not only affect joints and muscles, but can often involve surrounding structures such as nerves, blood vessels, and connective tissues. As a result, they can significantly impair mobility, limit both basic and instrumental activities of daily living, and negatively impact mental health and quality of life.
Common MSK disorders encountered in general practice include:
While some conditions have an acute onset, such as trauma, others like arthritis or chronic back pain tend to be progressive or recurrent. Early intervention is crucial, because what begins as a minor strain can evolve into a complex, chronic pain disorder if left unmanaged.
General practitioners play a central role in both early detection and ongoing management.
Thorough clinical assessment to distinguish between specific and non-specific MSK pain.
Referral for imaging or specialist input when red flags or structural pathology are suspected.
Coordinating multidisciplinary care, including physiotherapy, occupational therapy, psychology, and pain specialists.
Supporting self-management, such as education on pacing, exercise, posture, weight management, and medication adherence.
Pharmacological management may involve analgesics, anti-inflammatories, and, in some cases, neuropathic pain agents. Where pain is persistent and disabling, interventional treatments or surgical referral may be indicated.
Many complex MSK issues are work-related or aggravated by occupational stressors. GPs can assist patients by identifying workplace contributors and advising on strategies for risk reduction.
Ergonomic and workplace modifications can include:
Improving environmental conditions (e.g. temperature control, lighting, noise).
Encourage patients to:
Patients should be referred for specialist or allied health input if they report significant or worsening pain, experience functional decline or workplace impairment, have red flag symptoms (e.g. neurological deficits, systemic signs, trauma), or show minimal improvement with first-line interventions.
Collaborative care models are ideal for managing chronic MSK pain, with a focus on improving function and self-efficacy rather than complete resolution of symptoms.
MSK conditions are common and complex, often requiring more than a biomedical approach. GPs are ideally positioned to coordinate holistic, multidisciplinary care that addresses physical, psychological, and occupational contributors to pain and dysfunction. Early intervention, proactive workplace advice, and patient education can dramatically improve outcomes and reduce the risk of chronic disability.
- Dr Humda, Physiotherapist
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