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Musculoskeletal Disorders - Disease Topic Overview

Pain, discomfort and loss of function in the back, neck and extremities are common among working people. These ailments are commonly termed musculoskeletal disorders (MSDs).¹

MSDs include a wide range of inflammatory and degenerative conditions affecting the muscles, tendons, ligaments, joints, peripheral nerves, and supporting blood vessels.² These include clinical syndromes such as tendon inflammations and related conditions (tenosynovitis, epicondylitis, bursitis), nerve compression disorders (carpal tunnel syndrome, sciatica), and osteoarthrosis, as well as less well standardised conditions such as myalgia, lower back pain and other regional pain syndromes not attributable to known pathology.² Body regions most commonly involved are; the lower back, neck, shoulder, forearm, and hand, although recently the lower extremity has received more attention.²

Musculoskeletal disorders (MSDs) are the most common work-related health problem in Europe, affecting millions of workers.1 According to a European survey carried out across 31 countries in 2005; up to 25% of them reported back pain and 23% muscular pain in arms and legs. The proportion of workers exposed to repetitive movements has increased since 2000, reaching 62.3% in 2005.¹

Despite a significant decrease of MSDs in some Member States, these disorders remain the leading work-related diseases in Europe.¹ They are therefore now a priority for the prevention of occupational hazards.¹ However, the multifactorial origin (biomechanical, organisational and psychosocial) of MSDs makes it is difficult to implement effective prevention measures in enterprises.¹

1. European Agency for Safety and Health at Work. Work-related musculoskeletal disorders: prevention report. Luxembourg: Office for Official Publications of the European Communities. 2008 : 106 pages.
2. Laura Punnett L. et al. Work-related musculoskeletal disorders: the epidemiologic evidence and the debate. Journal of Electromyography and Kinesiology. February 2004 ; 14 (1) : 13-23.

Arthritis
Arthritis is a complex disorder that comprises more than 100 distinct musculoskeletal conditions and can affect people at any stage of life. Arthritis causes joint pain, loss of movement, and inflammation.

Common forms of arthritis include osteoarthritis (OA) and rheumatoid arthritis. Both OA and RA are chronic and incurable but respond well to intervention.Osteoarthritis is the most common type of arthritis.

The prevalence increases with age, and most people over 60 years will have some radiological evidence of it. Osteoarthritis is the result of active, sometimes inflammatory but potentially reparative processes rather than the inevitable result of trauma and ageing.Rheumatoid arthritis is a chronic symmetrical polyarthritis of unexplained cause.

It is a systematic disorder characterized by chronic inflammatory synovitis of mainly peripheral joints. Its course is extremely variable and it is associated with nonarticular features.

To diagnose arthritis, there are a number of guidelines which outline the classification criteria, as well as tools to assess the patients pain.

There are a variety of treatment options available to help manage the pain and inflammation of osteo and rheumatoid arthritis, both pharmacological and non-pharmacological. It is important to balance the potential benefit against the potential side-effects.

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Arthritis is a complex disorder that comprises more than 100 distinct musculoskeletal conditions and can affect people at any stage of life. Arthritis causes joint pain, loss of movement, and inflammation. Common forms of arthritis include osteoarthritis (OA) and rheumatoid arthritis. Both OA and RA are chronic and incurable but respond well to intervention.

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Osteoarthritis Perspectives
The EULAR (European League Against Rheumatism) 2011 satellite symposium was held in London in May 2011. The symposium entitled Clinical Choices in Osteoarthritis Pain Management – Evidence Versus Practice: An Interactive Case-Based Assessment discussed the treatment regimens available for the treatment of OA.

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Osteoarthritis (OA) is a debilitating rheumatological disease that causes significant morbidity; it affects 45% of women over 65 and is a major cause of disability¹. OA is characterised by the degeneration of articular cartilage in synovial joints causing bone hypertrophy. Although this is a disease with no cure, many treatments for OA symptoms are available. Many people with OA have co-morbidities which affect which treatments are appropriate.

A satellite symposium symposium entitled Clinical Choices in Osteoarthritis Pain Management – Evidence Versus Practice: An Interactive Case-Based Assessment which was held at the EULAR Congress 2011 in London, UK, discussed the the treatment regimens available for the treatment of OA.

This interactive webcast contains three multimedia presentations delivered by Michael Doherty MA MD FRCP FHEA, Marc C. Hochberg MD MPH and Francis Berenbaum MD PhD.The first presentation, presented by Michael Doherty, explains how evidence-based guidelines provide the tools for effective, individualised treatment for patients with OA. Marc C. Hochberg discusses the importance of identifying patients with gastrointestinal risk (GI) factors and specific treatments available for these people. Francis Berenbaum completes the webcast with a presentation on treatment of patients with both cardiovascular and GI risk factors.

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References

1. Chasm R.M. et al. Pediatric Orthopedic Emergencies. Emergency Medical Clinics of North America. November 2010 ; 28 (4) : 907-926

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Soft Tissue Sarcoma
Soft Tissue Sarcomas (STS) are malignant (cancerous) tumors that develop in tissues which connect, support, or surround other structures and organs of the body. Muscles, tendons (bands of fiber that connect muscles to bones), fibrous tissues, fat, blood vessels, nerves, and synovial tissues are types of soft tissue.

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Soft Tissue Sarcomas (STS) are malignant (cancerous) tumors that develop in tissues which connect, support, or surround other structures and organs of the body. Muscles, tendons (bands of fiber that connect muscles to bones), fibrous tissues, fat, blood vessels, nerves, and synovial tissues are types of soft tissue.

Soft tissue sarcomas are grouped together because they share certain microscopic characteristics, have similar symptoms, and are generally treated in similar ways¹. They are usually named for the type of tissue in which they begin.

Every year approximately 13,000 new cases of soft tissue sarcomas are diagnosed in adults and children in Europe. The 5-year survival rate for patients with soft tissue sarcoma is around 90% if the cancer is detected in early phases and before it has spread. However, the 5-year survival rate is 10% to 15% for sarcomas with metastasis.

Management of STS depends on the stage of disease and histological subtype². Surgery is the mainstay of treatment for patients with localised disease and is often curative. However, as recurrence is likely to occur when tumour cells remain after surgery, adjuvant radiotherapy is often also considered, especially for patients with intermediate or high-grade tumours. Radiotherapy is also often administered for patients in whom surgery is inappropriate or who decline surgery.²

There are a number of Associations and Organisations across Europe who strive to inform others of this disease as well as offer help and support to those affected or to those who know and want to help those suffering.

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References

1. Cormier JN, Pollock RE. Soft tissue sarcomas. CA: A Cancer Journal for Clinicians 2004; 54(2):94–109.
2. Clark MA, Fisher C et al. (2005) “Soft-tissue sarcomas in adults.” N Engl JMed 353(7): 701–11.

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Latest Multi Media

What Causes Osteoarthritis? An Informative Animation

Musculoskeletal Disorders Drug Data - A-Z English

Drug Updates

Diclomax Retard

For rheumatoid arthritis; osteoarthritis; low back pain; acute musculo-skeletal disorders and trauma such as periarthritis (especially frozen shoulder), tendinitis, tenosynovitis, bursitis, sprains, strains and dislocations; relief of pain in fractures; ankylosing spondylitis; acute gout; control of pain and inflammation in orthopaedic, dental and other minor surgery.

Difflam Cream

Difflam Cream/ Difflam-P Cream is a topical analgesic and non-steroidal anti-inflammatory agent.

Voltarol Tablets

Adults and Elderly: Relief of all grades of pain and inflammation in a wide range of conditions, including: (i) arthritic conditions: rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, acute gout, (ii) acute musculo-skeletal disorders such as periarthritis (for example frozen shoulder), tendinitis, tenosynovitis, bursitis, (iii) other painful conditions resulting from trauma, including fracture, low back pain, sprains, strains, dislocations, orthopaedic, dental and other minor surgery.

Latest Social Media

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Latest Clinical Trials

VIDEO: Vitamin D evaluation in osteoarthritis

Does vitamin D help people with knee osteoarthritis?

Conjoint Analysis of Treatment Preferences for Osteoarthritis

The purpose of this study is to develop a conjoint analysis-based questionnaire and decision aid for patients with osteoarthritis of the knee and to compare the responses of two groups of subjects, one receiving only printed information about knee osteoarthritis, the other participating in a computer-based adaptive conjoint analysis program.

Latest Journal Publications

Pain

The role of psychosocial factors in the development of upper limb musculoskeletal disorders has now been clearly demonstrated. However, only a few studies have analysed the association between the organisational work environment and musculoskeletal disorders in health care workers. The main goal of this study was to test the hypothesis that some specific organisational constraints may be related to upper limb musculoskeletal symptoms experienced by registered nurses, independently of the effort/reward imbalance model and major confounding factors. In 2006, 2194 female registered nurses in 7 French teaching hospitals, recruited from the baseline screening of an epidemiological cohort study (the ORSOSA study), responded to valid self-report questionnaires (ERI [effort–reward imbalance], Nordic-style questionnaire). The organisational work environment was assessed by the self-rated Nursing Work Index—Extended Organisation scale. Multilevel models were used for analyses. We found that 2 organisational health care constraints: low level of shared values about work between members in the unit and lack of support from the administration were significantly associated with upper limb symptoms, independently of ERI perceptions. This study identified and quantified specific health care organisational factors that have an impact on nurses’ upper limb symptoms, sometimes independently of ERI perception. A prospective study is needed to clarify the causal role of psychosocial and organisational work factors in upper limb injury in nurses. Organisational approaches may be more effective in improving health at work and may also have a longer-lasting impact than individual approaches.

Clinical Rhematology

Diseases of blood and lymphoreticular system can have multisystem manifestations. Rheumatologic involvement has been reported in association with many benign and malignant haematological disorders; these patients are equally likely to present to both clinical rheumatologists and haematologists. This review focuses on the well-described rheumatologic features, other occasionally reported rheumatologic manifestations and unusual musculoskeletal complications related to the treatment in patients with underlying haematological conditions. The aim of this review is to help increase the awareness of rheumatologic manifestations seen in the blood disorders and to highlight the potential diagnostic pitfalls.

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23^rd February 2012

NX 1207 (Recordati/Nymox) starts Phase III trial for BPH Men's Health, Andrology and Urology Page

Recordati and Nymox Pharmaceutical Corporation announced the start of activities aimed to the preparation of a European Phase III clinical trial for NX-1207, following the successful completion of a Scientific Advice meeting with the European Medicines Agency. NX-1207, is a Phase III investigational drug from Nymox and is currently in clinical development in the United States for the treatment of Benign Prostatic Hyperplasia (BPH). The pivotal controlled clinical trial will assess the efficacy and safety of a single TRUS-guided intraprostatic injection of NX-1207 in patients with lower urinary tract symptoms (LUTS) associated with BPH not adequately controlled by medical therapy.The drug is injected by a urologist in an office setting directly into the zone of the prostate where the enlargement occurs and involves little or no pain or discomfort. NX-1207 has successfully completed a series of blinded controlled multi-center U.S. clinical trials where a single dose of NX-1207 has been found to improve the signs and symptoms of BPH, with improvements about double those reported for currently approved BPH drugs, and without the side effects associated with those drugs, which can include sexual problems and blood pressure changes. Follow-up studies have shown evidence of long lasting benefit with a significant proportion of men reporting maintained improvement in BPH symptoms without other treatments for up to 7½ years.

Zelboraf (Daiichi Sankyo/Roche) is EU approved for BRAFV600 mutation Metastatic Melanoma Page

Plexxikon Inc., a member of Daiichi Sankyo Group,has announced that the European Commission has approved Zelboraf (vemurafenib) for the monotherapy treatment of adult patients with BRAFV600 mutation-positive unresectable or Metastatic Melanoma. The cobas 4800 BRAF V600 Mutation Test, a companion diagnostic used to identify patients with the BRAF mutation, is CE marked and commercially available in Europe. Zelboraf is designed to selectively inhibit the BRAF mutation that occurs in about half of all cases of melanoma. Zelboraf and its companion diagnostic have already been approved in the United States, Switzerland, Israel, Brazil, New Zealand and Canada. In the United States, Zelboraf is being co-promoted by Daiichi Sankyo, Inc. and Genentech, a member of the Roche Group. Roche promotes Zelboraf outside of the United States.

CHMP recommends Pixuvri (CTI Life Sciences) for Non Hodgkin's B-cell Lymphoma Oncology Page

The CHMP has given a conditional recommendation for the approval of Pixuvri (pixantrone dimaleate) from CTI Life Sciences for relapsed or refractory aggressive non-Hodgkin’s B-cell Lymphoma. The drug application at the FDA was withdrawn as additional information was requested. The drug is now scheduled to be considered at the FDA Advisory Comitteee meeting in April 2012.