Chronic Musculoskeletal Pain

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Overview

• The majority of chronic pain experienced by older adults is musculoskeletal in origin

• The symptom experience and impact of this pain varies greatly

• Chronic musculoskeletal pain is often associated with reduced activity, sleep disturbance, fatigue and mood alterations, and can result in severe disability

• Regional pain in a single joint area is very common. It may be referred from above, or be due to periarticular lesions, as well as arthritis. A good history and careful examination should result in an accurate diagnosis

• There are two main forms of arthritis: osteoarthritis (OA) and inflammatory arthritis. Pain in OA does not correlate well with pathology, is largely ‘mechanical’ in nature, and is difficult to treat. The pain of inflammatory arthritis is associated with severe joint stiffness and responds well to anti-inflammatory therapy

• Generalised musculoskeletal pain in the absence of peripheral pathology (‘fibromyalgia’) is also common. There is evidence that this condition is due to pain sensitisation and loss of the normal inhibitory mechanisms that help reduce pain