Musculoskeletal (MSK) clinics - Managing muscle, bone and joint pain
What are musculoskeletal (MSK) problems?
MSK clinics help people who experience muscle, bone or joint pain and cover a large range of conditions caused by illness, injury or age. Musculoskeletal refers to areas of the body that include muscles, bones, joints and connecting tissues (ligaments and tendons that connect muscles to each other and to bones). Conditions that are managed by musculoskeletal services may include arthritis (inflammation of the joints), osteoporosis (weakening of the bones normally seen with increasing age), sprains, strains, dislocations and other issues that may be caused by overuse of muscles and joints such as lower back pain due to manual lifting. People of all ages can be affected but conditions are more commonly associated with an increase in age.
What to look out for
As conditions are so wide-ranging you can experience a spectrum of different symptoms which may include general aching and stiffness in the joints or burning sensations in the muscles. Your muscles may feel tired (referred to as muscle fatigue) or you may notice muscle twitches and pain that gets worse when you move - MSK conditions often feel better with rest.
What you should do if you experience pain
Many people experiencing pain can be slow to seek help due to issues not appearing to be life-threatening or urgent. However, swift access to treatment can help to manage situations and prevent them from getting worse; helping to avoid taking time off work or having periods of time with reduced mobility. Problems account for approximately 30% of GP appointments - with lower back and neck pain amongst the highest causes of years lost to disability in the UK. If you experience pain, your first port of call is your GP who will assess you and may refer you to the relevant musculoskeletal services for further tests and treatment. MSK pain can often be worse at night, interfering with sleep so if you find you need to visit a healthcare expert at this time you can find details of the East Berkshire Out Of Hours clinics at https://ebpcooh.org.uk/
What happens in a musculoskeletal assessment
When you visit your GP or healthcare professional, they will ask questions about your lifestyle and medical history to identify any potential causes that may have an impact on your MSK system. This may be linked to your job or lifestyle if you perform lots of tasks that involve lifting items or standing for long periods of time. Your health professional will also palpate (assess by touch) the affected part for swelling, tenderness and heat. They will look at the muscle texture and see if there are any tense muscles or trigger points. Your nerves and tendons (tissues that attach muscle to bone), will also be tested for sensation, strength and response.
Once you have been assessed your healthcare professional may refer you for blood tests, X-rays or scans such as MRI or CT scans to have a more in-depth look at what may be causing the pain. Depending on the cause of pain you may be referred to occupational therapy (to assess ways you live and work), physiotherapy, acupuncture or steroid injections to manage pain and inflammation along with pain relief.
You can often take steps to manage your own condition at home and may be recommended to apply hot and cold compresses to ease swelling, pain and inflammation, particularly if the condition has been caused by an injury. Advice may include taking over-the-counter pain relief such as paracetamol or ibuprofen which also helps reduce inflammation. You may be provided with a series of exercises to perform to improve flexibility with regular stretching or to strengthen muscles. Some MSK pain can also be improved with stress-relieving techniques such as yoga and meditation.
Prevention: better than cure
Looking after yourself well with regular exercise including warming up and cooling down, supported with good nutrition can help maintain strong bones and joints and help prevent MSK pain. Also make sure you have good posture, particularly when sitting or standing for long periods of time and practice correct lifting techniques if needing to lift a heavy load - avoid bending the back but make sure it stays straight and you use the legs if the lift cannot be avoided. Limit repetitive movement and stretch muscles out regularly. It’s also wise to avoid smoking if you experience joint or muscle pain as this can cause inflammation.
Pain can often improve with the correct treatment so it is important you seek help from your GP or MSK clinic to ensure conditions can be managed. For further information or to book an appointment please visit the Chapel Medical Centre in Slough at https://www.chapelmedicalcentreslough.nhs.uk/appointments
The Menopause – making it a positive time of life
Hot flushes…night sweats….weight fluctuation…These are the more well known symptoms associated with the menopause. Did you know there are more than 30 different symptoms that affect women as they experience this phase of their lives? Some of these are well known but others are less talked about. Many women may not know that issues they experience are related to the menopause or “the change” as it has come to be commonly known.
Fall in hormone levels
Changes in the female body are caused by ovaries producing less of the female sex hormones oestrogen and progesterone. These hormones are involved in bodily processes that control appetite, sex drive, mood, bone strength and even heart health. The fall in oestrogen leads to monthly periods becoming irregular and eggs no longer being produced every month. Many women experience mood swings, headaches, decreased libido, hot sweats and disturbed sleep. Joint pain, digestive problems, gum problems, itchy skin, dizzy spells, allergies, anxiety and depression are less well known symptoms. The list goes on and many women may not know that they are experiencing symptoms related to the menopause, or how to live well throughout this phase of life.
The three phases
Menopause is a natural part of ageing that begins most frequently in the late 40s and early 50s but can start around the age of 40. The time of onset is largely down to genetics but lifestyle can also influence the timing. A healthy lifestyle with lots of regular exercise, a nutritious diet and lack of smoking can delay the onset by one to three years. There are three phases;
- perimenopause when the body begins the transition and periods become irregular,
- menopause which is indicated by 12 months without a period,
- postmenopause which is two to three years after the menopause when symptoms begin to subside.
These timings are only guidelines and for some the whole transition can take up to eight years. Bear in mind that after one year of no periods, bleeding is not normal so make sure you tell your GP if this occurs.
Many women may approach this stage of their lives with trepidation. Not knowing what to expect, how it will affect them, or what they can do about it. Mentally, it can be a huge barrier to overcome as menstruation becomes a thing of the past and reproductive years cease to exist. The menopause is different for each individual. However, good nutrition, regular exercise and a generally healthy lifestyle have been known to lessen the symptoms experienced.
A good starting point is to kick any old unhealthy habits such as smoking, drinking too much alcohol and caffeine. These lifestyle changes, along with eating lots of fruit, vegetables, wholegrains, fish, dairy products and taking regular exercise can help to manage symptoms and boost health.
Mood swings, low mood and anxiety can be helped by good self care including plenty of rest, yoga, meditation or tai chi. Regular exercise such as daily walks in the fresh air can help to support positive mental health. Other treatments are also available where symptoms have an impact on quality of life. Cognitive behavioural therapy or CBT – a talking therapy that can improve low mood and feelings of anxiety. Speak to your GP who is able to refer to CBT or recommend other medication if required.
The menopause is often associated with hot flushes and night sweats. Wearing light clothing, keeping the bedroom cool and taking a cool shower can help to ease these symptoms. Again taking regular exercise and avoiding triggers such as caffeine, spicy food, smoking and excessive alcohol.
Many women try herbal or natural remedies to alleviate symptoms. Your GP will be able to advise if you are considering taking these.
Hormone Replacement Therapy – HRT
The main treatment prescribed by GPs to manage symptoms of the menopause is Hormone Replacement Therapy, or HRT. In order to protect the lining of the womb progesterone is given and replaces oestrogen that is missing. HRT helps to reduce symptoms such as hot flushes, mood swings and joint pains. It can also help to prevent thinning of the bones (osteoporosis) which is common after the menopause.
However HRT isn’t for everyone. It can’t be taken if women have experienced certain types of cancer, blood clots, liver disease or strokes. Risk factors need to be discussed with a doctor or nurse before going ahead with HRT.
Menopause is a phase that all women will experience. It can be supported positively with good self-care and a healthy lifestyle. Any symptoms that impact on quality of life should be discussed with your GP.
For more information on the menopause, its symptoms and treatment visit: https://www.nhs.uk/conditions/menopause/
COVID-19 Walk in Vaccination Service
The NHS COVID-19 Vaccination centre at Salt Hill is now running a walk in service for anyone over the age of 18 living in the Slough area.
No appointment is necessary, simply turn up Monday to Friday between 5pm and 8pm.
Pfizer and Astrazeneca vaccine are available.
Salt Hill Activity Centre