At GCSP we have experts to help evaluate and treat bone, joint, and muscle disorders. Rheumatologists receive 2-3 years of specialized training in the diagnosis and treatment of various disorders affecting these areas. The earlier you are diagnosed and treated, the earlier you can reduce your chance for pain and disability and live an active and healthy life.
Joint Pain is the sensation of discomfort, inflammation, soreness, achiness or stiffness in a joint in the body. Joints are the spaces or areas where two or more bones meet. Joint pain can be related to an injury or other problem within the joint itself or be a symptom of a wide variety of systemic diseases, disorders and conditions. Arthritis is a common cause of joint pain and can have many causes and forms.
The term tendonitis refers to pain involving a tendon which is the thick fibrous cord that attaches muscle to bone. Tendonitis can occur either directly by injury or repetitive overuse of the tendon itself or indirectly by a systemic inflammatory arthritic disease or medication side effect. Some common tendonitis conditions include tennis elbow, golfer’s elbow, and achilles tendonitis.
Bursitis refers to inflammation in the bursa, which are fluid-filled sacs that cushion and reduce friction between bones and surrounding soft tissues such as tendons and ligaments. Common locations of bursitis include the shoulder, hip and knee. Causes of bursitis may result from excessive movement, malalignment, injury, pressure, infection, or inflammatory arthritis conditions such as gout or rheumatoid arthritis leading to the main symptom of bursitis which is pain.
Muscle pain can is a common complaint and can have many causes. It can occur as a primary muscle pain syndrome such as Fibromyalgia or be caused by an overuse, injury, or strain of a muscle. In some cases, however, muscle pain may secondary to another problem such as an infection, a systemic autoimmune rheumatic disease such as Polymyalgia Rheumatica or a medication side effect such as from certain cholesterol drugs.
Peripheral neuropathy may present with varied symptoms typically numbness and tingling, however, patients may also experience burning sensations or weakness. The term peripheral refers to involvement of the nerves outside of the brain and spinal cord. There are over 100 types of peripheral neuropathies, most which are caused by disease or even damage to a nerve or series of nerves. More than 50 medical conditions, drugs, and toxins are known to cause nerve damage, but many people have unexplained (idiopathic) nerve pain. One of the most common medical conditions that is known to cause nerve damage and painful peripheral neuropathy is diabetes. Several autoimmune rheumatic conditions can also cause neuropathy which can improve with treatment of the underlying arthritis.
Fibromyalgia is a common and often chronic disorder characterized by a generalized, aching pain in the muscles. Patients with fibromyalgia may have other accompanying symptoms including fatigue, irritable bowel symptoms, difficulty sleeping, headaches, depression, and difficulties with concentration, memory and the ability to focus (aka the “fibro fog”).
By some estimates, fibromyalgia affects over 5 millions people in the US aged 18 or older with the majority of those being women. Although the cause of fibromyalgia is not known, multiple factors can be involved including a history of a very stressful or traumatic event. Chronic pain can also lead to individuals developing fibromyalgia symptoms based in part on how the central nervous system processes pain. In some cases of uncontrolled inflammatory arthritic conditions such as Rheumatoid Arthritis or Lupus, proper treatment of the underlying arthritis can alleviate or reduce the symptoms of fibromyalgia.
Although fibromyalgia can be difficult to treat, it often requires a team approach with various health professionals that understand it. Proper sleep and exercise are important to help with recovery. There are several FDA approved medications that can be used to help treat the symptoms of fibromyalgia, but many times other medications may be used. Many patients may find benefit with alternative and complementary therapies such as chiropractic treatments, acupuncture, yoga, tai chi, and massage.
Carpal Tunnel Syndrome
Carpal tunnel syndrome is caused by pressure on the median nerve that travels through the structures of the wrist. Symptoms of carpal tunnel include numbness and tingling in the fingers. If the condition progresses, weakness of the hand may occur. A number of factors can contribute to carpal tunnel syndrome including repetitive use injury, thyroid disease, inflammatory arthritic conditions such as Rheumatoid Arthritis, and even pregnancy.
Plantar fasciitis is a painful condition involving the plantar fascia (a strong band of tissue that supports the arch in the foot). The area where the plantar fascia, which is a ligament, inserts into the heal is the most common site for pain. Symptoms are often worse when first attempting to walk after rest. Repetitive activities such as participation in sports can place strain on the plantar fascia and induce tiny tears that lead to inflammation and pain. Treatment involves rest, ice, stretching, arch support and sometimes bracing. Anti-inflammatory medications such as NSAIDs (ie ibuprofen) and injections may help as well.
Vitamin D Deficiency
Vitamin D, also known as the “sunshine vitamin” is produced by the skin in response to sunlight; however it also occurs naturally in some foods such as fish, egg yolks, and fortified products. Vitamin D helps the body absorb calcium, maintain strong bones, and is important for overall good health.
The activated form of Vitamin D in the body functions as a hormone and is involved in many different processes in addition to bone health including keeping a healthy immune system and muscle function. Research into fully understanding all the benefits of Vitamin D is ongoing.
Vitamin D deficiency can lead to soft and brittle bones, a condition called rickets in children and osteomalacia in adults. It also plays an important role in osteoporosis. Low Vitamin D has also been associated with other conditions such as cancer, diabetes, high blood pressure, depression, fibromyalgia, autoimmune diseases, and increased lupus activity. Increasing vitamin D to optimal levels has been suggested to supply a protective effect against some of these conditions.
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