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Musculoskeletal disorders (MSDs) are medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. A community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home. Musculoskeletal pain was reported by 57% of those interviewed. A major restriction of joint movement range was frequent in the shoulder but uncommon in other joints(1).
Types of Musculo-Skeletal disorders in elder(2)
1. Osteoarthritis
2. Gout
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
6. Osteoporosis
7. Low back pain
8. Fibromyalgia
Osteoarthritis
Osteoarthritis (OA), a form of arthritis, is defined as a condition of as a result of aging causes of wear and tear on a joint, affecting over 25 million people in the United States in alone. University of Porto Medical School indicated that one must understand the differences in prevalence and incidence estimates of osteoarthritis (OA), according to case definition, in knee, hip and hand joints(3).
The characteristics of osteoarthritis are aching pain(5), stiffness(6), or difficulty of moving the joint or joints(7). The pain usually gets worse in change of weather, at night and in the advanced diseases, the pain can occur even at rest(8). Today management of osteoarthritis (OA) focuses on pain relief and improved physical function through pharmacological, non pharmacological, and surgical treatments(4).
The Causes and Risk Factors
A. Causes
1. Process of wear and repair
Osteoarthritis (OA), a widespread degenerative disease of skeletal joints(34) and is often associated with senescence in vertebrates. arising from long term wear and tear, heavy long-term use or specific injuries(35). Improper repair process of injure of joints can also result of symptoms of Osteoarthritis (OA)(36) in old age(37), according to TCM.
2. Nutrient deficiency and overload
Poor nutritional conditions experienced early in life are linked to greater prevalence of osteoarthritis (OA)(35)(38), such as vitamin D. On the other hand, nutrient overload and metabolic surplus, such as obesity may contribute to early onset of osteoarthritis (OA)(38).
3. Cartilage
Cartilage is a flexible connective tissue cushioned the ends of bones in your joints and allowed the joints to move smoothly. Rough or wears down cartilage due to aging or damage can causes pain due to bone in the joint rubbing against another bone(39)(40).
The above causes of Osteoarthritis (OA) may also be the result of injure(35), overuse(15)(16), Rheumatoid Arthritis(41), etc.
4. Etc.
B. Risk factors
Aging changes in the musculoskeletal system contribute to the development of OA by making the joint more susceptible to the effects of other OA risk factors(39)(40)
1. Abnormal biomechanicsThe biomechanics of the foot and ankle is important to the normal function of the lower extremity(42). Abnormal biomechanics can cause abnormal stress and eventual breakdown of connective tissue and muscle(42) of that can lead to early onset of Osteoarthritis (OA)(43).
2. Joint injury and obesity
According to the University of Calgary, joint injury and obesity were associated with an increased risk of OA of the knee and hip(44). Dr. Rogers LQ and the research team at the Southern Illinois University School of Medicine indicated that the high and low joint stress from physical activity (PA)
ate associated to reduce risk of the disease(45). In obesity, according to Duke University Medical Center, it is one of the most significant, and potentially most preventable, risk factors for the development of osteoarthritis due to a strong association between body mass index and osteoarthritis of the hip, knee, foot and hand(46)(47).
3. Age-related sarcopenia(48)(49) and increased bone turnover(49) have found to be associated to the development of OA(49). Other suggested that Osteoarthritis development in the injured joints is caused by pathways of joint-related mechanisms and deconditioning of the musculoskeletal system(50). As well as intra-articular pathogenic processes initiated at the time of injury(51).
4. Normal Aging
Normal aging in humans is associated with declines in skeletal muscle mass and strength and increased muscle fatigability (sarcopenia)(52).
5. Muscle strength
Reduced muscle strength due to ageing, injure or other conditions is regarded as a risk factor for pain and disability in osteoarthritis (OA)(53)(54).
6. Gender
Women are susceptible to the greater risk for the development of osteoarthritis (OA), but research in sex and gender differences in osteoarthritis to date, may not be appreciated by the orthopedic community, according to Mayo Clinic(56)(57)
7. Genetic
Asian are at higher risk to develop osteoarthritis, according to research of Praxisklinik für Unfallchirurgie und Orthopädie(57)(58), due to genetic polymorphisms associated with osteoarthritis and related end-points(58).
8. Deformation of bone
People who were born with defective joints or cartilage are at increased risk of developing osteoarthritis(59)(60).
9. Physical activity
People who involve in activity such as sport are at higher risk to develop osteoarthritis, if injure(61).
10. Occupations
Certain occupations are associated to the increased risk of osteoarthritis, especially to workers involving repetitive movements that stress on a particular joint(61)(62).
11. Deficiency in DNA repair
Progeroid human DNA repair syndrome trichothiodystrophy may be associated to the to the development of osteoarthritis(63).
12. Other diseases and conditions may have a higher risk of developing the condition.
a. Gout
Gout is a type of arthritis as a result of uric acid builds up in blood causes of joint inflammation(64). According to a total of 4249 completed questionnaires returned (32%) from 359 attendees, 164 cases of gout were clinically confirmed, there is highly significant association existed between the site of acute attacks of gout and the presence of OA(65).
b. Rheumatoid arthritis
Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disease, causing the attack of flexible (synovial) joints, inflammation of the surrounding tissues and many tissues and organs. Patients with heumatoid arthritis (RA) are associated to increase risk of OA due to progression of aging(66).
c. Paget’s disease of the bone
Paget’s disease of bone is a condition a chronic disorder of excessive and abnormal bone remodeling result in excessive breakdown and formation of bone tissue causing pain, misshapen bones, fractures, and arthritis in the joints near the affected bones(67) with prevalence trends of doubling each decade from the age of 50 onwards, causing bone pain, depending on skeletal sites involved and range from secondary osteoarthritis to malignant degeneration(68).
d. Septic arthritis
Septic arthritis is a condition of inflammation of a joint as a result of bacterial or fungal infection causes of osteoarthritis(69).
9. Etc.
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References
(1) Prevalence of rheumatic symptoms, rheumatoid arthritis, ankylosing spondylitis, and gout in Shanghai, China: a COPCORD study by Dai SM1, Han XH, Zhao DB, Shi YQ, Liu Y, Meng JM.(PubMed)
(2) Musculoskeletal Disorders in the Elderly by Ramon Gheno, Juan M. Cepparo, Cristina E. Rosca,1 and Anne Cotten(PMC)
(3) The effect of osteoarthritis definition on prevalence and incidence estimates: a systematic review by Pereira D1, Peleteiro B, Araújo J, Branco J, Santos RA, Ramos E.(PubMed)
(4) Effect of therapeutic aquatic exercise on symptoms and function associated with lower limb osteoarthritis: systematic review with meta-analysis by Waller B1, Ogonowska-Slodownik A2, Vitor M3, Lambeck J4, Daly D5, Kujala UM6, Heinonen A7.(PubMed)
(5) Effects of therapeutic ultrasound on pain, physical functions and safety outcomes in patients with kneeosteoarthritis: A systematic review and meta-analysis by Zhang C1, Xie Y2, Luo X3, Ji Q3, Lu C3, He C4, Wang P3.(PubMed)
(6) Oral intake of purple passion fruit peel extract reduces pain and stiffness and improves physical function in adult patients with knee osteoarthritis by Farid R1, Rezaieyazdi Z, Mirfeizi Z, Hatef MR, Mirheidari M, Mansouri H, Esmaelli H, Bentley G, Lu Y, Foo Y, Watson RR.(PubMed)
(7) Functional ability, mobility, and pain before and after knee replacement in patients aged 75 and older: a cross-sectional study by Limnell K1, Jämsen E, Huhtala H, Jäntti P, Puolakka T, Jylhä M.(PubMed)
(34) Targets, models and challenges in osteoarthritis research by Thysen S1, Luyten FP2, Lories RJ3.(PubMed)
(35) Ecology of arthritis. by Peterson RO1, Vucetich JA, Fenton G, Drummer TD, Larsen CS.(PubMed)
(36) Handout on Health: Osteoarthritis(NIH)
(37) Age-related changes in the musculoskeletal system and the development of osteoarthritis. by Loeser RF1.(PubMed)
(38) Metabolic triggered inflammation in osteoarthritis by Wang X1, Hunter D2, Xu J3, Ding C4.(PubMed)
(39) [Osteoarthritis. Etiology, typing, staging and histological grading].[Article in German] by Söder S1, Aigner T.(PubMed)
(40) [Typing, grading and staging of osteoarthritis: histopathological assessment of joint degeneration].[Article in German] by Aigner T1, Söder S.(PubMed)
(41) Association of rheumatoid arthritis and primary osteoarthritis with changes in the glycosylation pattern of total serum IgG by Parekh RB, Dwek RA, Sutton BJ, Fernandes DL, Leung A, Stanworth D, Rademacher TW, Mizuochi T, Taniguchi T, Matsuta K, et al.(PubMed)
(42) Abnormal biomechanics of the foot and ankle by Donatelli RA.(PubMed)
(43) Lateral compartment osteoarthritis of the knee: Biomechanics and surgical management of end-stage disease by Scott CE1, Nutton RW, Biant LC.(PubMed)
(44) Are joint injury, sport activity, physical activity, obesity, or occupational activities predictors for osteoarthritis? A systematic review by Richmond SA1, Fukuchi RK, Ezzat A, Schneider K, Schneider G, Emery CA.(PubMed)
(45) The association between joint stress from physical activity and self-reported osteoarthritis: an analysis of the Cooper Clinic data by Rogers LQ1, Macera CA, Hootman JM, Ainsworth BE, Blairi SN.(PubMed)
(46) Why is obesity associated with osteoarthritis? Insights from mouse models of obesity by Griffin TM1, Guilak F.(PubMed)
(47) Diet-induced obesity differentially regulates behavioral, biomechanical, and molecular risk factors forosteoarthritis in mice by Griffin TM1, Fermor B, Huebner JL, Kraus VB, Rodriguiz RM, Wetsel WC, Cao L, Setton LA, Guilak F.(PubMed)
(48) Sarcopenia: a histological and immunohistochemical study on age-related muscle impairment. by Tarantino U1, Scimeca M2,3, Piccirilli E4, Tancredi V5, Baldi J4, Gasbarra E4, Bonanno E6.(PubMed)
(49) Age-related changes in the musculoskeletal system and the development of osteoarthritis by Loeser RF1.(PubMed)
(50) Joint injury causes knee osteoarthritis in young adults by Roos EM1.(PubMed)
(51) The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. by Lohmander LS1, Englund PM, Dahl LL, Roos EM.(PubMed)
(52) Age-Related Sarcopenia in Humans Is Associated with Reduced Synthetic Rates of Specific Muscle Proteins1,2 by D. N. Proctor, P. Balagopal*, and K. S. Nair*,3(The Journal of Nutrition)
(53) Muscle strength, pain and disability in patients with osteoarthritis by Steultjens MP1, Dekker J, van Baar ME, Oostendorp RA, Bijlsma JW.(PubMed)
(54) Effects of muscle-strength training on the functional status of patients with osteoarthritis of the knee joint by Schilke JM1, Johnson GO, Housh TJ, O'Dell JR.(PubMed)
(55) How do sex and gender affect knee OA? By Jennie McKee(AAOS)
(56) Osteoarthritis of the hip and knee: sex and gender differences by O'Connor MI1.(PubMed)
(57) [The prevalence of radiological osteoarthritis in relation to age, gender, birth-year cohort, and ethnic origins].[Article in German] by Spahn G1, Schiele R, Hofmann GO, Schiltenwolf M, Grifka J, Vaitl T, Schneider S, Liebers F, Klinger HM.(PubMed)
(58) The genetic epidemiology of osteoarthritis by Valdes AM1, Spector TD.(PubMed)
(59) Clinical significance of bone changes in osteoarthritis, Monitoring Editor: Gerolamo BianchiTuhina Neog(PMC)
(60) Mechanobiology: Cartilage and Chondrocyte edited by J. F. Stoltz
(61) Are joint injury, sport activity, physical activity, obesity, or occupational activities predictors for osteoarthritis? A systematic review. by Richmond SA1, Fukuchi RK, Ezzat A, Schneider K, Schneider G, Emery CA.(PubMed)
(62) Primary osteoarthritis and occupations: a national cross sectional survey of 10 412 symptomatic patients by Rossignol M1, Leclerc A, Hilliquin P, Allaert FA, Rozenberg S, Valat JP, Avouac B, Coste P, Savarieau B, Fautrel B.(PubMed)
(63) Analysis of osteoarthritis in a mouse model of the progeroid human DNA repair syndrome trichothiodystrophy by Botter SM1, Zar M, van Osch GJ, van Steeg H, Dollé ME, Hoeijmakers JH, Weinans H, van Leeuwen JP.(PubMed)
(64) Questions and Answers about Gout(NIH)
(65) Are joints affected by gout also affected by osteoarthritis? by Roddy E1, Zhang W, Doherty M.(PubMed)
(66) Patient compliance in rheumatoid arthritis, polymyalgia rheumatica, and gout by de Klerk E1, van der Heijde D, Landewé R, van der Tempel H, Urquhart J, van der Linden S.(PubMed)
(67) Paget's disease of bone(Wikipedia)
(68) Paget's disease of bone: a review by Colina M1, La Corte R, De Leonardis F, Trotta F.(PubMed)
(69) Septic arthritis complicating hip osteoarthritis by Donell S1, Williamson DM, Scott DL.(PubMed)
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