- \n
- \n
- \n
- Reason<\/strong><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n
The causes of musculoskeletal pain are diverse, can be acute or chronic, can be local or widespread. Caused by trauma such as sudden movements, car accidents, falls, fracture<\/a> sprains<\/a>, dislocation and direct impacts on the muscles, etc. can also cause musculoskeletal pain. Other causes include pain from constant tension, repetitive movements, overuse and motionless<\/a> lengthen. In extreme cases, changes in posture or physical inactivity can cause spinal problems and shorten muscles, causing other muscles to strain and cause pain. Pain from overstretching affects 33% adults, common in low back pain.<\/p>\n
Musculoskeletal pain also depends on many factors of the patient such as: age, gender, body shape, activity level and lifestyle.<\/p>\n
- \n
- Diagnosis and symptoms <\/strong><\/li>\n<\/ul>\n
Diagnose<\/a> Motor system pain should be based on:<\/p>\n
- \n
- Origin of pain: local or penetrating pain, reflex pain (Zakharin Head) or psychological<\/li>\n
- Pain may be present in one or more different locations \u2013 Factors that reduce or increase pain: changes in posture, movement \u2013 Other symptoms (eg, rash, fever, dry eyes, etc.) ).<\/li>\n<\/ul>\n
Symptoms depend on pain caused by trauma or abuse, whether acute or chronic. These symptoms can also vary from person to person.<\/p>\n
Symptoms often vary in patients, but are usually:<\/p>\n
- \n
- Local or extensive pain that changes with movement<\/li>\n
- Feeling of muscle being overstretched<\/li>\n
- Pain or stiffness in the whole body<\/li>\n
- Tired<\/li>\n
- Sleep disorders<\/li>\n
- Muscle twitching<\/li>\n
- The feeling of "burning, burning".<\/li>\n<\/ul>\n
- \n
- Classification of types of motor pain<\/strong><\/li>\n<\/ul>\n
Bone pain:<\/strong> Often felt as deep, sharp, dull pain, often the result of trauma, it is important to ensure that the pain is not related to a fracture or tumor. Other causes include infectious bone pain (myelitis<\/a> bone), endocrine disorders.<\/p>\n
Synovial bag:<\/strong> th\u01b0\u1eddng \u0111au t\u0103ng khi v\u1eadn \u0111\u1ed9ng t\u00fai ho\u1ea1t d\u1ecbch v\u00e0 gi\u1ea3m khi ngh\u1ec9, t\u00fai ho\u1ea1t d\u1ecbch b\u1ecb \u1ea3nh h\u01b0\u1edfng c\u00f3 th\u1ec3 s\u01b0ng l\u00ean, g\u00e2y ra b\u1edfi ch\u1ea5n th\u01b0\u01a1ng, l\u1ea1m d\u1ee5ng, b\u1ec7nh gout<\/a> hay nhi\u1ec5m tr\u00f9ng.<\/p>\n
Muscle pain:<\/strong> Less intense than bone pain but can be very uncomfortable, the pain may include muscle spasms or cramps (eg, a spasm of the calf muscle that causes severe pain commonly referred to as a Charley horse). Myalgia can be caused by trauma, autoimmune reactions, decreased muscle perfusion, infections, or tumors.<\/p>\n
Tendon and ligament pain:<\/strong> \u0111au \u00edt h\u01a1n \u0111au x\u01b0\u01a1ng, \u0111au t\u0103ng khi c\u00e1c khu v\u1ef1c b\u1ecb \u1ea3nh h\u01b0\u1edfng b\u1ecb k\u00e9o c\u0103ng hay di chuy\u1ec3n v\u00e0 lu\u00f4n gi\u1ea3m khi ngh\u1ec9. Nguy\u00ean nh\u00e2n ph\u1ed5 bi\u1ebfn c\u1ee7a \u0111au g\u00e2n l\u00e0 vi\u00eam g\u00e2n<\/a>, vi\u00eam bao g\u00e2n<\/a>, vi\u00eam l\u1ed3i c\u1ea7u ngo\u00e0i hay trong, t\u1ed5n th\u01b0\u01a1ng. Nguy\u00ean nh\u00e2n ph\u1ed5 bi\u1ebfn c\u1ee7a \u0111au d\u00e2y ch\u1eb1ng l\u00e0 ch\u1ea5n th\u01b0\u01a1ng (bong g\u00e2n).<\/p>\n
Athritis:<\/strong> Joint injuries and diseases always cause stiffness, pain, arthritis<\/a>. The pain ranges from mild to severe, increases with joint movement, joints may swell. Pain may be acute (eg, infection, trauma, or gout) or chronic (eg, when caused by rheumatoid arthritis or inflammation of the bone<\/a> joint). Arthritis is a common cause of pain, and arthritis pain is present even at rest. Disorders that can cause arthritis include rheumatoid arthritis, osteoarthritis, septic arthritis, gout and related disorders, autoimmune, and inflammatory vasculitis (such as systemic lupus erythematosus and systemic lupus erythematosus and vasculitis). Sch\u00f6nlein-Henoch allergic vasculitis), caseation<\/a> bone, an injury that affects a part of the bone inside a joint.<\/p>\n
Tunnel syndrome: <\/strong>This disorder causes pain from nerve compression, pain that radiates to the nerve and may feel like a burning sensation, often accompanied by tingling, numbness, or both. Includes: syndrome carpal tunnel<\/a>, cylindrosis syndrome and tarsal tunnel syndrome.<\/p>\n
3. SOME FREQUENT POSITIONS OF PAIN<\/strong><\/h3>\n
3.1. Hip pain<\/strong><\/p>\n
Inside hip joint<\/a> There is always a minimal amount of fluid that allows the femoral head to rotate within the acetabulum. Any disease or injury that causes inflammation causes this space to fill with fluid or blood, straining the joint capsule and leading to pain.<\/p>\n
The femoral head and acetabulum are lined with articular cartilage, allowing the bones to move within the joint with little friction. The acetabulum margin is covered with marginal cartilage, which can be torn or torn, causing pain.<\/p>\n
There are thick bands of tissue that surround the hip joint, forming a tight capsule. This helps stabilize the hip joint, especially during movement.<\/p>\n
The movement of the hip is due to the surrounding muscles and their tendons attaching across the hip joint. The muscles also help maintain joint stability.<\/p>\n
The large fluid-filled sacs that surround the hip joint allow the tendons to slide more easily over the bony ridges. These structures can become inflamed.<\/p>\n
Symptoms: Depending on the cause and condition causing the pain, the patient will experience discomfort in:<\/p>\n
- \n
- Femoral<\/li>\n
- In the hip joint<\/li>\n
- Inguinal, outside the hip \u2013 Buttock area.<\/li>\n<\/ul>\n
Pain increases with activity (especially in the presence of arthritis) and decreases range of motion. Some patients limp if the pain is persistent.<\/p>\n
\u00a0\u0110\u00f4i khi \u0111au t\u1eeb c\u00e1c khu v\u1ef1c kh\u00e1c c\u00f3 th\u1ec3 lan xu\u1ed1ng h\u00f4ng: vi\u00eam d\u00e2y th\u1ea7n kinh t\u1ecda (\u0111\u1eb7c bi\u1ec7t n\u1ebfu r\u1ec5 L1, L2 c\u00f3 li\u00ean quan), c\u00e1c vi\u00eam d\u00e2y th\u1ea7n kinh c\u00f3 th\u1ec3 bi\u1ec3u hi\u1ec7n nh\u01b0 \u0111au h\u00f4ng, th\u1ea7n kinh b\u00ec \u0111\u00f9i ngo\u00e0i (th\u01b0\u1eddng vi\u00eam trong th\u1eddi k\u1ef3 mang thai, m\u1eb7c qu\u1ea7n \u00e1o ch\u1eadt ho\u1eb7c \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng<\/a>).<\/p>\n
Pain from an inguinal or thigh hernia can also cause pain to be felt in the hip.<\/p>\n
![\"Picture3\"](\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/05\/Picture3-1-239x300.jpg\" "\\"\\"")
Figure 3.1.<\/strong> Hip joint. Source: Frank H. Netter's Atlas of Human Anatomy<\/em><\/figcaption><\/figure> ![\"Picture5\"](\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/05\/Picture5-231x300.jpg\" "\\"\\"")
Figure 3.2.<\/strong> Hip joints. Source: Frank H. Netter's Atlas of Human Anatomy<\/em><\/figcaption><\/figure><\/p>\n 3.2.1. Reason<\/h4>\n
Arthritis:<\/strong> Inflammation in the body can affect the hip joint. Synovitis, or stromal inflammation, causes fluid to leak into the joint, resulting in painful swelling. Osteoarthritis<\/a> It is a common cause of hip pain in people over the age of 50. Other diseases: arthritis<\/a> rheumatoid arthritis, ankylosing spondylitis, arthritis associated with inflammatory bowel disease (Crohn's disease or ulcerative colitis). Common symptoms: pain in the groin or front of the thigh, the patient may feel groggy, stiff, or reduced mobility, usually pain immediately and does not get better with activity. Pain develops after a period of inactivity and eases when "warmed up" with use. But as activity increases, the pain returns.<\/p>\n
Injury:<\/strong> Usually the cause of hip pain, felt immediately, is more common in the elderly, has osteoporosis causing fractures of the upper femur, acetabulum, pelvic branch or hip dislocation. Cases of contusions (bruises), sprains, strains that can be the result of trauma but not fractures can be very painful, requiring further laboratory tests for diagnosis such as: X-ray<\/a>, CT scan, MRI.<\/p>\n
Tendonitis:<\/strong> Iliotibial band syndrome (ITBS) is common in sports activities, walking, biking, climbing, etc. pain is located on the outside of the pelvis. knee joint<\/a>, to varying degrees. Pain is relieved at rest, while walking, when performing sports that require a change in the level of running. A steady, continuous, prolonged walk causes pain on the outside of the knee, sometimes causing the patient to stop.<\/p>\n
- \n
- Piriformis syndrome: a neuromuscular disorder caused by the pear-shaped muscle compressing the sciatic nerve (sitting or running long distances, kicking), the pear-shaped muscle helps to fix the hip joint, lift and rotate the thigh. allow walking, lifting in body weight from foot to foot, maintaining balance. Symptoms usually begin with pain, tingling, or numbness in the buttocks, pain that may radiate down the sciatic nerve, pain when walking up stairs or leaning, increased with prolonged sitting, and decreased range of motion in the hip.<\/li>\n<\/ul>\n
![\"Picture6\"](\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/05\/Picture6-300x172.png\" "\\"\\"")
Figure 3.3.<\/strong> Pear muscle syndrome<\/figcaption><\/figure>\n <\/p>\n
- \n
- FAIR test (hip flexion, adduction, internal rotation): the patient was lying on the painless side, the leg was painful at 60\u00b0 hip flexion, knee flexion, hip adduction, and internal rotation. The examiner applies pressure to the knee in a downward direction, thereby straining the pear muscle and increasing pressure on the sciatic nerve.<\/li>\n<\/ul>\n
![\"Picture7\"](\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/05\/Picture7-300x204.png\" "\\"\\"")
Figure 3.4.<\/strong> FAIR test in pterygium syndrome<\/figcaption><\/figure>\n - \n
- Gluteus medius syndrome: Pain and inflammation in the outer part of the groin caused by a tendon tear (tension) of the gluteus medius muscle. The gluteus medius muscle plays a role in helping to shape the thigh and stabilize the groin when walking, running, and jumping. Consists of two groups: group 1 stretches but does not stretch tendons; group 2: tension and elongation of tendon or partial tear, causing reduced function. Common symptoms: pain, often limping, when walking and running, soft pressure on the outside of the groin. Pain, stiffness, swelling, heat, redness on the outside of the thigh, worse when moving the groin, often with groin weakness, and increasing or weak pain when flexing the thigh.<\/li>\n
- Iliopsoas tendinitis and Iliopsoas syndrome: tendinitis caused by repetitive flexion of the groin or overuse of the groin, iliopsoas syndrome caused by sudden contraction of the muscle, resulting in muscle tearing, Common in athletes who run, jump, and sports that require kicking or lifting weights. Common symptoms: pain in the groin, thighs when walking or running, with back pain; Flexion of the hip joint is weak and painful, reducing the force, in some cases can be stiff. Examine this case for the patient to lie down, bend the knee 10 - 20o<\/sup>, raising the leg is antagonistic, pain occurs with lumbosacral fasciitis.<\/li>\n<\/ul>\n
Injury to joint capsule, cartilage, border cartilage: <\/strong>Often due to overuse, pain begins minutes or hours after the injury, then causes muscle spasms and the joint surface becomes inflamed, causing fluid accumulation. Pain is usually anterior to the groin, but may be outside the groin or buttocks area, and may lead to a limp.<\/p>\n
Synovitis:<\/strong> The bursae around the trochanter are often inflamed from trauma or overuse.<\/p>\n
Other causes: <\/strong><\/p>\n
- \n
- Due to inguinal or thigh hernia?<\/li>\n
- Gynecological or back: when the lining of the uterus grows or pain due to damage from the nerve roots<\/li>\n<\/ul>\n
- \n
- Sickle cell disease: a joint may swell during an active episode with or without an underlying infection. The hip is not the only joint affected<\/li>\n
- Viral or bacterial infections: Lyme disease, Reiter's syndrome and food poisoning infections<\/li>\n
- Avascular necrosis of the femoral head: may occur in long-term corticosteroid users. The femoral head loses its blood supply, causing gradual necrosis and pain<\/li>\n
- Legg-Perthes-calf disease (or Perthes disease) describes avascular necrosis of the femoral head in children and is idiopathic, meaning the etiology is unknown. It usually affects men between the ages of 4 and 8<\/li>\n
- Fibromyalgia: systemic pain syndrome associated with pain and stiffness.<\/li>\n
- Bone cancer.<\/li>\n<\/ul>\n
3.2.2. Conclude<\/h4>\n
Hip pain is a non-specific complaint that requires a healthcare professional to find the underlying cause of potential injury or illness. Approaching the diagnosis of hip pain requires an open mind, because the source of the injury or the cause of the disease is unclear. 3.3. Knee pain<\/strong><\/p>\n
3.3.1. Anatomy<\/h4>\n
The main function of the knee joint is flexion, extension and movement, partly twisting and turning. The structure includes:<\/p>\n
- \n
- Bones: femoral condyle, tibial plateau, patella, fibula cap<\/li>\n
- Ligaments: there are 4 ligaments in the knee joint including cruciate ligament<\/a> anterior (ACL), ligament rear cross<\/a> (PCL), lateral ligament<\/a> medial (MCL), external ligament (LCL)<\/li>\n
- The patellar muscle and tendon are two important structures<\/li>\n
- articular cartilage and meniscus<\/a>: create space and cushion for the knee joint<\/li>\n
- Synovial sacs: there are four important groups of synovial sacs: below the quadriceps tendon, below the patella, below the patellar tendon, and the gooseberry muscle (inside and below the knee joint 3 cm).<\/li>\n<\/ul>\n
![\"Picture8\"](\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/05\/Picture8-237x300.png\" "\\"\\"")
Figure 3.5. <\/strong>Knee ligaments. Source: Frank H. Netter's Atlas of Human Anatomy<\/em><\/figcaption><\/figure>\n <\/p>\n
3.3.2. Reason<\/h4>\n
Fracture: <\/strong>Often due to high impact injuries, severe pain is felt and the patient is unable to put pressure on the knee. X-ray is a simple and highly effective measure.<\/p>\n
Ligament damage: <\/strong><\/p>\n
- FAIR test (hip flexion, adduction, internal rotation): the patient was lying on the painless side, the leg was painful at 60\u00b0 hip flexion, knee flexion, hip adduction, and internal rotation. The examiner applies pressure to the knee in a downward direction, thereby straining the pear muscle and increasing pressure on the sciatic nerve.<\/li>\n<\/ul>\n
- Piriformis syndrome: a neuromuscular disorder caused by the pear-shaped muscle compressing the sciatic nerve (sitting or running long distances, kicking), the pear-shaped muscle helps to fix the hip joint, lift and rotate the thigh. allow walking, lifting in body weight from foot to foot, maintaining balance. Symptoms usually begin with pain, tingling, or numbness in the buttocks, pain that may radiate down the sciatic nerve, pain when walking up stairs or leaning, increased with prolonged sitting, and decreased range of motion in the hip.<\/li>\n<\/ul>\n
- Classification of types of motor pain<\/strong><\/li>\n<\/ul>\n
- Diagnosis and symptoms <\/strong><\/li>\n<\/ul>\n
- Reason<\/strong><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n
![\"Picture9\"](\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/05\/Picture9-231x300.png\" "\\"\\"")