The musculoskeletal system
The musculoskeletal system comprises 206 bones, over 600 muscles, and the joints, ligaments and tendons that connect them. Problems in this system can arise from trauma (fractures, sprains, tears), overuse (tendinopathies, bursitis, stress fractures), degeneration (osteoarthritis), inflammatory conditions (rheumatoid arthritis, ankylosing spondylitis), and systemic factors (osteoporosis, diabetes, neuropathy).
A thorough musculoskeletal evaluation identifies the specific structure causing symptoms, distinguishes mechanical from inflammatory or systemic causes, and assesses the impact on function. This informs a targeted treatment plan that addresses both the immediate problem and contributing factors.
- Joint pain and swelling — arthritis, effusion, instability
- Muscle pain and weakness — strains, overuse, myopathy
- Tendon pain — tendinopathy, tears, tenosynovitis
- Ligament injuries — sprains, instability
- Bone pain — fracture, stress injury, metabolic bone disease
- Nerve-related musculoskeletal pain — carpal tunnel, sciatica, entrapment
Related: Orthopedics → · Dr. Jitendra Knowledge Hub → · ICHD-3 Topic →
Approach to musculoskeletal care
The approach begins with a detailed history — onset, location, character, aggravating and relieving factors, prior treatments, and impact on daily life — followed by a focused physical examination. Investigations (X-rays, blood tests, MRI) are ordered when they would change management, not as a routine screen.
Treatment is individualized and may include activity modification, physiotherapy, medication, injections, bracing or surgery depending on the diagnosis and severity. The goal is always to restore function, reduce pain, and prevent recurrence. Dr. Gautam emphasizes patient education and self-management strategies alongside clinical interventions.
| Common presentation | Possible causes | First steps |
|---|---|---|
| Knee pain with stairs | Osteoarthritis, patellofemoral syndrome, meniscal tear | Examination, weight-bearing X-ray if indicated |
| Shoulder pain overhead | Rotator cuff tendinopathy, impingement, adhesive capsulitis | Examination, ultrasound or MRI if not improving |
| Low back pain | Mechanical (disc, facet), muscle strain, rarely serious pathology | History, red-flag screen, targeted examination |
| Heel pain morning | Plantar fasciitis, fat pad atrophy, stress fracture | Examination, X-ray if diagnosis unclear |