Musculoskeletal Medicine

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What is Musculoskeletal Medicine?

Musculoskeletal Medicine (MSK medicine) is the diagnosis and treatment of problems arising from the musculoskeletal system. This includes injuries and diseases affecting the muscles, bones and joints of the limbs and spine. Approximately 30% of all GP consultations relate to problems with the musculoskeletal system 1.

Specialist MSK Medicine is carried out by physicians with special training rather than by surgeons. Doctors trained in Sport & Exercise Medicine (SEM) are uniquely equipped to manage these conditions. In addition to training in MSK Medicine, they have training in Exercise Medicine which often has an important role in treating these conditions 2. MSK physicians manage over 80% of their patients without the need for referral to surgeons 3. In addition to their clinical skills these doctors often use diagnostic ultrasound in the clinic and are trained in the use of injections and other non-surgical techniques in their treatment. Many SEM doctors work with sports teams and the techniques of diagnosis and treatment can be transferred to benefit the general population.

Who sees Musculoskeletal Medicine doctors?

Anyone with a problem affecting the musculoskeletal system, whatever the cause of the problem or their age. MSK doctors do not just see patients with sports injuries. The patients with sports and exercise related injuries range from professional elite athletes to those taking occasional recreational exercise. MSK doctors see people with a huge range of problems, including work related injuries or symptoms such as work related upper limb disorder and other problems related to office or manual work. Musculoskeletal disorders are by far the most prevalent cause of work-related illness in the UK affecting twice as many people as stress. They result in 9.5 million lost working days, and currently cost society £7.4 billion a year.4

The NHS

An SEM trained doctor is the ideal person to lead a multidisciplinary team (MDT) providing Musculoskeletal medicine services within the NHS. There are already numerous examples where this has been effective and cost efficient in managing MSK conditions and improving access to a range of treatments, either within a hospital trust, or in the community 5. The FSEM (UK) is working hard with the NHS and other medical specialties to show the benefits of using an appropriately trained MSK physician as part of a team to treat and manage many common MSK conditions.

Increasing numbers of musculoskeletal problems presenting to the NHS can be effectively managed by having more Sport and Exercise Medicine consultants and MSK specialists working with NHS multidisciplinary teams.

References:

1 Combined direct and indirect costs of physical inactivity CMO Report 2005

2 ARUK report on the use of exercise in managing MSK conditions 2017

3 Sport & Exercise Medicine A Fresh Approach in Practice – NHS Information Document 2014 main trends and clinical outcomes.

4 The Work Foundation Report – Fit for Work?  MSK Disorders and Labour Market Participation http://www.fitforworkeurope.eu/website-documents/44_fit_for_work_small.pdf

5 Sport & Exercise Medicine A Fresh Approach in Practice – NHS Information Document examples of MSK Models of Care Primary and Secondary. Tay Vision 10 Years of Primary Care MSK Services Presentation by Dr Niall Elliot FFSEM.

Links

Arthritis and Musculoskeletal Alliance (ARMA)

Royal College of GPs Musculoskeletal and Rheumatology Clinical Resources

FSEM (UK) Higher Specialty Training Curriculum