Common Musculoskeletal Problems

Subject: Geriatric Nursing (Theory)

Overview

Common Musculoskeletal Problems

Osteoarthritis

Degeneration of the joint cartilage and underlying bone causes osteoarthritis, which is sometimes referred to as degenerative arthritis, degenerative joint disease, or osteoarthrosis.

Symptoms

  • Stiffness and joint discomfort.
  • Joint swelling that is bumpy.
  • The sound of a joint creaking or grinding.
  • Decreased joint performance

Management

  • Changes to one's lifestyle (exercise, food for weight loss/maintenance).
  • Physical actions (moderate exercise).
  • Analgesics.
  • Surgery (joint arthroplasty) (joint arthroplasty).

Self-management

  • Encourage safe pharmaceutical use.
  • Help the patient deal with the emotional effects of their new social and economic situations.
  • Encourage the patient's attempts to take part in treatment decisions and continue with regular activities.

Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune illness in which our immune system, which normally defends against germs and viruses and other external substances, mistakenly targets our joints.

Management

  • Only relieve symptoms; no cure.
  • Remission, a state of absence from or extremely low inflammation, is the intended outcome of treatment.
  • Regular checkups and blood tests that show how well a treatment is working should be used to track the level of disease activity or inflammation.

Osteoporosis

A gradual bone disease called osteoporosis is characterized by a loss of bone mass and density, which can raise the risk of fracture. Bone microarchitecture deteriorates, bone mineral density (BMD) is decreased, and the quantity and variety of proteins in bone are changed in osteoporosis.

Management

  • Altering one's way of life (cessation of smoking, moderate smoking intake),
  • Nutrition ( vitamin D with calcium and vitamin K to lower the incidence of stones and MI) ( vitamin D with calcium and vitamin K to reduce the risk of stones and MI),
  • Medications (alendronate, etidronate, risedronate and strontium ranelate) (alendronate, etidronate, risedronate and strontium ranelate),

Gout

Gout is a chronic inflammatory arthritis that typically causes recurrent outbreaks of red, painful, hot, and swollen joints. The biggest toe's metatarsal-phalangeal joint is most frequently impacted. Elevated uric acid levels in the blood are the cause of it.

Self-management

  • Use prescription drugs as directed.
  • Use a cane or other comparable assistance to maintain weight off the possible while a joint is hot and swollen.
  • Maintaining elevation of the inflamed joint may be beneficial.
  • Ice packs can be useful for pain relief. also decreasing inflammation
  • Keeping well-hydrated is essential for reducing attack frequency and severity.

Polymyalgia Rheumatic

In older adults, polymyalgia rheumatica is a typical cause of all-over aching and stiffness.

Management

  • Steroids as medicine.
  • Immunosuppressive drugs like methotrexate are occasionally prescribed to patients.
  • Follow-up.

Degenerative Disk Disease

Degenerative disc disease or degenerative disc disorder refers to the degeneration of one or more intervertebral discs in the spine. Although most people do not have any issues with this aging condition, for certain people an untreated deteriorated disc can lead to significant persistent pain.

General Management

  • Pain relief, preventing or reducing stress on the discs, and maintaining normal function are the aims of treatment.
  • Learn and put into practice good body mechanics.
  • Rest and limit your activity.
  • limited bed rests to relieve spinal pressure.
  • Mild exercise, such riding, swimming, and walking.
  • Apply hot or cold compresses.
  • Water acts as a brace.
  • Acupuncture for pain relief.
  • Massage therapy helps ease tension and muscular spasms.
  • Flexibility and strength are increased by physical therapy to enhance function band.

Medication

  • Medicines that are non-steroidal anti-inflammatory.
  • Drugs that reduce pain.
  • Muscles relaxants.
  • Injections in the spine.
  • Antidepressants.
  • Aids to sleep.

Surgery

  • Fusion and discectomy.
  • Corpectomy.
  • Facetectomy.
  • Laminotomy.
  • Laminectomy of the spine.

Fractures of Hip/Extremities

A fracture is a break in the continuity of a bone.

Management

  • Using Buck's extension/traction as a stopgap treatment to prevent permanent soft tissue damage.
  • Hip spica for a closed reduction.
  • Internal fixing and open reduction.
  • Whole-body hip replacement

Prevention

  • Calcium and vitamin D-rich diet.
  • Environment (dry floor and non-slippery) (dry floor and non-slippery),
  • The bed has side rails.
  • Exercise properly and regularly to lose weight.
  • Bathroom and bedroom designed for older people.
  • Regular eye examinations

Multiple Myeloma

Multiple myelomas are a malignant proliferation of plasma cells in the bone marrow and bones.

Management

  • Thalidomide, either alone or in conjunction with melphalan, steroids, or both.
  • Dexamethasone together with lenalidomide.
  • Melphalan combined with bortezomib.
  • Melphalan used with prednisone,
  • VAD (vincristine, doxorubicin, and dexamethasone).

Cervical Myelopathy and Spinal Canal Stenosis

Osteoarthritis with or without a concurrent disc herniation can result in a narrowing of the spinal canal in the cervical or lumbar regions.

  • Some people may find relief through rest.
  • Calming physical therapy.
  • Analgesics or NSAIDS.

Management for Musculoskeletal Problems in Elderly

Assessment: Assessing the elderly's level of discomfort and physical mobility is the first stage. It is important to evaluate risk factors such as obesity, trauma, injury, and genetic predisposition.:

Reduce Pain

  1. Whenever there is an intense pain flare-up, administer opioid analgesics.
  2. Help put on a back brace and make sure it fits properly.
  3. Regular exercising routines at home.
  4. Encourage the patient to stay away from painful activities.
  5. Use heat as directed.
  6. To avoid persistent muscle soreness and tension, teach proper body mechanics and posture.
  7. Offer a can, braces, or crutches.
  8. To reduce stress on weight-bearing joints, promote weight loss.

Increasing Physical Mobility

  • Encourage movement as much as you can without hurting anyone.
  • Introduce ROM (range of motion) exercises.

Promoting Self-Care

  • Give pharmaceutical advice, such as recommending looser clothing without buttons, setting up a bench in the bathtub or shower for bathing, and eating at a table.
  • Assistance in acquiring assistive items, such as padded utensil handles and grooming aids, to encourage independence.

Preventing Pathological Fractures

  • Gently and patiently assist the patient as they move.
  • Don't shake the patient or the bed.
  • When relocating the patient, support the joints.
  • Protect the sufferer against falls.
  • Create a safe environment by providing adequate lighting and avoiding wet and slick surfaces.
  • Use assistive technology while moving around.
  • Follow-up and regular health screenings.
Things to remember

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