How to manage musculoskeletal conditions

Musculoskeletal conditions are becoming more prevalent in the aging and increasingly overweight Western population. Many such conditions are chronic, and most people concerned have problems with more than one anatomical joint region, resulting in cumulatively increased problems with performing daily tasks. Management is complex because of the chronic nature of many of these conditions, the need for regular assessment of disease impact, the individual's responses to the disease and its treatment, the presence of co-morbidities, and the lack of well-designed studies of long-term outcome to guide treatment. There are significant issues about how to monitor outcomes in routine practice, and many outcome measures have been developed for use in clinical trials. Principles of modern management include involvement of people in their own care, early intervention, and the need to consider a multidisciplinary approach. Most conditions will require combinations of one or more non-pharmacological therapies (especially muscle strengthening and aerobic exercise) and pharmacological agents, with attention given to appropriate timing of surgical interventions.