Curriculum for General Practice - The Royal New Zealand College ...

Musculoskeletal
M
Musculoskeletal
Musculoskeletal symptoms are common
presentations in general practice with 8.9
percent of consultations attributed to this
patient group. 1 They affect all age groups,
and range from acute to chronic, simple
to complex. They may be injury-related or
linked with a wide range of other conditions
and factors, including normal ageing.
Given the frequency of musculoskeletal presentations, early
diagnosis, education and negotiation of a management
plan are important, and may delay disease progression
considerably. These are skills that a general practitioner is
well placed to provide. Accurate and timely diagnosis and
management of paediatric conditions is also important.
The impact of long-term or progressive symptoms on an
individual, their family/whānau and carers may be financial,
but may also lead to mental health issues and other
sequelae of chronic pain and increasing disability.
Musculoskeletal conditions may be associated with
significant costs for both individuals and employers, and
may be implicated in time off work, limited work capacity
and early retirement. For those who are not in employment,
the cost may be in terms of ability to perform daily
activities, mobility and maintenance of independent living.
Accidental injury is a frequent cause of musculoskeletal
symptoms. Preventive strategies, maintaining function and
early return to work or activity should be encouraged by
general practitioners, where appropriate, supported by early
diagnosis and relevant investigations. Māori are underrepresented
in ACC claim figures, which suggests cultural
barriers still need to be overcome. 2 The possibility of nonaccidental
injury must always be borne in mind, along with
a clear strategy for management.
It is not unusual for patients to have sought treatment
or advice from elsewhere before presenting to a general
practitioner with musculoskeletal symptoms – hospital
specialists, allied health professionals, complementary
practitioners, sports coaches, the internet and so
on. Interdisciplinary teamwork is a key feature in
musculoskeletal medicine, and is essential in managing
both acute and long-term effects.
1
http://www.health.govt.nz/publication/family-doctors-methodology-and-description-activity-private-gps
2
Accident Compensation Corporation. 2008. Te turoro Maori me a mahi. Wellington.
3
http://cnx.org/content/m13589/latest/
www.rnzcgp.org.nz
Curriculum for General Practice
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