Encyclopedia of Health and Medicine

322 The Musculoskeletal System
• ANALGESIC MEDICATIONS such as acetaminophen
and NONSTEROIDAL ANTI-INFLAMMATORY DRUGS
(NSAIDS) to relieve pain
• ANTIDEPRESSANT MEDICATIONS to treat depression
and to relieve pain
• MUSCLE RELAXANT MEDICATIONS
• CHIROPRACTIC, OSTEOPATHIC MANIPULATIVE TREAT-
MENT (OMT), and MASSAGE THERAPY to relax muscles
and improve range of motion and
FLEXIBILITY of joints
• ACUPUNCTURE for pain relief and stress reduction
• YOGA and TAI CHI to improve flexibility, STRENGTH,
and balance and to relieve stress
• MEDITATION for stress relief
Doctors seldom prescribe narcotic pain relievers,
sleep medications, CORTICOSTEROID MEDICATIONS
(such as prednisone), or benzodiazepine muscle
relaxants (such as diazepam), because these treatments
interfere with normal activities and are not
proven to improve symptoms long term. As well,
the side effects and potential dependency issues
with these medications are greater than the shortterm
benefits for most people. Doctors also recommend
daily physical exercise because it increases
the release of endorphins and enkephalins, the
body’s natural pain relievers. It also stretches and
strengthens the muscles and connective tissues,
and promotes a sense of accomplishment and
well-being.
Risk Factors and Preventive Measures
About 80 percent of people who have fibromyalgia
are women, though researchers do not know
why this gender correlation exists. People who
have autoimmune forms of arthritis, such as
rheumatoid arthritis or ANKYLOSING SPONDYLITIS, also
have increased risk for fibromyalgia. Because
researchers do not know what causes fibromyalgia,
there are no recommended preventive measures.
See also ACUTE PAIN; ALTERNATIVE METHODS FOR
PAIN RELIEF; CHRONIC FATIGUE SYNDROME; CHRONIC PAIN;
STRESS AND STRESS MANAGEMENT.
fracture A break in a BONE. The most common
cause of bone fracture is traumatic injury. Spontaneous
fracture may occur in people who have
health conditions such as OSTEOGENESIS IMPERFECTA,
severe OSTEOPOROSIS, or BONE CANCER. Fractures
may take various forms, including
• avulsion, in which a small chip of bone breaks
away
• closed (simple), in which the bone ends remain
relatively in alignment and do not penetrate
through the SKIN
• comminuted, in which the bone fragments into
multiple pieces
• compression, in which the bones collapse onto
one another (such as vertebrae in the back)
• greenstick, which typically occur in young children
whose bones are still supple and appear as
a bend or curve rather than an outright break
in the bone
• open (compound), in which the bone ends are
significantly separated and protrude through
the skin, causing an open wound
• spiral, which occur when sudden force twists
the bone and the break runs in line with the
bone’s axis
• stress, in which hairlike cracks develop in bones
subject to repetitive stress (such as the tibia, the
long bone in the lower leg, with running)
Bone fractures require prompt care from a doctor.
Nearly always it is necessary to immobilize the
bone ends so they remain aligned and can heal
back together.
Do NOT move a person who may have a
fractured neck or back. Summon emergency
medical aid and keep the person
still, calm, and as comfortable as possible.
Symptoms and Diagnostic Path
Severe PAIN and rapid swelling after trauma are
the most common symptoms of bone fracture.
Most often, the person cannot bear weight or put
pressure on the involved area. The limb or digit
may appear distorted or a bone end may protrude
through the skin. X-RAY nearly always confirms
the diagnosis, though more sophisticated imaging
procedures such as MAGNETIC RESONANCE IMAGING
(MRI) and bone scan are occasionally necessary