Muscle Or Joint Pain?
Which One is It? By Dr. Jim Hendricks
I
typically hear this same question weekly, if not daily, “Is my pain coming from the muscle or joint?” I usually answer, “Probably a little of both.” This always seems to put a perplexing look on most patients’ faces. The bones and the muscles depend on each other to function properly and an injury to one, more than likely causes pain and dysfunction to the other.
Musculoskeletal System
The musculoskeletal system is composed of your bones, joints, muscles, ligaments and tendons. Each of which has its own specific function but together create stability and function. The ligaments attach the bones together to form joints while the muscles attach to the bones by tendons to make an anchor for locomotion. A “joint complex” consists of the union of two or more bones and all the surrounding muscles, ligaments and tendons. For the most part, in- juries I see here involve the entire joint complex, which consists of treating the joint dysfunction or pain and at the same time address- ing muscular sprain/spasm as well.
Joint Sprains Joint sprains are injuries that occur when a joint is suddenly
moved or forced beyond its normal range of motion and the liga- ments are severely stretched or torn. Ligaments connect adjacent bones together to give support and stability to joints. Sprains cause the injured joint to become weak and unstable. A common injury for athletes is the ankle sprain. This is caused when the ankle “rolls” outwardly, forcing the joint beyond its normal range of motion. How badly the ligaments are damaged defines the degree of injury. A first-degree sprain is a minor stretch of the ligament while the integrity of the joint remains intact. Usual symptoms include mild pain, swelling and immobility of the joint. In the case of a second degree sprain, the ligament is stretched more severely caus- ing a degree of micro-tearing of the ligaments. This will result in increased pain, swelling, moderate immobility, moderate instability
12 Essential Living Maine ~ August 2014
of the joint and bleeding of the tissues causing ecchymosis (bruis- ing) of the skin at the site of injury. Third degree sprains occur when the ligaments are more torn to the point of rupture. Symptoms are severe pain, swelling and joint instability. Ruptures or complete ligament tears occur when the fibers of the supporting ligaments become torn and are no longer intact.
Muscular Sprains
Muscular sprain/strains or “pulls” as patients call them are injuries to the muscles and tendons from over-stretching or exert- ing some part of the muscle beyond its normal length. Muscles are attached to bones by tendons and the tendons are what allow the muscle to contract. When there is an injury to the muscle it can be- come stretched or torn and muscular strains are graded according to their severity. First degree sprains are a mild injury to the muscle causing mild tissue tearing and pain. The result is pain, mild swell- ing, muscular spasm, but with full range of motion. Second-degree muscle strains involve moderately torn muscle or tendon tissues. Along with above symptoms of the first degree sprain, ad- ditionally there will be a loss of muscular strength, limited range of motion and bleeding of the muscle fibers that will result in an ecchymosis at the site of injury. Third degree strains are a complete rupture of the muscle or tendon from the bone. In this case, there will be a complete loss of muscle function. Initially with injury there will be severe pain with limited or no movement.
Injury Cases
In the majority of injury cases, whether it is an ongoing condi- tion or an acute injury, there is usually a muscular and a joint component. Granted, I am not saying that there are not true joint injuries (a ligament tear of the ACL of the knee) or muscular injury (a strain of back muscle), because initially this is true. However, with either a joint or a muscle injury, both can lead to adverse effects on the other. The bones of the skeleton are the frame and
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