Musculoskeletal Health

This page is designed to help you understand more about musculoskeletal health, the impact of imbalances in this area and what you may be able to do to help improve this area of your health.

Making improvements to your musculoskeletal system can be extremely powerful. Living with chronic pain due to imbalances relating to the musculoskeletal system is not only physiologically stressful but psychologically impactful as well. If anything, the psychological impact of chronic musculoskeletal imbalances and pain often outweigh the physical trauma itself.

Interestingly, a vicious cycle can develop with poor psychological and emotional health further exacerbating the physical symptoms that we experience.

What is the Musculoskeletal System?

The musculoskeletal system is made up of bones, muscles, tendons, ligaments and connective tissues. Our skeleton provides a framework for muscles and the soft tissue. Together they support our bodyweight, maintain posture and allow us to move.

Bones – Support the body and also store minerals, fat and produce red and white blood cells. Surprisingly bones only make up around 2-4kg of your total bodyweight, this is because they are a hard outer shell that surrounds a spongy centre.

Cartilage – Helps to cushion the bones within the joint, along the spine and ribcage. This helps to prevent rubbing or bones coming into contact with other tissue like nerves. Cartilage is also found in the ears, nose, lungs, pelvis etc.

Ligaments – Connect bone to bone within a joint. Ligaments are made of tough collagen fibres and help to stabilise the joint.

Muscles – Made up of thousands of fibres, muscles allow you to move.

Tendons – Tendons attach muscle to bone. As muscles contract the tendon pulls on the bone producing movement. When muscles relax then the joint can return to its relaxed position.

There are many disorders, conditions and injuries that can lead to problems in the musculoskeletal system, some of which can be acute and short term in nature and many others that can be chronic.

The musculoskeletal system, what can go wrong?

There are hundreds of diagnosable conditions and multiple injuries that can cause problems in the musculoskeletal system. They range from those that suddenly arise such as fractures, sprains and strains to chronic conditions more associated with chronic pain and disability.

Some of the most common to cause musculoskeletal pain include:

• Joint issues – osteoarthritis, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, gout, back and neck pain, sprain injury, herniated disks etc.
• Bone issues – osteoporosis/osteopenia, stress fractures, traumatic fractures.
• Muscles – sarcopenia, muscle strains.
• Nerves – neuropathy, nerve damage, nerve compression etc.
• Aging and Postural Imbalances – Over time our bone and tissue can become weaker, we become more prone to wear and tear and more at risk of injury and the onset of chronic conditions due to degeneration.
• Cancer & other diseases – Many cancers impact the musculoskeletal system. Bone cancer, sarcomas that grow in connective tissue, diseases that cause muscle/bone degeneration etc.

On the most part, musculoskeletal symptoms are caused by postural imbalances, and issues with weak or tight tissue, many of which can be addressed with appropriate movement. It is however always advisable with any musculoskeletal pain to consult with your Dr or medical specialist, and discuss with potentially an osteopath or physiotherapist the issues you are having.

A musculoskeletal specialist will also be able to pick up on red flags associated with the musculoskeletal system as well as offer advice and treatments to help address any imbalances that might be present.

We work closely with a number of osteopaths and physiotherapists to support our clients with imbalances in this area. Likewise, we work closely with those specialists to offer nutrition and lifestyle therapies to help support their clients. This adds another level of support to help address underlying causes that might be contributing to their musculoskeletal symptoms.

Managing Chronic Pain

Pain comes in many forms, increased neuropathic pain, hyperalgesia/increased sensitisation to pain and much more. Pain is often then associated with a number of other symptoms such as fatigue, insomnia, brain fog, headaches, mood disorders and digestive issues. It can feel like the whole body is under attack and often those suffering with chronic pain have developed a lot of distrust in their own body.

Drugs that treat chronic pain are marginally effective. Most fail to respond or have side effects that means they discontinue their treatment. Conventional treatment is focused on the end product of the imbalance and not the imbalances themselves.

Whilst in the UK we don’t have quite the same opioid crisis as in the US, many people do turn to opioid drugs to manage their pain. In reality, chronic opioid use actually enhances pain through a number of mechanisms, one of which is the increase in inflammation.

Like so many chronic conditions, acute therapy taken over a sustained period of time is typically not the answer. Certainly not if we are looking for a long-term positive outcome.

When it comes to centralised pain (pain that is occurring when the central nervous system doesn’t process pain signals properly), there are many factors that we want to consider, here are some of the potentially contributing factors:

• Inflammation and autoimmunity
• Genetics
• Depression & Anxiety
• Mitochondrial Function (how our cells make energy)
• Infections and Lipopolysaccharides (inflammatory bacterial by-products)
• Metabolic dysfunction, obesity, diabetes etc
• Nutrient insufficiencies
• Pain perception
• Medications
• Altered intestinal permeability/leaky gut

We are now seeing in the research the role of more integrative therapies in the management of chronic pain. These include:

• Mindfulness and meditation
• CBT, clinical hypnotherapy, progressive relaxation
• Exercise – strengthening, yoga, Pilates, Thai chi
• Massage, acupuncture
• Rehabilitation physiotherapy and corrective exercise
• Nutrition optimisation – particularly anti-inflammatory dietary habits and nutritional optimisation for energy production
• Sleep optimisation

We must widen our lense when it comes to managing pain, and understand that we need to work on overall physiology to help turn the dial down on pain and reduce the levels of sensitisation to pain.

Biopsychosocial approach to musculoskeletal issues

Negative thoughts and feelings are a very common effect of pain. Likewise, low mood and anxiety have been shown to make the pain system more sensitive, thus exacerbating the pain and making it harder to manage. You can see how a vicious cycle can develop with pain.

When we consider the biopsychosocial model of health, this considers the relationship between three areas: Biology, Psychology and Social Context.

Biology relates to gender, physical illness and imbalance, genetics, immune function, stress response, hormones and medications etc.

Psychology relates to attitudes/beliefs, personality, behaviours, emotions, past trauma, coping strategies, learning and memory etc.

Social context refers to your social support, cultural traditions, education, social/economic status and family background.

This is a much more holistic approach to managing pain and one that fits well with a more Integrative and Functional Medicine approach to musculoskeletal health. This model acknowledges that the mind and body interact, influencing one another both positively and negatively.

Here are some tips you can consider when it comes to managing musculoskeletal symptoms through the above more holistic approach.

Be kind to yourself

So often I will work with clients that seem at war with their body, like their body has conspired to work against them. This conflict often creates a negative cycle that I believe can harm their ability to recover or serves only to exacerbate symptoms.

Do things you enjoy

When you have pain or a specific injury, this can be limiting and may prevent you from doing certain activities that you enjoy doing. However, look for other things that you enjoy doing and focus on those for this moment. Doing more of what you enjoy creates a more positive headspace.

Be as active as possible

Even if you have musculoskeletal issues there will be some activities that you can still do. You may need guidance from a professional such as an osteo, physio, exercise coach etc or just work within your own current limits of what you know you can tolerate. Complete inactivity rarely serves to support ones physical and mental health.

Create support network

Speak with people that are close to you. Making time for family and friends that make you feel positive and energised after spending time with them is important. Equally, if you have people that drain you making you feel more negative, try and spend less time with these people.

Consider the role of mindfulness and meditation

There is a lot of emerging and positive research on the role of mindfulness on pain. Getting a mindfulness coach can be good to help understand, learn and manage expectations with the practice of mindfulness. There are also specific techniques that can be used to help specifically with pain.

Understand your imbalances

People are often submissive with their health, paying little attention to the reason they feel the way that they do. Creating an understanding of your situation guided by a professional and not Google can be very empowering.

Nutritional considerations to support musculoskeletal health

Nutritionally there is a lot we can do to support musculoskeletal pain. One of the corner stones is the development of an anti-inflammatory diet. This involves adopting an overall anti-inflammatory diet, not just adding in single ingredients or supplements hoping for an acute therapeutic effect. Yes, turmeric and ginger can be beneficial for inflammation, however, spooning in heaps of these spices and doing little else is not going to make a big difference. We must step away from such reductionist approaches and think about things on a more holistic level.

Anti-inflammatory diets can be very different for everyone. We all respond differently to foods, meaning that one person’s medicine can be another person’s poison. However, there are some consistencies across all anti-inflammatory diets that seem to be beneficial for the large majority of the population.

Some of the general anti-inflammatory recommendations include:

• Eating a mostly wholefood diet.
• Eating a diet rich in phytonutrients from colourful foods, herbs and spices.
• Eating oily fish to help support fatty acid balance and to increase levels of the omega 3 fatty acid EPA.
• Minimising the intake of sugars, refined starches, processed oils.
• Limiting the intake of saturated fatty acids, ensuring they are not the dominant fatty acid and therefore promoting the intake of monounsaturated fats, like olives and olive oil, nuts, avocado etc.
• Adding herbs like turmeric and ginger for their potent anti-inflammatory compound curcumin.
• Manage your blood sugar levels by eating balanced levels of proteins, fats and carbs.
• Eat appropriate levels of calories. If we are overweight this is a significant contributing factor for inflammation in general, so optimising body composition should always be a goal with anyone who has inflammatory issues. Also optimising body composition for those with musculoskeletal issues will reduce excessive load on the joints and tissues.

You can also utilise tools like a food, symptom and emotions diary to help discover how certain foods seem to impact the body. Do certain choices/habits exacerbate symptoms. Equally we can use testing to help discover whether certain foods increase immune and inflammatory load.

For those with more acute musculoskeletal issues, we can use combinations of anti-inflammatory style diets with specific additions to help with optimising bone formation, connective tissue recovery and more. We have successfully supported many clients following injuries and surgeries through the different stages of recovery based upon their injuries.