Disorders of Muscular and Skeletal Systems

The muscular and skeletal systems play a vital role in movement, posture, and support of the human body. Disorders of the muscular and/or skeletal system can cause pain, limited movement, deformity, and weakness. Understanding musculoskeletal disorders is important for maintaining musculoskeletal health.

1.0Disorders of the Muscular System

Muscular disorders primarily affect the muscles, impairing their ability to contract and relax properly.

Muscular Dystrophy (MD)

Muscular dystrophy is a group of inherited genetic disorders that cause progressive weakness and degeneration of muscle fibres. The most common type is Duchenne Muscular Dystrophy (DMD).

• Cause: Muscular dystrophy results from a change in a gene that disrupts the production of proteins necessary for building and maintaining healthy muscle. In Duchenne muscular dystrophy, the gene responsible for producing dystrophin has changed. Dystrophin, as we will learn, is essential for the structural integrity of muscle fibres. Without dystrophin, muscle cells become damaged and are slowly destroyed.
• Symptoms: Symptoms usually develop in early childhood and can include an inability to walk, frequent falls, a waddling gait, and difficulty getting up from seated or lying positions. Over time, the condition will become severely debilitating and progress to further problems with mobility and possible effects on the heart and respiratory muscles.

Myasthenia Gravis

Myasthenia gravis is a chronic autoimmune disorder that causes progressive weakness and rapid fatigue of the voluntary muscles. The term "myasthenia" means "muscle weakness," and "gravis" means "severe."

• Cause: The immune system of the body inadvertently generates antibodies that attack and block the acetylcholine receptors at the neuromuscular junction in the body. Acetylcholine is a neurotransmitter considered crucial for muscle contraction processes. Without the ability for these receptors to be destroyed, the nerve impulses cannot reach the muscles effectively, and the muscles will be unable to contract appropriately. This is an instance of an autoimmune disease.
• Symptoms: Symptoms may differ but usually consist of droopy eyelids (ptosis), double vision (diplopia), difficulty swallowing or chewing, slurred speech, and generalised muscle weakness that gets worse with activity and better with rest.

Fibromyalgia

• Definition: Chronic pain disorder affecting muscles and soft tissues.
• Symptoms: Widespread muscle pain, stiffness, fatigue, and sleep disturbances.
• Management: Pain management, exercise, stress reduction techniques.

Muscular Atrophy

• Definition: Loss of muscle mass due to inactivity or nerve damage.
• Cause: Sedentary lifestyle, ageing, nerve injury, malnutrition.
• Management: Physiotherapy, resistance training, nutrition support.

2.0Disorders of the Skeletal System

Skeletal disorders affect the bones and joints, compromising the body's structural integrity and movement.

1. Osteoporosis

Osteoporosis is a disease in which bones become thin and fragile due to a decrease in bone mass and density, causing the bones to break easily. It typically occurs in older individuals, particularly post-menopausal women, as estrogen, a hormone that helps maintain bone density decrease. This disorder also stems from a lack of calcium and vitamin D.

2. Arthritis

Arthritis is a broad term for the inflammation of joints, causing pain and stiffness. There are several types, but for NEET, Osteoarthritis and Gouty Arthritis are particularly important.

• Osteoarthritis: This is a degenerative joint disease that occurs due to the breakdown of articular cartilage, the smooth tissue covering the ends of bones. The loss of cartilage causes bones to rub directly against each other, leading to pain, stiffness, and reduced joint mobility. It is a common condition associated with aging, injury, and joint overuse.
• Gouty Arthritis (Gout): Gout is an inflammatory condition caused by the accumulation of uric acid crystals in the joints, most commonly in the big toe. Uric acid is a waste product from the metabolism of purines. When uric acid levels in the blood are too high (hyperuricemia), it can crystallize and deposit in joints, causing sudden, severe pain, swelling, and redness

Rickets

Rickets is a childhood bone disorder caused by a severe deficiency of vitamin D, calcium, or phosphate. Vitamin D is essential for the body's absorption of calcium. Without enough calcium, bones become soft and weak, leading to skeletal deformities such as bow-leggedness, thickened ankles, and wrists. The adult equivalent of rickets is osteomalacia.

Slipped Disc

A slipped disc, or herniated disc, occurs when the soft inner core of a spinal disc pushes out through a tear in the tougher outer layer. The spinal discs act as cushions between the vertebrae. This bulge can press on the nearby spinal nerves, causing sharp pain, numbness, or weakness in the back, arms, or legs. It is often a result of sudden strain or injury to the spine.

3.0Causes of Muscular and Skeletal Disorders

• Genetic factors: Muscular dystrophy, osteogenesis imperfecta.
• Nutritional deficiencies: Vitamin D, calcium, and protein deficiencies.
• Ageing: Osteoporosis, sarcopenia.
• Autoimmune reactions: Rheumatoid arthritis, myasthenia gravis.
• Injury or trauma: Fractures, sprains, dislocations.
• Infections: Osteomyelitis, septic arthritis.

4.0Prevention and Management 

• A balanced diet rich in calcium, vitamin D, and protein.
• Regular weight-bearing and resistance exercises to strengthen bones and muscles.
• Avoid a sedentary lifestyle; maintain good posture.
• Early diagnosis and treatment of joint pain and muscle weakness.
• Regular screening for osteoporosis in high-risk individuals.