‘We should be catching rabbits and climbing trees’

In terms of pre­vent­ing mus­cu­loskele­tal con­di­tions or keep­ing them at bay, there is a cer­tain amount of bad news – but also a fair bit of good.

The like­li­hood of some con­di­tions devel­op­ing is linked to genet­ics or wear and tear of the bones and joints, but there are fac­tors with­in our con­trol, such as our lifestyles or fre­quen­cy of exer­cis­ing, that can either reduce the risks or lim­it the impact.

Pre­dis­po­si­tion to osteoarthri­tis is often linked to genet­ics, says Dr Amit Saha, a con­sul­tant rheuma­tol­o­gist at Maid­stone and Tun­bridge Wells NHS Trust. “If your mum has thin bones, then you may well have thin bones as well,” he says.

Skele­tal struc­ture also deter­mines the risk of pain in your joints and bones. “If you are knock-kneed or bow-legged, you will affect how forces are trans­mit­ted through your joints,” says Cliff Eaton, a char­tered phys­io­ther­a­pist and clin­i­cal spe­cial­ist for DJO UK, a sup­pli­er of orthopaedic equip­ment.

Obe­si­ty is a risk fac­tor for mus­cu­loskele­tal con­di­tions includ­ing osteoarthri­tis. As Mr Eaton says: “If it was sug­gest­ed you strap a bag of pota­toes around your waist and car­ry it around all day, you would con­sid­er it to be crazy. But being over­weight means that your joints have to cope with unnec­es­sary load.”

Peo­ple just don’t move about enough – we haven’t evolved to be just sit­ting down

Smok­ers are much more like­ly to devel­op rheuma­toid arthri­tis than non-smok­ers, it is wide­ly believed. An influ­en­tial study pub­lished in the jour­nal Arthri­tis and Rheuma­tism in 1996 made the link after study­ing the cig­a­rette smok­ing his­to­ry among twins and link­ing it to rheuma­toid arthri­tis.

Some con­di­tions have asso­ci­at­ed high­er risks of addi­tion­al ill­ness­es. Rheuma­toid arthri­tis has been linked with increased like­li­hood of occur­rences, such as heart attacks and stroke, as doc­u­ment­ed in stud­ies pub­lished in 1994 also in the Arthri­tis and Rheuma­tism jour­nal.

Diet through­out life, but espe­cial­ly dur­ing infan­cy and puber­ty, are risk fac­tors, says Mr Eaton. “Ensur­ing we have a bal­anced intake of vit­a­mins is crit­i­cal for the devel­op­ment of nor­mal bone struc­ture. Lack of cal­ci­um can result in poor bone min­er­al den­si­ty. Lack of expo­sure to sun­light can result in vit­a­min D defi­cien­cies, which can alter bone align­ments and joint con­gruity.”

Stephen Moore, a Lon­don-based osteopath at Waltham­stow Osteopaths, believes that much of our back, neck and shoul­der pain results from seden­tary lifestyles. “Peo­ple just don’t move about enough – we haven’t evolved to be just sit­ting down,” he says. “We’re hunters and gath­er­ers, and we’re sup­posed to be catch­ing rab­bits and climb­ing up trees.”

Mr Moore comes across plen­ty of peo­ple whose injuries are a result of repet­i­tive move­ments in their jobs. “Man­u­al labour­ers like plas­ter­ers get shoul­der and arm prob­lems because a lot of their work is high above their heads. Peo­ple on super­mar­ket check­outs keep twist­ing their body on the same side so they can get bad backs. For brick­lay­ers it can be even worse because they work out in the cold.”

Exer­cise can be a good way of lim­it­ing the effects of mus­cu­loskele­tal com­plaints. Researchers from the Uni­ver­si­ty of Mel­bourne in Aus­tralia, report­ing in the Jour­nal of Sci­ence and Med­i­cine in Sport, found that exer­cise is ben­e­fi­cial for peo­ple with osteoarthri­tis “of all sever­i­ties”.

Guide­lines by the Nation­al Insti­tute for Health and Clin­i­cal Excel­lence (NICE) state that exer­cis­es, such as local mus­cle strength­en­ing and gen­er­al aer­o­bic fit­ness, should be a “core treat­ment” for peo­ple with osteoarthri­tis irre­spec­tive of age, comor­bid­i­ty, pain sever­i­ty or dis­abil­i­ty.

Exer­cise regimes have to be tai­lored for dif­fer­ent con­di­tions. Mr Eaton says: “If the knees or hips are affect­ed and weight bear­ing activ­i­ties cause pain, then we need to con­sid­er non-weight bear­ing activ­i­ties, such as swim­ming or cycling.”

Dr Saha rec­om­mends 30 min­utes a day of walk­ing for osteo­poro­sis. Run­ning is also worth con­sid­er­ing, although many patients with osteo­poro­sis are in their 60s or 70s and so this may not be fea­si­ble, he says.

Mr Moore says: “Men often think that going to the gym is a good way of keep­ing their  bod­ies flex­i­ble and strong, but some men actu­al­ly increase their like­li­hood of mus­cu­loskele­tal pain by con­cen­trat­ing on build­ing up their biceps and their pecs because they think it’s sexy.” Build­ing up core strength in the low­er part of the trunk can help, he adds.

Accord­ing to Dr Saha there is no strong evi­dence that diet has a sig­nif­i­cant treat­ment effect on mus­cu­loskele­tal con­di­tions. But he says: “I do some­times get peo­ple say­ing to me that they have cut out some­thing, such as pota­toes, from their diet and their joints feel amaz­ing­ly bet­ter. Some patients think that cer­tain things work and, if that’s the case, I tell them to car­ry on doing what they are doing.”

An obvi­ous way of try­ing to tack­le or pre­vent mus­cu­loskele­tal con­di­tions is to seek advice from health pro­fes­sion­als, such as GPs and phys­ios, but many peo­ple do not both­er, says Mr Eaton. “I saw one study where 1,000 peo­ple were inter­viewed and near­ly half report­ed signs and symp­toms of arthri­tis. Yet only 155 had gone to their GP and only 47 had gone to a phys­io­ther­a­pist,” he says.

There are options to reduce the like­li­hood of mus­cu­loskele­tal con­di­tions and to mod­er­ate the effects. “Pop­u­lar mis­con­cep­tion is that noth­ing can be done for peo­ple with con­di­tions like arthri­tis because it is sim­ply about wear and tear that wors­ens with age. I think the main mes­sage is to keep active, and do exer­cise to strength­en the bones and joints. If you don’t use it, you lose it,” Mr Eaton con­cludes.