Uncommon Musculoskeletal Conditions

Many people are fairly familiar with the most common orthopedic conditions that cause back and joint pain, including degenerative disc disease, osteoarthritis, inflammatory arthritis (e.g. rheumatoid arthritis), compression fractures, and muscle spasms. The diseases mentioned above probably account for over 99% of all cases of back pain and joint pain. But there are several other uncommon orthopedic and joint conditions that still affect millions of people, keeping them bedridden, disabled, or in a chronic state of pain. Let's take a look at some of these uncommon musculoskeletal conditions, what causes them, and how they may be treated or managed.

Spinal Infection: Osteomyelitis is one of the most common spinal infections, in which the vertebral body is affected. This is an uncommon cause of back pain in young healthy people, though the elderly may be vulnerable, as well as those with certain diseases. This is an infection that usually has spread from another part of the body. The most common pathway of entry of the infection is from the Batson's plexus, a group of veins in the lower spine that drain the pelvis. Because of the location of this plexus, many patients contract this type of infection after urologic procedures such as a cystoscopy, a radiologic procedure that involves doctors a look at the urethra and bladder.



Patients who are vulnerable to contracting this condition include intravenous drug users, the elderly, and those whose immune system has been compromised. Patients who have used steroids for a long period of time to treat chronic disease are at an increased risk for this type of infection. AIDS and organ transplant patients are at an increased risk of contracting osteomyelitis because of the immune system compromise. Patients with cancer, malnutrition, and those with insulin dependent diabetes are at an increased risk.

Osteomyelitis is a bacterial infection that usually involves the bacteria Staphylococcus Aureus. A Pseudomonas infection is most likely the cause of osteomyelitis in intravenous drug users. When this infection strikes, it is usually in the thoracic spine, though intravenous drug abusers usually get in the cervical spine.

To treat this infection, it usually requires a combination of rest, bracing, and intravenous antibiotic therapy. This is one of the few back pain treatments where doctors actually recommend back bracing, because it has been discovered that immobilization actually reduces most patients' ability to get better.

Vertebral Fracture: The bones and muscles of the spine are very strong, and it is only in the event of an extremely traumatic event that fractures occur. Still we live in a world where we travel in fast vehicle, and no community is 100% safe from accidents, despite the best efforts from law enforcement and careful drivers. Of the vertebral fractures that do occur, some are due to extreme trauma, while most are related to the collapse of bones due to bone density loss.

Patients who are at risk of sustaining vertebral fractures may or may not be aware of their vulnerability. Women who are approaching or actively in the process of going through menopause should get their bones checked to see if they have enough bone density to maintain bone strength.

Compression fractures are fractures that do not involve clean breaks, but where the bone actually collapses in on itself, like partial demolition. A compression fracture is also sometimes known as a wedge fracture, osteoporotic fracture, or vertebral fracture.

In the human spine, must vertebral bodies are block shaped, which allows them to provide mechanical weight bearing support for the spine. Compression fractures may occur across the entire vertebral body, or they may mainly collapse on one side while the other side remains intact. Wedge fractures account for this scenario where the collapse usually occurs in the front of the vertebra. Other types of fractures include osteoporotic fractures, where the collapse occurs throughout the body, and burst fractures, where the entire vertebral body loses some of its height.