Musculoskeletal disorders

Musculoskeletal disorders are the biggest cause of sick leave and disability benefits in Norway. Physical activity prevents such diseases and is central to the treatment and rehabilitation of musculoskeletal disorders.

In the following sections, the symptoms of the most common musculoskeletal disorders will be reviewed alphabetically. You will find information about what you can do yourself to improve the condition and finally find information about what Eyr can help you with.

  • Achilles tendons

    Inflammation of the Achilles tendon
    The Achilles tendon is the tendon of the two large calf muscles at the back of the calf, and it is this tendon we can see and feel as a thick string on the back of the ankle.

    Inflammation of the Achilles tendon is a condition that occurs primarily among athletes, exercisers and the elderly. The typical ailment is burning pain and stiffness 2 to 6 cm above the heel bone. Most people who are bothered do not really have any inflammation in the tendon itself, but more what are called wear and tear. Probably the very first ailments are an expression of a small injury in the tendon with a subsequent and transient inflammation. Eventually, wear and tear and small tears in the tendon itself will cause persistent ailments. Runners are especially vulnerable, and especially if you run a lot on hard surfaces.

    The main symptoms of inflammation in or around the Achilles tendon are heel pain. The pain comes from exertion, for example when running. They want to slow down a bit during the activity, only to get worse afterwards. Stiffness in the Achilles tendon persists for hours to days after a workout, even at rest. In advanced condition, there is also pain at rest. If you are flatfooted, the risk of problems with the Achilles tendon is greater.

    What can I do myself

    Stretching of the calf muscles, alternative training and possible use of anti-inflammatory drugs are often sufficient. An insole in the heel part of the shoes that builds 0.5 to 2 cm, will be able to relieve the tendon and thus provide some relief. The sole should only be used for a few days to a few weeks.

    In acute symptoms, anti-inflammatory and analgesic medication is often used. The usefulness of such medications is questionable in long-term ailments.

    Low-dose laser treatment together with stretching exercises is an alternative treatment that can lead to faster symptom relief than stretching alone. There is some uncertainty about the effect of shock wave therapy.

    Exercise treatment according to instructions from a physiotherapist can also be a relevant treatment method.

  • Elbow

    Stress injuries in the elbow are common both in working life and in sports, and tend to become chronic ailments.

    Tennis elbow and golf elbow
    The most common ailments are called tennis elbow or golf elbow. Although the names suggest sporting reasons, this is only exceptionally the explanation. The pain condition in the elbow is due to overload of tendon attachments, usually as a result of repeated, one-sided movements.

    • Tennis elbow, is located on the outside of the elbow and is called lateral epicondylitis.
    • Golf elbow, is located on the inside of the elbow joint and is called medial epicondylitis.

    The names indicate which sports predispose to the two conditions, but the vast majority who get epicondylitis are not athletes. Many people get epicondylitis in their profession, such as electricians, plumbers, painters, butchers.

    The pain may come a few days after an acute or prolonged congestion.

    The symptoms come in the form of a murky pain or pain on one side of the elbow, most often on the outside, often radiating down the forearm towards the wrist.

    The function of the arm is affected; it can be difficult to pour, hold a cup, drink; and working with the hand can be problematic. Some people have had mild ailments for several months and see a doctor because they do not get well on their own.

    Tennis elbow is a very common condition, while golf elbow is far rarer.

    What can I do myself

    The purpose of the treatment is to relieve the pain and to alleviate the inflammatory reaction. You should for a period of time avoid activity and strain that causes pain. If necessary, you should change the working method to reduce the load on the elbow. Most people are good at relieving and taking it easy for a few days or weeks.

    In the acute phase, some may have the effect of anti-inflammatory and analgesic medication such as ibuprofen. Many people also experience the positive effect of painkillers in gel form, which are applied to the sore area.

    Other treatment that may be relevant for persistent and chronic ailments is physiotherapy in the form of instruction in exercises you can practice yourself to remedy the problem.

    Cooling with ice can also relieve the pain, and in case of severe pain, bandaging and bracing of the elbow joint may be necessary. Athletes can benefit from taping.

    Inflammation of the mucous sac in the elbow

    The mucous sac on the back of the elbow often becomes inflamed. The mucus sac is a jelly-like sac, which usually contains a small amount of synovial fluid. Inflammation of the mucous sac in the elbow, a swelling occurs in a short time in the area which gives pressure and a feeling of bursting. The pain worsens when you bend your elbow. Sometimes the inflammation is complicated by a bacterial infection. Then the swelling will also be redder and warmer than an inflammation without bacteria.

    Inflammation of the mucous sac in the elbow is a relatively common condition and can occur as a result of injury (shock / blow). It can also occur after persistent irritation, for example when constantly leaning on the elbow during work or while reading (student arc).

    What can I do myself

    As a rule, it is sufficient treatment to protect the elbow from shock and pressure for a few days, but in some cases anti-inflammatory agent is used. The purpose of the treatment is to relieve the pain, treat any infection and prevent later relapses.

    It is important that you dont use the elbow too much and make sure to avoid pressure and irritation against the mucus bag by changing / varying the working position and by using elbow pads.

    In the most painful phase, you should keep your arm in a sling.

    A simple treatment is the application of an nsaid preparation (eg Voltarol) in gel form. Alternatively, NSAIDs can be given as a short-term tablet regimen such as ibumetin.

  • Ankle

    Ankle sprain
    Ankle pain is common and is often caused by injuries and overloads.

    An unstable ankle is an ankle with constant tendencies to sprains, ie twists or overstretches (overstretches). A sprain in the ankle is an injury that occurs when you twist the ankle in the wrong direction. It can stretch or tear over the tight ligaments that help hold the ankle legs together. The ligaments stabilize the joints and prevent abnormal range of motion.

    A sprained ankle occurs when the ligaments are stretched beyond their normal stretching length. Most sprained ankles involve the ligaments on the outside of the ankle.

    In an acute sprain, one can feel that the ankle fails under load, especially during ball games or when moving in rough terrain. Swelling occurs either immediately or within a few hours, and pain at rest that increases with strain on the ankle. After a few hours, discoloration may occur due to blood leaks in the joint area.

    An unstable ankle is the result of repeated overstretches. This makes the ligaments slack so that an unstable ankle is an ankle with constant tendencies to new sprains. It is a fairly common condition.

    What can I do myself
    In acute sprains, it is important to quickly ice the ankle down, sit with the foot raised, take painkillers, apply a bandage and take it easy.

    The purpose of the further treatment is to prevent repeated later sprains.

    You should choose shoes with a wide heel and a high and stiff heel cap. Use a bandage or tape the ankle for physical activity. Prescription "gout medications" are analgesic and anti-inflammatory. They can be used for a few days in acute sprains.

    Physical treatment with balance training and muscle training can in many cases be sufficient treatment of a chronically unstable ankle. One of the most important measures in the training is the use of balance boards. It helps to strengthen the ankle so that the risk of new overdrafts is not greater than for people without previous overdrafts.

  • Hip, pelvic and groin pain

    Hip, pelvic and groin pain can occur from a wide range of conditions in the hip and from injuries elsewhere that radiate to the hip.

    Pelvic girdle pain
    Pelvic pain, or pelvic joint pain, occurs in more than 15 percent of all pregnant women in Norway. In the vast majority of cases, the symptoms return after birth.

    Typical ailments in this condition are pain over the anterior part of the pelvis, the symphysis (pubic bone) and the back of the pelvis. The pain can radiate to the groin and down into the legs, and typically occurs during exercise and / or afterwards. Problems with walking, standing and sitting over time are characteristic. Position changes and rotational loads (eg getting out of a car) can be particularly difficult. Some people have difficulty coping with daily tasks, such as taking clothes out of the washing machine or vacuuming.

    The pain often increases throughout the day, and often occurs with a time delay after physical activity / load. The symptoms most often occur for the first time in the fifth to eighth month of pregnancy, but can debut earlier for each new pregnancy and are seen as early as the first trimester.

    Women who experience pelvic pain for the first time can be significantly affected, including mentally. From being functionally healthy, everyday life can be affected by a reduced level of function. Some can only work in short sessions, or can only walk short distances. Some people get poor night's sleep because of the pain. Most people eventually learn how to deal with the pain, but while it is going on, many experience that it affects the quality of life, their relationship, the role of mother and the desire to undergo new pregnancies.

    What can I do myself
    Pelvic pain mostly passes after childbirth. Before that time, it is the adaptation of one's own everyday life that is the most important strategy.

    It is individual how much and what kind of activity results in pain. For many, the pain comes with a time delay. For some, it will therefore work to be somewhat more restrictive than normal.

    Good resting positions combined with adapted activity are recommended. Avoid activities that aggravate the ailments. If the pain comes in an upright position - sit more. Sit or use a stool instead of standing while cooking or emptying the washing machine. Take breaks at the mall. Frequently varying between sitting and standing position can be good for many.

    Try to get your workday adapted, if it causes pain. If facilitation is not possible, sick leave is an alternative.

    Even load on the legs is important. Stand with the weight evenly distributed and a little distance between the legs. Take short steps. Most people will benefit from placing a pillow between the thighs, knees, ankles and perhaps in front of the abdomen for good rest in the supine position. When turning in bed, it can help to have smooth fabric under you and keep your legs bent together.

    When carrying, the weight should be distributed on both arms, you should carry close to the body and use a backpack. Physical activity should be kept within the pain limit, and it is important with relief and opportunities for rest.

    Some may benefit from advice from a physiotherapist, you do not need a referral from a doctor to get such help. An individualized training program can be set up with strength exercises that do not cause pain. This may not limit the pain itself, but can be useful for maintaining muscles so that you get to the hooks faster after birth.

    Groin strain

    Groin strain is a common sports injury. Tendonitis in the "iliopsoas" muscle is one of several causes.

    If the cause is congestion, there has usually been a gradual development over weeks and months of pain in the front of the hip or groin. In the beginning, the patient notices pain only in connection with provocative activities, and that the discomfort disappears after the activity has ended. The condition may gradually worsen, and the symptoms may also appear at rest. This development usually takes place over many months.

    The symptoms are often related to specific sports activities such as running or kicking. The pain is located centrally in the groin, it may radiate down the front of the thigh towards the knee. In some people, a click is heard in the hip or groin ("snapping hip syndrome"). Some patients experience anterior knee pain due to a tight iliopsoas muscle.

    What can I do myself

    The goal of treatment is to relieve pain, muscle tension and swelling. Secondly, to get the patient back to normal activity, for example in sports. Many patients only seek medical attention after months of ailments, which indicates that treatment will also take time.

    The treatment options are cooling down, rest, anti-inflammatory drugs and stretching exercises. The main principles of the treatment are strength and mobility training with gradually increasing load.

    In case of a lot of pain, local cooling with an ice pack for 20 minutes every 1-2 hours will help relieve pain, muscle cramps and inflammation. Activities that strain the iliopsoas muscle must be avoided. Stretching exercises must be performed with caution in the beginning. It is important that you do not stretch immediately after cooling down, as this increases the risk of straining the tendon / muscle. Hold the stretch for 20 seconds, relax for 30 seconds and repeat this stretch 5 times per session. Crutches may exceptionally be required if you have developed a lame gait, to ensure adequate relief.

    If you have had tendonitis in the iliopsoas, it is more important than before to be careful with good warm-up and stretching before and after sports activities. Otherwise, the risk of relapse is increased. Focus on bending and stretching the hips, knees and body (abdominal muscles).

    Mucositis on the outside of the hip, trochanter major pain syndrome

    Pain on the outside of the hip may be due to inflammation of the tendons that attach to the bone attachment "trochanter major". In most people, the symptoms go away on their own.

    Trocants major pain syndrome usually occurs as a result of prolonged strain in the hip region. Prolonged walking and standing can trigger the condition, as can a fall on the hip and a changed walking pattern. Changes in walking pattern may be due to low back pain (75 percent), and length difference in the legs (10 percent). Knee pain and ankle sprains can also change the gait pattern and predispose to trochanter major pain syndrome.

    The main symptom is pain on the outside of the thigh / hip. Often it is particularly tender over the trochanter major. Sometimes the pain can radiate to the outside of the calf. The pain is often aggravated by walking or movements that particularly strain the gluteal muscles, for example when you go up a flight of stairs or a hill, or when you get up or sit down. Constant, aching pain is also common. The pain often increases when you lie on the inflamed side, but the pain is often present no matter which side you lie on at night. In some cases, the pain is so excruciating that you can not walk properly, but have to limp.

    What can I do myself

    The condition often goes away on its own. Limiting activities that aggravate the ailments is often the only necessary treatment. In case of need for active treatment cortisone injection and / or use of an anti-inflammatory drug useful.

    Stretching exercises that stretch the outside of the thigh / hip can be beneficial. It is particularly beneficial if you perform a resistance exercise during stretching where you press your leg against, for example, the wall. Only in exceptional cases is physiotherapy required.

    Any cortisone injection is placed in the area where you have the most pain. The syringe contains local anesthetic, so if the syringe is inserted correctly, you will quickly become pain-free. In many cases it lasts with a syringe, while sometimes a new syringe must be inserted after 1-2 weeks.

    Wear and tear in the hip, hip arthritis

    Hip osteoarthritis is due to wear and tear in the hip joint. Every year, approximately 9,000 hip prostheses are inserted in Norway.

    Pain gradually develops in the groin and anterior side of the thigh. The pain often radiates down to the knee. The pain often comes at the beginning when you start walking. Then becomes less intense after a few seconds or minutes of walking, but will get worse again after a period of walking. A lot of strain on the legs increases the ailments. Gradually, pain develops at rest and at night. At night pain, the condition has come a long way. The walking distance becomes shorter, the patient limps and has to use a cane for relief.

    What can I do myself

    If possible, you should lose weight if you are overweight. This can be especially important in advance of an operation where an artificial hip is to be inserted. Avoid prolonged standing work, heavy lifting and carrying. When you go to sleep, it is an advantage to lie on your stomach or on your side with a pillow between your legs, to avoid shrinkage in the muscles around the hip joint and thus increased stiffness. Physical activity in the form of cycling and swimming is good. Using a crutch / stick on the opposite side of the painful hip can be helpful for many. Training under the instruction and guidance of a physiotherapist will be useful for most people.

  • Knee

    Jumpers knee
    The jumper's knee, patellar tendinitis, causes pain in the anterior part of the knee joint as a result of overloading of the tendon attachments on the patella. The pain is triggered especially by sports with a lot of jumping and the cause is an irritation or inflammation in the tendon attachments to the large thigh muscle.

    When you land with bent knees after a jump, almost the entire load will be placed on the knee stretch tendon. In most cases, the pain starts creeping in and develops over weeks and months. The pain usually starts in a smaller area of ​​the tendon. Eventually, the pain spreads to all or large parts of the tendon, and they increase in intensity. The pain is aggravated by running and jumping. There may also be pain when climbing stairs, driving a car, sitting in a cinema, etc.

    What can I do myself
    Avoid activities that provoke pain. Cool with ice for 20-30 minutes, 4-6 times a day, especially after activity. Make regular stretches of the thigh flexor and stretch muscles. Taping the lower edge of the kneecap can help relieve the pain. Many people achieve a good effect from an adapted exercise program.

    Anti-inflammatory drugs can be tried in the acute phase (7-10 days), but there is no convincing of its effect.

    Meniscus injury in the knee joint
    The menisci are two shock-absorbing cartilage discs inside the knee joints. They can be injured by trauma or as part of the development of wear and tear in the knee. Stinging / cutting knee pain is the most common symptom.

    Acute injuries of the menisci are seen especially among athletes, and especially in contact sports such as handball and football. But also workers with heavy lifting and a lot of bending in the knees are exposed to meniscus injuries.

    The acute injury is usually caused by a sharp twist in a position with a bent knee. Meniscus injuries can also develop gradually over a longer period of time as the meniscus loses some elasticity and flexibility and is therefore increasingly exposed to wear.

    The most common symptom is severe, most often stabbing or cutting pain in the knee - usually localized to the joint gap on the inside of the knee. The pain will usually come and go, and it usually worsens with physical exertion. In particular, meniscus pain is triggered by rotations in the knee joint. Many patients therefore experience that turning in bed and going up stairs and squatting can be very painful.

    During the first hours after an acute injury, you get a swelling in the knee, and some may in the time after notice that it snaps in the joint when moving. In people where small pieces of cartilage have been torn loose, or the meniscus has been chipped up, one can experience what is called a locking phenomenon. That is, the knee suddenly locks and cannot move. Such a situation is painful and should be examined by a doctor.

    What can I do myself

    First aid for all acute injuries of this type is performed according to the PRICE principle:

    P - Paracetamol. Take 1 gram of paracetamol up to 3 times a day.

    R - Rest. Stop the activity you are doing and lie down on your back if possible.

    I - Ice. Apply ice / cold pack over the knee. This will cool the area and limit the damage.

    C - Compression. Apply compression bandage around the knee.

    E - Elevation. Raise the knee above heart level if possible.

    Minor injuries of the menisci and changes in wear do not require surgical treatment. The treatment is a short period of relief and then gradual training. It is often recommended to use crutches and avoid full strain on the knee joint until you notice that it goes better. In the training, special emphasis is placed on strengthening the muscles around the knee joint.

    Wear in the knee

    The knees, together with the hip joints, are the joints in the body that are most stressed throughout life. Injuries to cartilage or bone in the knee joints is a common condition called osteoarthritis. The treatment is weight loss, physical activity, painkillers, relief measures and in some cases surgery.

    Typically, there will be pain and stiffness in the knee joint. The pain is worst as soon as you start physical activity, get better after some activity, and get worse again with prolonged or vigorous activity.

    During the examination of the knee joint, the doctor will often find that the joint is more swollen than normal, and the mobility will be reduced over time. Often creaking sounds are also heard during movements in the joint.

    What can I do myself

    The purpose of treatment is to relieve the symptoms and prevent worsening of the condition. Medications are only symptom-relieving and do not affect the course of the disease. Some need surgery.

    • Weight reduction is the most important single measure when this is relevant.
    • Exercise or training with the aim of strengthening the front thigh muscles.
    • Support bandage or orthosis (relieving splint) can relieve some of the ailments.
    • Use a cane or crutch to reduce the weight load on the relevant side.
    • Engage in activities that do not strain the knee too much, such as cycling and swimming or low-intensity aerobics.
    • Wear shock-absorbing footwear.
    • When using painkillers, the use of paracetamol is recommended.

    Physical therapy can be helpful. The treatment includes physical activity and strength exercises. The goal is to strengthen the muscles and increase the mobility of the joint. Relieving measures such as shock-absorbing soles, wedge-shaped inserts under the heel or orthoses (relieving splints) can be useful. Surgery may be appropriate for some.

  • Neck

    Muscle pain in the neck
    Muscle pain in the neck is a very common disorder. It is often related to tension and little variation in working position. In the case of mental stress, or in the stress and strain of daily life, it is common for us humans to tighten the muscles in the neck and lift the shoulders. If the muscles are often, or all the time, tighter than usual, it will eventually lead to an irritation in the muscles. The muscles become numb and sore. This is the same as we can feel anywhere in the body if we have overloaded some muscle groups. With pain in the neck muscles, it is often not as easy to see the connection with overload, as it is with e.g. leg stiffness the days after a long run. When the neck muscles are tight, this will also lead to a stronger pull on the tendon attachments where the muscles attach to the cervical vertebrae and to the back of the skull. Tight neck muscles therefore also lead to pain in the head and the spine itself.

    What can I do myself
    There is no quick and effective treatment for neck pain.

    Physical activity is the best preventive measure. By identifying what is likely to be the cause of the problem and processing it, many people can cure their neck pain relatively quickly. In some people, a fear of movement will develop as a result of the pain. In such situations, it is important to break the vicious circle that could otherwise lead to more prolonged ailments.

    Physical exercise is the most important measure, not least to prevent ailments.

    Specific strength training (weights that could be lifted 8-12 times in 3 sets, 3 times a week of 20 minutes) has a lasting effect ten weeks after the end of the training. Cardio training also reduces the intensity of pain, but only for a short time and to a lesser extent than strength training.

    Relaxation exercises can be useful, especially if you have a problem related to stress management.

    In some patients it may be appropriate to use medication, but this is the exception. In that case, the current medicine is paracetamol.

    In addition, there are also offers in the form of physiotherapy, massage, heat treatment and acupuncture.

    Sick leave should be avoided if possible as it is better to get started with your usual chores.

    Crick in the neck

    Acute crick in the neck often causes the head to lock in a skewed position. Characteristics of the condition are pain in the neck and shoulders and that they go away on their own. The causes of kink in the neck are not known for sure.

    A typical medical history is that the patient wakes up one morning with a stiff, painful neck after lying with his head in a skewed position at night. In some cases, the condition can occur after straining in connection with physical activity, or by neck injury. In children, the condition can also occur with infections with swollen lymph nodes.

    Kink in the neck is common, and is most common in people between 15 and 30 years.

    What can I do myself

    Acute kink in the neck is in most cases a harmless condition that always goes away on its own. In order to accelerate the improvement and alleviate the ailments as much as possible, it is important to have relief and good support for the neck. The relief can be in the form of pillows that provide extra support. If needed, the pain can be alleviated with the help of painkillers, such as Ibux or Paracet.

    If there is no improvement within two weeks, which is very unusual, a referral to a specialist is recommended.

    Neck prolapse
    Wear or damage to the intervertebral disc in the neck can lead to prolapse that presses against nerves that extend from the cervical spine. It can cause radiating pain in one arm and / or weakened force in the arm.

    It is often the case that the prolapse or surrounding tissue becomes irritated or inflamed, and swells up. Then it becomes narrower in the nerve canal, the pressure on the nerve increases, and pain and discomfort increase.

    Neck prolapse can come on acutely or insidiously over time.

    Anyone can get disc herniation, some groups are more likely to get the condition.

    • People who have several relatives with the same condition
    • People with congenital changes in the vertebrae
    • People who smoke. It has been shown that there is an increased incidence of prolapse among smokers. It is believed today that the reason may be that smokers have poorer blood circulation to the back discs

    What can I do myself
    Most people who have neck prolapse recover well on their own. Admittedly, the ailments can come and go, but for many, the discomfort is bothersome for a period of time, only to never return later.

    Many people do well with taking mild painkillers when they have ailments. In some cases, it may be appropriate to use stronger painkillers or anti-inflammatory drugs. These are medications that alleviate the irritation around the prolapse.

    The further treatment depends on the size of the prolapse. For most people, it is important to take measures that make the condition go away on its own. For example, you should avoid activities that put a lot of strain on your neck. A good rule of thumb is not to do things that cause pain. You should be careful with running, jumping and the like in the beginning. The same debt are unilateral positions of the neck and back.

  • Back

    Low back pain
    60-70 percent of the population will experience back pain one or more times during their lifetime. We believe that the most important causes of low back pain are overexertion or overload of muscle groups or ligaments in the lower back.

    In most cases, pain and stiffness occur acutely in connection with lifting or twisting. In many of those who get long-term ailments, there have been injuries or strains in advance that have weakened the structures in the back. There may be muscle wear due to prolonged one-sided stressful work, or there may be calcifications in the skeleton or ligaments. Skews in the back will also increase the risk of incorrect loads and pain.

    Mental conditions seem to play a role as well and are often important contributing factors in chronic back pain. What comes first or last is not always easy to decide, but dissatisfaction, stress, anxiety, depression are examples of conditions that can be important.

    What can I do myself
    A pain-free and strong back is important for our ability to function.

    In both acute and more chronic cases, there are some pieces of advice that seem to be of great importance in preventing the back from stiffening and becoming a permanent problem:

    • Bed rest should be avoided, the absolute maximum is 1-2 days in connection with the most intense pain. Bed rest weakens the muscles and delays healing.
    • Heat treatment can reduce pain and improve function somewhat.
    • Early activity is important. You should resume normal activities as soon as possible, even if it still hurts your back. The pain in this context is a sign that you are using the injured part of the back, and this is important to prevent it from stiffening. Studies clearly show that the earlier you get active, the faster you get well. You should try to get back to work as soon as possible, even if you still have back pain.
    • Exercise is important when the acute ailments are over. The training should consist of general cardio and exercises to strengthen the abdominal and back muscles. The training leads to better blood flow in muscles and tendons, and thereby better repair ability. Even in a person with chronic back pain, this is useful, but it takes time and requires perseverance and courage.

    Some people may need painkillers in the acute phase and during periods of a lot of pain. Paracetamol is often used alone or in combination with anti-inflammatory drugs such as ibux.

    For patients who experience multiple acute episodes, regular exercise when you are healthy can help prevent new episodes.

    What all therapists seem to agree on is that self-training and activity are the most important elements in all forms of treatment of patients with chronic back pain.

    Disc herniation and sciatica

    The spine consists of vertebrae with adjacent cartilage discs between the vertebrae. The discs are important for damping shocks, and for the vertebrae to be able to move in relation to each other.

    The individual disc consists of a fixed outer ring with a soft core in the middle. The outer ring may rupture due to aging changes, or due to acute strains. When the capsule ring ruptures, parts of the soft core may protrude and remain as a pouch on the outside of the disc. It is this bulge that is called prolapse. If the prolapse presses against the nerve, which runs out into channels between the vertebrae, this will lead to pain and possible damage to the nerve. The disease is thus localized in the back, but the typical symptom is back pain with radiating pain to one of the legs.

    Most well known is sciatica, which is a specific form of root pain in which the prolapse presses on the sciatic nerve. This leads to pain from the back and down the foot corresponding to the course of the sciatic nerve. Sciatica can occur in all age groups, but the condition is most common in the 30-50 age group

    What can I do myself

    In the beginning, you do not give any active treatment, but wait and see how the condition develops. It is recommended that you try to be a little active, rather than staying in bed. Pain medication is often needed in the first few days.

    When the acute inflammation subsides, the symptoms will subside. After a few days or weeks, the prolapse may also decrease in size, and the symptoms due to pressure disappears. During this period, it is natural to avoid strains that aggravate the pain. It is still important to make sure you get into physical activity as soon as possible. Be sure to keep moving, and start taking short walks as soon as possible. Most people get well this way, but it can take several weeks and months before the ailments are completely gone.

    Research has not shown that general physical therapy, exercise or chiropractic (manipulation treatment) leads to improvement. Based on experience, however, exercise seems to have a beneficial effect in getting started when the acute pain period is over. The most important thing in such treatment is to get started with movements, so that the back does not stiffen. It also appears that a general strengthening of the stomach and back muscles are useful. Any treatment by a physiotherapist should be set up so that the patient learns how exercise can take place on their own.

  • Shoulder

    Shoulder pain is pain based in and around the shoulder joint itself.

    Shoulder pain is usually due to tendonitis, mucositis or frozen shoulder- mixed conditions can occur

    Tendonitis, tendinopathy, in the shoulder is an irritation of a tendon, usually as a result of injury or congestion.

    A distinction is made between acute and chronic (long-term) tendonitis.

    The main symptoms are pain in the shoulder that worsens with certain movements, which depends on which tendon is inflamed. The pain reduces the function of the shoulder. In some people, the pain occurs after unfamiliar work or activity.

    Congestion is the most common cause of ailments.

    What can I do myself
    The goal of treatment is to alleviate the pain and to drive the inflammation back with, for example, anti-inflammatory drugs such as ibux. However, it is not always necessary to use medication. In the first place, it is important to adapt physical activity to avoid the activities that trigger or aggravate pain. At the same time, you should avoid keeping your arm as still as possible. Then the shoulder stiffens, and it can take a long time and give you a lot of trouble to get up the movement again. There may be a need for adaptation in the workplace or possible sick leave if the ailments are related to your work situation. Then it is important that you implement a gradual training program that should be supervised by your therapist.

    Frozen shoulder
    Is an inflammation of the synovial membrane that surrounds the shoulder joint. The synovial membrane eventually sticks together with the joint head, and this results in prolonged pain and significant mobility in the shoulder.

    Frozen shoulder is a very disabling condition. It usually lasts for 1-3 years, but some may still feel symptoms ten years later. About 15 percent will develop inflammation in the other shoulder as well, this usually happens within 5 years. The incidence of frozen shoulder is just over 2 percent. Frozen shoulder is most often found in people between the ages of 40 and 70. Women are more vulnerable.

    What can I do myself
    The purpose of the treatment is to relieve the pain and to prevent the condition from becoming chronic. It is important that you keep your arm moving within the pain-free area.

    Cortisone injections into the shoulder may be appropriate. Cortisone is a hormone that reduces inflammation and provides pain relief. Repeated such injections into the shoulder joint can reduce the pain and improve the quality of life. Treatment is stopped when the pain is under control, and this usually happens after 4-6 injections.

    Other medications used are anti-inflammatory tablets, Nsaids, for short periods if the syringes do not have the desired effect. In addition, common over the counter painkillers are also used.

    Physiotherapy should be avoided. Such treatment does not seem to provide any benefit in frozen shoulder, and too intensive physiotherapy can aggravate the condition.

    Surgical treatment is little used for the condition. This is especially because most people will get well by themselves.

    Mucus bag inflammation shoulder
    Shoulder bursitis is caused by inflammation of the mucous membranes of the shoulder. These mucous sacs lie between the tendons, and they can swell and cause pain when inflamed.

    The condition can be acute or chronic (prolonged).

    Acute inflammation in one or more of the shoulder mucous sacs, bursae, causes significant pain in the shoulder within hours to a few days. Acute bursitis of the shoulder is perhaps the most painful of all the inflammations that can occur around the shoulder joint, and it is accompanied by significant dysfunction. The pain will develop over a short period of time and is localized to the shoulder and the front of the arm. The pain will be strong even when the arm is at rest and at night. Often the pain can be so bad that you can not sleep. The patient will have problems using the shoulder, for example to get dressed.

    Chronic inflammation is a persistent inflammation of the mucous membranes of the shoulder. These pains are clearly milder than those caused by acute bursitis. The pain will usually be located on the side of the shoulder, sometimes with radiation down the front (bending side, inside) of the arm. The pain is usually felt only when you are active, and they have often lasted for a long time. Unaccustomed work and strain can lead to flare-ups of inflammation. Then the pain can also be present at rest and at night.

    Chronic bursitis is not uncommon. The condition is most commonly seen in young adults and middle-aged people, rarely in the elderly.

    What can I do myself
    Acute inflammation:
    The purpose of the treatment is to relieve the pain and to alleviate the inflammation. It is important that you keep your arm still for as long as the pain dictates, but only for a few days - otherwise the mobility of the shoulder joint will be quickly reduced. Cooling down with an ice pack against your shoulder can make sense the first day, for example 10 minutes per hour. In addition, you should take painkillers such as paracetamol or an NSAID such as ibux.

    Chronic inflammation: The purpose with treatment is to relieve the pain. You can use your arm freely within the pain limit. Lifting the arm above shoulder height should be avoided because it causes the mucous sacs to be squeezed. This will cause pain and maintain the inflammation.

    The most effective treatment method for chronic shoulder bursitis is injection of steroids. Such treatment has an anti-inflammatory and analgesic effect, and is often combined with local anesthesia in the mucous sacs. Such treatment can be repeated up to three times at 1-2 week intervals.

    "Gout medications" Nsaids that are both pain-relieving and anti-inflammatory can be tried, but they rarely provide more than temporary relief.

    In chronic cases, long-term exercise therapy may be helpful. Surgery may be appropriate to make it more spacious around the mucous sacs so that they are less congested.

  • What can Eyr help with?
    • Eyr can assess which disorder you most obviously suffer from
    • Eyr can provide advice and guidance on the condition
    • Eyr can guide you on your own training
    • Eyr can refer to physiotherapy and chiropractor
    • Eyr can refer to imaging if necessary
    • Eyr can prescribe painkillers and renew regular medications
    • Eyr can refer to specialist assessment if needed
    • Eyr can conduct a support interview
    • Eyr can assess children's musculoskeletal disorders, guide and provide reassurance about the way forward
    • Eyr can, with some exception, write short-term sick leave of 1-2 days
    • Eyr can be helpful with a doctor's statement
    • Eyr can discuss imaging findings by X-ray, MRI or CT

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Reference: Norwegian Medical Handbook, NEL. Edited and medically quality assured by Dr. Theresa Franck, specialist in general medicine.