Bones, joints, tendons and muscles: they keep us upright, get us from one place to another and allow us to perform a wide variety of movements. But the forms of wear and tear on our skeletal structure are varied, usually painful and consequential for work and leisure. What is the function of bones and joints and how is everything connected? What complaints can occur and what examinations can a doctor perform? We present the most important connections here.
Structure and function of bones and joints
The human skeleton consists of more than 200 bones, most of which are connected by joints. The joint surfaces are covered with cartilage and synovial fluid – making movement possible. Tendons and muscles support the joint connections and enable the movement of bones in the joint. The skeleton, along with the muscles, keeps us upright and allows us to perform a wide variety of movements – natural to us until discomfort forces us to rethink our movement patterns.
Common joint complaints
Pain is most common in the musculoskeletal system. Whether it’s neck, back or knee pain, pain on movement or after a fall, sore muscles or a limb that has fallen asleep, pain comes in many forms. Back pain can occur even in children, because the weight of the school bag is often more than is allowed. Lumbago (also called lumbago) is common and can be triggered by tense back muscles in addition to disc problems. In addition to pain, restricted movement is another important symptom that something is wrong with muscles or joints. Joint wear and tear (arthrosis) or joint inflammation, as in rheumatoid arthritis, can lead to restricted movement, as can scars or a bone fracture, as often occurs in osteoporosis or in childhood. Malpositions of the joints, as in hallux valgus, or of bones in relation to each other, as in flatfoot or hollow-countersunk splayfoot, are also common conditions. In addition to infections of bones or joints, bone cancer also occurs on the skeleton – or metastases from breast or colon cancer develop, leading to severe pain in the spine. Pain and restricted movement are often associated with swelling and overheating of the affected area in the case of rheumatic inflammation. In addition, there may be a noticeable loss of height – this does not refer to the normal difference in height that occurs in everyone throughout the day, but a loss of height as in ankylosing spondylitis.
Rheumatism: four groups of this disease
Rheumatism is actually rather a collective name of different diseases: Between 200 and 400 diseases of the musculoskeletal system are grouped under the term rheumatism. The four main groups include:
- Degenerative diseases such as osteoarthritis of the hip joints, complaints of the Achilles tendon, tennis or mouse arm and intervertebral disc damage.
- Inflammatory rheumatic diseases such as rheumatoid arthritis, ankylosing spondylitis, joint involvement in psoriasis or during and after an infection (Lyme disease and Reiter’s disease).
- Metabolic diseases with rheumatic complaints such as gout, osteoporosis – which can occur in men as well as women – or rickets.
- Soft tissue rheumatism such as fibromyalgia
Injuries to bones, joints and ligaments, ranging from a mild sprain to a fracture or ligament tear, are among the diseases of the skeletal system. Thereby, both in childhood with the greenwood fracture, then during the sport-active midlife and in old age typical dangers are given – whether by overstraining (often in the case of fracture of the neck of the femur after a fall) or overestimation of their own abilities (in sports injuries).
Examinations for problems with bones and joints
In the case of bone and joint problems, the doctor has several options for making a diagnosis. We present the most important measures below.
Medical history
All complaints can be further narrowed down by asking specific questions. It is precisely this questioning of the medical history that takes place in the context of an anamnesis. Especially the duration of the pain and the dependence of the occurrence on the time of day or the activity often allow an initial differentiation between wear and tear disease or rheumatic inflammation.
Inspection and percussion
In gout and advanced rheumatoid disease, the finger and big toe joints are often characteristically deformed. The physician determines this by looking at (inspecting) the corresponding parts of the body. Careful tapping (percussion) of the spine can indicate whether cervical, thoracic, or lumbar vertebrae are involved in the pain pattern in cases of lumbago.
Functional testing
Each joint can be flexed or extended at a specific angle. Gently moving all joints indicates how much the range of motion is reduced. Especially during the course of the disease, these values are important to check whether the disease is continuing or whether therapy is successful.
Osteodensitometry
This method is used to test bone density – bone density measurement is particularly important in osteoporosis.
Blood and hormone tests
Blood and hormone tests help get to the bottom of the cause of increased bone loss in osteoporosis. Blood tests also help in rheumatic diseases to find substances produced by the body with which the immune system attacks its own body (autoimmune antibodies).
Imaging techniques
Imaging techniques include x-ray, ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI). Radiographs reveal many diseases of the boneskeleton (fractures, attachments and remodeling in bone zones near joints, spinal misalignments). Magnetic resonance imaging (MRI) is very good at detecting disc damage. Joint and muscle changes are visible in ultrasound. Sometimes it is also necessary to look inside a joint – this then requires an arthroscope.
Tips for bones and joints
Of course, there are different options for therapy for each disease, for example with medication or surgery. In many cases, however, regular exercise and the avoidance of excess weight are important pillars of therapy – as well as prevention, by the way. Excess weight puts additional strain on bones and joints – which is why it is better for those affected to lose every kilo of excess weight. Targeted exercises help to build up muscles and reduce tension. Fitness – also at the workplace – and back-friendly sitting at school and in the office prevent back pain. Foot bone health can be supported by the right footwear.
Exercise to strengthen bones and joints
If you have back pain, there are plenty of exercises to strengthen your back. Whether with Pezziball or Thera-Band, back gymnastics or muscle training – the possibilities to do something for the weak point of the back are large. However, physical fitness should be determined before extended sporting activities so that no additional injuries occur. Nordic walking or cycling are sports that are easy on the back. But here too, too much can cause damage. For sports injuries, apply the PECH rule (rest, ice, compression, elevation); enzymes can also help. Enzymes or collagen hydrolysate are also given for joint wear or knee pain, so surgery may be unnecessary.
Healthy diet for joints and bones
A diet rich in calcium, which also contains plenty of vitamin D and vitamin C, benefits bones and connective tissue. Likewise, silica helps the body regenerate. However, dietary supplements, as they are often offered for athletes, are usually superfluous. In particular, to prevent osteoporosis, a calcium-rich diet (lots of dairy products) should be a matter of course from a young age. Cola in particular, as a popular teenage drink, can permanently reduce bone density and should therefore only be drunk in small quantities.
Various therapy options
Surgery – except for fractures – is often the last therapeutic option when medications and exercise therapy have been exhausted: Whether outpatient or involving hospitalization for extensive procedures, there are many novel treatment concepts, such as a cervical disc prosthesis. Selected clinics offer computer-assisted healing water therapy or the combination of TCM, thermal bathing and art therapy for rheumatism or knee damage.
