Bones, Joints, and Muscle Disorders
SOFT TISSUE RHEUMATISM
Among the most common of musculoskeletal disorders are those which cause pain in muscular or tendinous areas of the extremities but not in joints. These are collectively termed "soft tissue disorders" and include a variety of localized forms of tendinitis and bursitis, as well as other more generalized pain disorders. These disorders are common causes of pain in the shoulder, elbow, hip, neck, and foot.
Muscles are attached to the bones they move by string-like structures called tendons. While soft tissue pain can often be localized to particular muscles and their attached tendons, the cause of this pain is poorly understood. For tendinitis, the cause may be related to muscle and tendon over-use. For shoulder and neck pain, overuse may be coupled with an acute or chronic injury. These disorders are often self-limited and respond to anti-inflammatory medications, but they often recur. Seven percent of the U.S. population has had an episode of shoulder pain lasting at least a month. Ten percent of the population reports neck pain of this duration. The prevalence of most of these disorders increases with age, and they are more prevalent in women than men.
Fibromyalgia is a generalized chronic disorder of diffuse muscular pain that constitutes a subtype of soft tissue rheumatism. Fibromyalgia affects up to 2 percent of women of all ages (it is much less prevalent in men) and is associated with a sleep disorder; with diffuse aching in the neck, back and extremities; and with fatigue and depressive symptoms (either as a trigger of the disorder or as a consequence of it). Treatment includes analgesic and sleep medications.
DAVID T. FELSON
Felson, D. T. (2000). "Epidemiology of the Rheumatic Diseases." In Arthritis & Allied Conditions, ed. W. Koopman. Philadephia, PA: Lippincott, Williams & Collens.