What is musculoskeletal (MSK) pain?

Reviewed By Dr. Alex Barrow, PT, DPT

If your knees ache on stairs, your back tightens after sitting, or your hip feels stiff in the morning, you are not alone. These are common signs of musculoskeletal pain, which involves muscles, bones, joints, tendons, and ligaments.

Globally, an estimated 1.7 billion people live with a MSK disorder. It is the leading cause of disability worldwide.

MSK pain: what is it exactly?

MSK pain is any pain, stiffness, or loss of movement in the body’s support system. It may start suddenly after an injury or build slowly due to overuse, strain, posture, or aging.

The system behind your movement

• Muscles: generate power and move our joints

• Bones: provide structure between our joints

• Joints: allow motion between our bones

• Tendons and ligaments: connect and stabilize joints and bones

• Nervous System: provides the instruction for how and when our muscles activate

Like an orchestra, each structure plays an important role, and must work together in harmony to provide efficient and effective mechanics. When one part is stressed or inflamed, the rest compensates. That compensation can create pain or imbalance somewhere else.

What causes musculoskeletal pain?

There is rarely a single cause. Most MSK pain comes from mechanical overload and imbalance that place extra stress on tissues over time.

Common Causes

• Repetitive movements or overuse from exercise, sports, typing or other work -life demands

• Muscle weakness or imbalance

• Poor posture or suboptimal ergonomics

• Sudden trauma such as falls, sprains, or fractures

• Joint wear and tear such as osteoarthritis

• Nerve compression such as sciatica or carpal tunnel

• Inflammatory or autoimmune conditions such as rheumatoid arthritis or lupus

Even active people can develop MSK pain if they move inefficiently. Examples include walking with asymmetry, sitting slouched for long periods, or standing with locked knees. 

The challenge is that these aspects are normally silent and subconscious. We do not tune into the small differences with our mechanics or posture until pain is present.

What are the risk factors for MSK disorders?

Certain factors make musculoskeletal pain more likely or more severe, especially as we age.

What does MSK pain feel like?

Symptoms vary by cause and tissue involved, as well as the mechanical positioning of the joint. Knee pain may be more intense or “sharp” on the stairs, and less intense or “dull” while walking:

• Dull, aching pain in muscles or joints

• Sharp or shooting pain from nerve compression

• Burning or tingling from nerve irritation

• Stiffness after rest

• Weakness, fatigue, limited mobility

Morning stiffness that eases with movement is a common early sign of joint degeneration or poor circulation.  This early sign should not be ignored, but addressed.

How is MSK pain diagnosed?

As mentioned, our movement systems all interact with and influence each other; A thorough evaluation looks beyond the sore spot to find the true driver.

• History: duration, triggers, and what helps
• Movement exam: posture, gait, range of motion, coordination, stability
  • Imaging or lab tests: when red flags or inflammatory disease are suspected
  • Functional assessment: impact on daily activities, walking pattern, and balance

The goal is to identify the root cause, not only treat symptoms. Where is the weak link in the chain? Why is the stress and load accumulating in this area?

 

Which treatments work for MSK pain?

Musculoskeletal pain management usually combines lifestyle, movement, and—if needed—medical or surgical care.

• Most people do best with a plan that combines lifestyle, movement, and targeted medical care when needed.

• Understanding the cause of the pain allows for the most specific treatment application.

 

Lifestyle and prevention

• Maintain a healthy weight

• Strengthen key muscle groups such as core, glutes, and thighs

• Move daily, even light walking to improve blood flow and joint lubrication

 

Movement-based therapy

• This is the foundation of recovery. Physical therapists use exercise, mobility work, and gait training to improve alignment and stability.

• However, Physical therapy or exercise typically does not address alignment.

 

Medication and injections

• Short-term options such as acetaminophen or NSAIDs, and localized steroid or hyaluronic injections. These can help with flares but are not a cure. 

• Steroid injections specifically should be used cautiously and measuring the short term versus long term priorities. With every steroid injection, the rate of potential surgery to address the pain goes up.

 

Mobility aids and supports

• Canes, crutches, walkers, and rollators to offload painful joints and improve balance

• Braces, sleeves, and compression wraps to stabilize and reduce swelling

• Orthotics or insoles to redistribute pressure and improve alignment. This does “assist gait” but it is an indirect effect based on the alignment change.

 

Surgical options

Consider surgery only after conservative care has been tried or if there was a traumatic injury.

• Joint replacement (hip, knee) for end-stage arthritis

• Spinal decompression or fusion for severe nerve compression

• Arthroscopy or tendon repair for structural tears

Surgery involves risks, rehabilitation, downtime and of cource high costs.

 

Device-Based Biomechanical Solutions

Living with chronic MSK pain affects far more than joints. It changes how you work, sleep, and show up in daily life.

To break the cycle, you must address how your body moves in synergy as a whole, and why certain joints are feeling more pressure or load than others.

How Apos^® works

Apos^® is an FDA-cleared medical device and treatment plan that not only relieves pain but also addresses the underlying causes behind it. Without this, you may only be “covering up” the symptoms, instead of finding a solution.

• Apos^®-trained physical therapists analyze your medical history, biomechanics, coordination, and neuromuscular patterns and responses.

• They customize your foot-worn device using uniquely calibrated pods that shift pressure away from painful areas, reducing pain immediately.

• As you walk, the pods guide your body to relearn healthier movement patterns, correcting misalignment. (one of the most common drivers of chronic pain).
• This will “unwire” the nervous system patterns that led to wear and tear and subconsciously “rewire” more effective and efficient movements.

• Over time, your body learns to move more naturally, reducing pain even when you’re not wearing the device.

 

You wear Apos^® for about an hour a day, right at home  during your normal routine.

✔ Walking around the house

✔ Making coffee

✔ Working at your standing desk

The science works behind the scenes as you go about your day.

The Results

• Significant pain relief
• Improved mobility and functionality
• Freedom to get back to what you love

FAQs about musculoskeletal pain

Can MSK pain get better on its own?

Mild pain often improves with rest and movement correction, but persistent or worsening symptoms should be evaluated by an Orthopedist or physical therapist.

Is MSK pain the same as arthritis?

Arthritis is one type of MSK condition involving joint inflammation; many other MSK problems involve muscles, tendons, or nerves.

Is heat or ice better for MSK pain?

Use ice for new swelling or sharp pain; heat for stiffness or chronic tension. Newer evidence demonstrates icing slows down the healing process… I would not recommend icing unless severe pain and no other solutions.

Does age cause MSK pain?

No. While risk increases with age, staying active, maintaining strength, and addressing posture can prevent or minimize it.

Is surgery always required for severe MSK pain?

Rarely. Most people improve with conservative care and movement-based therapies before surgery is considered.