Musculoskeletal pain and work related injuries


Musculoskeletal (MSK) injuries refer to problems affecting the muscles, bones and joints of the limbs and spine. It is estimated that approximately 30% of all GP consultations relate to problems with the musculoskeletal system. Musculoskeletal disorders are by far the most prevalent cause of work-related illness in the UK affecting twice as many people as stress. They result in 9.5 million lost working days, and currently cost society £7.4 billion a year.

Common examples include pain, swelling or clicking affected the knee, shoulder, lower back, elbow and Achilles tendon and sciatica.

Work related problems are usually due to overuse, poor technique and posture. Typical examples of work related conditions are wrist pain due to constant use of keyboard in an office worker and constant use of tools and equipment in a manual worker. Poor posture related to sitting long hours at a desk can lead to neck strain, low back pain, shoulder and elbow symptoms.

Whether someone is an elite athlete, an office worker who is a recreational runner or a busy mum with young children, anyone can develop musculoskeletal complaints. The mechanism of injury could be diverse and multifactorial. The management of work and overuse injuries focuses on the aggravating factors, pain relief and rehabilitation.

As a sports physician, Dr Kulothungan has the skills and experience to treat anyone with a musculoskeletal complaint. Both in the NHS and in private practice, Dr Kulothungan uses a one-stop clinic approach in most cases from diagnosing to treating on the same day*. This is aided by the use of diagnostic ultrasound and ultrasound guided procedures all performed at the same clinic visit.

It is also estimated that sports and MSK physicians manage over 80% of their patients without the need for referral to surgeons 

* Please note that the "one stop clinic" is not applicable to all conditions. This is usually available in his NHS practice and at the London private clinic (Freedom Clinics).


Some conditions would require further investigations prior to any interventional treatment. 


Private patients would need prior approval from their insurers for ultrasound scans and injections.


Self funding patients should consider ultrasound diagnostic costs which are additional to the consulting fees.


Combined direct and indirect costs of physical inactivity CMO Report 2005

2 ARUK report on the use of exercise in managing MSK conditions 2017

3 Sport & Exercise Medicine A Fresh Approach in Practice – NHS Information Document 2014 main trends and clinical outcomes.

4 The Work Foundation Report – Fit for Work?  MSK Disorders and Labour Market


Sport & Exercise Medicine A Fresh Approach in Practice – NHS Information Document examples of MSK Models of Care Primary and Secondary. Tay Vision 10 Years of Primary Care MSK Services Presentation by Dr Niall Elliot FFSEM.