Pain
Most patients with diseases and traumatic conditions or disorders of the muscles, bones, and joints experience pain. Bone pain is typically described as a dull, deep ache that is “boring” in nature. This pain is not typically related to movement and may interfere with sleep. Muscular pain is described as soreness or aching and is referred to as “muscle cramps.” Fracture pain is sharp and piercing and is relieved by immobilization. Sharp pain may also result from bone infection with muscle spasm or pressure on a sensory nerve. Joint pain is felt around or in the joint and typically worsens with movement . Rest relieves most musculoskeletal pain. Pain that increases with activity may indicate joint sprain, muscle strain, or compartment syndrome, whereas steadily increasing pain points to the progression of an infectious process (osteomyelitis), a malignant tumor, or neurovascular complications. Radiating pain occurs in conditions in which pressure is exerted on a nerve root.
The time of day that the pain occurs may be important to evaluate. Those experiencing pain with a rheumatic disorder experience pain that is worse in the morning, especially upon waking. Tendonitis worsens during the early morning and eases by midday, whereas osteoarthritis worsens as the day progresses . Pain is variable, and its assessment and nursing management must be individualized.