Every musculo-skeletal pain has its own character. Neck or back pain may be acute or chronic. However all pain do not seek treatment — most of them are self-limiting. Musculoskeletal pain that causes mild to severe disability that hound doctors to diagnose the exact cause. For instance, knee pain that limit your movement may cause from various sources.

If the patient is elderly we can primarily diagnose this as osteoarthritis. Just an x-ray of the affected knee joint can confirm the diagnosis. Thus the treatment will be very simple, which is electrotherapy.

Nonetheless, electrotherapy capitulates in the case of nonspecific knee pain. Doctors then go for a differential diagnosis like ligament or meniscus injury or even internal derangement of the knee joint. Manipulative physiotherapy in internal derangement or in mild ligament injury is absolutely golden. Three to seven sessions of manipulation can ease the patient from severe knee pain.

Neck pain sometimes may be stubbornly severe, dogmatic in character. This type of neck pain may occur all on a sudden.

A patient, 32, was absolutely alright at night but in the morning developed bizarre neck pain. Now she is unable to even turn her neck to the right. However, x-ray showed nothing except little straightening of the cervical column. This could be of muscular origin. Neck muscles, especially a muscle named 'sternocleidomastoid' can lose its elasticity due to poor posture during sleep and can cause severe pain. Three to four sessions of skilled manipulative therapy can relieve the patient from pain and make him/her feel fit.

A patient aged 60 with diabetes suffering from neck pain for more than three weeks deserves advance investigation like MRI. Treatment will depend on MRI findings. This case can be managed by electrotherapy. We have a lot of physical equipment in our hand and can use them in proper dose and manner to relieve mild to severe pain.

Musculoskeletal pain can swindle. Doctors should be shrewder than the pain. Manipulation or electrotherapy can be a powerful weapon to control the pain. It is easy and effective when you will choose right weaponry for the right enemy.

Dr Mohammad Ali is the Head of Physiotherapy Department of Uttara Adhunik Medical College Hospital, Uttara, Dhaka.

Email: hprc2005@live.com