One of the best parts of my job as a family medicine interest group and family medicine career advisor is reading student drafts of their personal statements for residency applications. It is deeply rewarding to read the students’ values highlighted in their stories and experiences. One of the values that students often highlight as they describe their reasons for joining this field is whole-person care.
I thought about whole-person care frequently as I worked on this edition of FP Essentials. Musculoskeletal conditions are often acute and episodic; a single injury occurs and heals, and the patient is back to baseline quickly. Just as often, though, musculoskeletal conditions are chronic, ongoing concerns, and these require a whole-person approach to care. Chronic conditions are associated with significant mobility restrictions that can affect other health problems, such as respiratory or cardiovascular disease.1 Ongoing pain from musculoskeletal or other sources is associated with anxiety and depression as well.2 Taking care of the musculoskeletal concern truly means taking care of the whole person.
This edition of FP Essentials addresses acute and chronic aspects of musculoskeletal care. The first section reviews fracture management, with focuses on recognizing injuries that can be safely managed in family medicine and those requiring referral. The second section discusses injection therapies, emphasizing indications, techniques, and safety considerations when using corticosteroids, prolotherapy, viscosupplementation, and other injections. The third section explores physical modalities, including exercise, physical therapy, osteopathic manipulation therapy, and other nonpharmacologic approaches to treating musculoskeletal pain. In the fourth section, you’ll find information on screening for and diagnosis of co-existing mental health conditions, as well as information on integrative therapies. This section also recommends ways to assess the quality and reliability of integrative therapies, which is useful for both clinicians and patients.
I hope you share my optimism about the students who are writing these thoughtful personal statements, and I hope you find this edition useful in your clinical practice.
Kate Rowland, MD, MS, FAAFP, Associate Medical Editor
Vice Chair of Education and Associate Professor,
Department of Family Medicine
Rush University, Chicago, Illinois
