Painful Musculoskeletal Disorders in Children with Neurological Diseases (part 1)

Changes in movement and posture, sensory and motor functions are observed in all congenital and acquired diseases of the brain, spinal cord, nerves and muscles. Depending on the duration of the disorder, reversible and/or irreversible changes in the movement function and form of the movement organs occur, which follow biomechanical laws. As these musculoskeletal changes are commonly responsible for underestimated pain, immobility, a lack of social participation and thus a massive reduction in quality of life, detailed knowledge of functional anatomy and these laws is necessary as the basis for successful prevention and treatment. The most important aspect of early diagnosis is the prompt recognition of strength imbalances in joints, altered lever arms of the musculature, chronic pain as a sign of reactive overload and the start of movement restrictions. Screening programs should be developed that include all disorders and that can be quickly implemented in everyday clinical practice. The earlier prevention and treatment of neuro-orthopaedic problems in chronic neuromotor diseases begin, the more successfully undesirable developments as well as irreversible secondary damage, structural changes, malposition, contractures (sub)luxations, loss of function, immobility and disabilities can be avoided. In the first part of this work, the relevance and pathophysiology of these musculoskeletal changes are described.