They are focal pathologic conditions affecting muscles, tendons, ligaments, bursa, subcutaneous tissues. They include small & large joint disorders(arthritis, periarthritis, infections, bursitis etc), back pain, neck pain, fibromyalgia,complex regional pain syndromes(reflex sympathetic dystrophy), nerve entrapement syndromes like carpaltunnel syndrome, tarsal tunnel syndrome, brachial neuralgia etc. Key to diagnosis of these disorders is through clinical examination along with good cinical history. Extensive testing is not very helpful to identify these conditions. Among these disorders fibromyalgia is challenging both interms of diagnosis and management.

Treatment of these disorders includes pain killers, good physiotherapy, nutritional support, repeated councelling and reassurance, correction of underlying vitamin D deficiency, thyroid abnormalities, sleep disturbance etc.