Surprising new data and ongoing initiatives highlight that increasing pain and disability associated with musculoskeletal disorders may have reached pandemic proportions. Musculoskeletal diseases are the greatest cause of disability — topping the list in the United States and second only to mental and behavioral disorders worldwide — according to newly released reports. Back pain was found to cause the most disability worldwide, while osteoarthritis has shown the greatest increases in the last 20 years.
They newest study, Global Burden of Disease 2010, published in The Lancet December 15, 2012 [available here], is the first comprehensive research into the worldwide impact of all diseases and risk factors. Among other findings, researchers conclude that musculoskeletal (MSK) conditions such as arthritis and back pain affect more than 1.7 billion people worldwide and have the 4th greatest impact on the overall health of the world population, considering both death and disability. This burden has increased by 45% during the past 20 years and will continue to escalate unless action is taken.
This landmark study of the global burden of all diseases provides indisputable evidence that MSK conditions are an enormous and emerging problem in all parts of the world and need to be given the same priority for policy and resources as other major conditions like cancer, mental health, and cardiovascular disease. The Global Burden of Disease 2010 project was led by Professor Christopher Murray, Institute for Health Metrics and Evaluation, Seattle, Washington, and involved researchers from around the world. Here are some key facts:
- Musculoskeletal conditions include joint diseases such as osteoarthritis and rheumatoid arthritis; back and neck pain; osteoporosis and fragility fractures; soft tissue rheumatism; injuries due to sports and in the workplace; and trauma commonly related to road traffic accidents. They cause pain, physical disability, and loss of personal and economic independence.
- Current estimates of people affected worldwide include: back pain 632 million, neck pain 332 million, osteoarthritis of the knee 251 million, and other MSK conditions 561 million [all numbers rounded].
- As a group MSK disorders cause 213% of all years lived with disability (YLDs), which is second only to mental and behavioral disorders that account for 22.7% of YLDs. The leading cause of disability worldwide is low back pain contributing 10.7% of total YLDs, as compared with major depression contributing 8.1%.
- Major contributors among MSK disorders are low back pain (83.1 million YLDs), neck pain (33.6 million YLDs), and osteoarthritis (17.1 million YLDs). Osteoarthritis of the knee accounts for 83% of the osteoarthritis category total.
- Disability due to MSK disorders is estimated to have increased by 45% from 1990 to 2010 compared to a 33% average across all other disease areas. Osteoarthritis is the fastest increasing major health condition, which relates to aging of the global population, increased obesity, and lack of physical activity.
- Disability due to MSK conditions can be effectively prevented by currently available interventions, such as accident prevention, modern treatment of arthritis and injuries, and by rehabilitation. The growing burden can be controlled if a high priority and ample resources are provided to ensure access to these interventions.
In the United States, a nationwide network of organizations has been working on the U.S. Bone and Joint Initiative (USBJI), which provides a forum for all stakeholders concerned with musculoskeletal health, raises the profile and priority of bone and joint health and disease prevention, and supports the advancement and expansion of musculoskeletal care and research through data dissemination, awareness-building programs, education initiatives, and advocacy [see website here]. Data on the prevalence of MSK disorders in the U.S. is published in their report, The Burden of Musculoskeletal Diseases in the United States: Prevalence, Economic and Societal Cost (2nd Edition). [document here]. Here are some key facts regarding the burden of MSK disease in the U.S.:
- In the 2008 National Health Interview Survey (NHIS), musculoskeletal conditions were reported by more than 110 million adults, and more than 1 in 4 persons in the U.S. has a MSK disorder requiring medical attention.
- Annual direct and indirect costs for bone and joint health are $849 billion — 7.7% of the gross domestic product.
- Research on MSK disorders currently represents less than 2% of the U.S. National Institutes of Health budget, while the burden of musculoskeletal conditions is expected to escalate in the next 10 to 20 years due to the aging population and sedentary lifestyles.
- MSK disorders and diseases are the leading cause of disability in the United States and account for more than half of all chronic conditions in people over 50 years of age.
- More research is urgently required if health and economic burdens are to be contained or lowered.
According to this report focusing on the U.S., and using 2008 census data, musculoskeletal conditions top the list in terms of the prevalence of self-reported primary medical conditions among persons aged 18 and over — or an age-adjusted prevalence rate of ≈48%. This is followed by emotional disorders (prevalence rate ≈35%), circulatory system disorders (≈30%), respiratory disorders (≈24%), and migraines/severe headaches (≈12%).
In sum, the impact of MSK disorders on individuals, families, and society is colossal. Yet, these conditions are not among the top 10 diseases funded by research, primarily due to the low mortality from these compared with other severe health conditions. However, it must be considered that the morbidity costs of MSK disorders are quite significant, because these disorders restrict activities of daily living, cause lost work days, and are a major source of lifelong pain.
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3 comments:
We need better ways of dealing with chronic pain as you all can see it affects millions of people.
Pain medications are being demonized to the point to where doctors are afraid to prescribe them and pharmacist don't want to fill them.
We must make these medications available for all the suffering people of the U.S.
Its become almost criminal to obtain these medications that can in return give suffering people their life back and make life somewhat livable.
I am very unhappy that in 2012 they not only cut 25% of my muscle relaxer, but also: I must go to a "Pain Mgt" physician every 30 days - paying a co-pay, to get a Rx I've been taking the same dose of for 20 years. They cut the dose and make me pay every 30 days??? This is wrong in so many ways,
Speaking of pain meds.... And I realize this is off topic. However, my husband had surgery this month. The surgeon called in a script to the pharmacy my husband has been going to for almost 20 years. He has chronic asthma & allergies, and spends hundreds of dollars a month at this CVS where he gets his scripts filled. He hasn't had an RX for a controlled substance for almost ten years. (Not since his LAST surgery when he needed post op pain control). Anyway... The doc called in his prescriptions after the surgery. Three altogether. The pain medication was Vicodin...less than 20 tablets of the lowest dose! When we went to get his prescriptions, they were all filled accept the Vicodin RX. They hadn't filled it, and said they needed the "written script" first. Well, that's not true, it's not a schedule II medication. Anyway, we gave the written script, and they said it would be AN HOUR to fill. So, he is in PAIN, in the car, waiting. I had to bring him home, get him settled, and head back to the pharmacy. A thirty minute drive EACH way. When I got there, they STILL hadn't filled it, and said they thought we were taking the script somewhere else, and didn't want to wait. How would we do that, when the doc called it in at THIS pharmacy, and they had our written script? I finally said, "do you need me to call the surgeon, so he can speak with the pharmacist?....my husband just had surgery today!". No.... They said. That won't be necessary. But! It will be a twenty minute wait!!!!!!! So, 20 minutes, 60+ minutes, then 20 minutes again. Absolutely ridiculous!
Needless to say, I don't use CVS for my own prescriptions.
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