ARTHRITIS AND MUSCULOSKELETAL PAIN

Abstract

Musculoskeletal disorders are common and have a major impact on the health and quality of life of the population as well as on the use of health care resources. There are three major categories of effects: 68 The physical and social consequences from pain, limitations on mobility and activities of daily living, loss of independence, and a reduced quality of life. Direct costs of diagnosis and treatment of musculoskeletal disorders and trauma. The indirect economic loss associated with reduced labor force involvement and the lost productivity and wages incurred. A considerable literature exists documenting prevalence of widespread pain in the general population, 11 measurement of health-related quality of life, 26 health status and quality of life in rheumotologic disorders, 21, 70 pain/disability relationships in rheumatic disorders, 30, 85 risk factors for disability among U.S. adults with arthritis, 84 work behavior after onset of arthritis, 51, 91 and the cumulative impact of arthritis. 93 The impact of musculoskeletal disorders is not restricted to the community living population, ranking second only to diseases of the circulatory system in overall frequency of hospitalizations in short-stay hospitals. 68 Musculoskeletal system diseases and connective tissue disorders rank fourth by major system or disease category in frequency among nursing home residents. 68 The aging of the U.S. population is likely to increase the relative impact of musculoskeletal conditions. This article reviews arthritis, musculoskeletal pain relating to the soft tissue rheumatic pain disorders, nonspecific musculoskeletal pain (fibromyalgia syndrome), and the regional musculoskeletal pain disorders (axial, upper extremity, and lower extremity). These syndromes present important challenges not only to the rheumatologist, but also to the pain specialist. Aspects of recognizing these syndromes are emphasized. The references include important reading relating to the issue of disability consequent to musculoskeletal pain. Disability issues are complex and intricately related to psychological and socioeconomic factors, including geographic compensation policies and therapist intervention issues.