The Burden of Musculoskeletal Conditions

Clémence Palazzo,Agathe Papelard,Philippe Ravaud,Jean-François Ravaud,Serge Poiraudeau,Arvind Chopra

doi:10.1371/journal.pone.0090633

Abstract

ObjectiveDespite the burden of rheumatic and musculoskeletal diseases (RMDs), these conditions probably deserve more attention from public health authorities in several countries including developed ones. We assessed their contribution to disability.MethodsData on disabilities associated with RMDs were extracted from the national 2008–2009 Disability-Health Survey of 29,931 subjects representative of the population in France. We used the core set of disability categories for RMDs of the World Health Organization's International Classification of Functioning, Disability and Health for analysis. Diagnosis and disabilities were self-reported. We assessed the risk of disability associated with RMDs using odds ratios (ORs) and the societal impact of RMDs using the average attributable fraction (AAF).ResultsOverall 27.7% (about 17.3 million people) (95% CI 26.9–28.4%) of the population reported having RMDs. The most prevalent RMDs were low back pain (12.5%, 12.1–13.1) and osteoarthritis (12.3%, 11.8–12.7). People reporting osteoarthritis were more disabled in walking (adjusted OR 1.9, 1.7–2.2) than those without. People reporting inflammatory arthritis were more limited in activities of daily living (from 1.4, 1.2–1.8 for walking to 2.1, 1.5–2.9 for moving around). From a societal perspective, osteoarthritis was the main contributor to activity limitations (AAF 22% for walking difficulties). Changing jobs was mainly attributed to neck pain (AAF 13%) and low back pain (11.5%).ConclusionRMDs are highly prevalent and significantly affect activity limitations and participation restrictions. More effort is needed to improve care and research in this field.

Highlights

Rheumatic and musculoskeletal diseases (RMDs) are a major cause of disability [1]
In the 2010 World Health Organization Global Burden of Disease (WHO-GBD) study, low back pain (LBP) was the leading cause of years lived with disability in the world, neck pain the fourth cause, and other musculoskeletal disorders the fifth; osteoarthritis (OA) increased from 15th in 1990 to 11th in 2010 in western Europe [1]
Prevalence of RMDs Overall, 27.7% of the population living in a household reported at least one RMD, corresponding to 17.3 million people

Summary

Introduction

Rheumatic and musculoskeletal diseases (RMDs) are a major cause of disability [1]. In the 2010 World Health Organization Global Burden of Disease (WHO-GBD) study, low back pain (LBP) was the leading cause of years lived with disability in the world, neck pain the fourth cause, and other musculoskeletal disorders the fifth; osteoarthritis (OA) increased from 15th in 1990 to 11th in 2010 in western Europe [1]. A barrier for prioritization of RMDs by public health policymakers is that they are not considered to be fatal, even though OA has been shown to be associated with increased mortality [6]. The French health system, where research and care for cardiovascular risks have been prioritized, perform significantly better than the mean of 18 other health systems for stroke, ischemic heart disease and diabetes but quite poorly for RMDs such as neck and back pain or osteoarthritis [7]. Production of representative national data on disability with a focus on RMDs may help national policymakers to prioritize public health strategies and convince them of the need to consider focusing on musculoskeletal conditions to improve population health

Methods

Results

Discussion

Conclusion