Reducing the global burden of musculoskeletal conditions

Musculoskeletal conditions include more than 150 diagnoses that affect the locomotor system. These conditions are characterized by pain and reduced physical function, often leading to significant mental health decline, increased risk of developing other chronic health conditions and increased all-cause mortality.1 Many musculoskeletal conditions share risk factors common to other chronic health conditions, such as obesity, poor nutrition and a sedentary lifestyle. Musculoskeletal conditions account for the greatest proportion of persistent pain across geographies and ages.2 Back and neck pain, osteoarthritis, rheumatoid arthritis and fractures are among the most disabling musculoskeletal conditions and pose major threats to healthy ageing by limiting physical and mental capacities and functional ability. Although the prevalence of major musculoskeletal conditions increases with age, they are not just conditions of older age. Regional pain conditions, low back and neck pain, musculoskeletal injury sequelae and inflammatory arthritides commonly affect children, adolescents and middle-aged people during their formative and peak income-earning years, establishing trajectories of decline in intrinsic capacity in later years. While point prevalence estimates vary with respect to age and musculoskeletal condition, approximately one in three people worldwide live with a chronic, painful musculoskeletal condition. Notably, recent data suggest that one in two adult Americans live with a musculoskeletal condition, a prevalence comparable to that of cardiovascular and chronic respiratory diseases combined, which cost 213 billion United States dollars in 2011 (or 1.4% of gross domestic product).3 Data from lowand middle-income countries are fewer, yet comparable.4 Musculoskeletal health is critical for human function, enabling mobility, dexterity and the ability to work and actively participate in all aspects of life. Musculoskeletal health is therefore essential for maintaining economic, social and functional independence, as well as human capital across the life course. Impaired musculoskeletal health is responsible for the greatest loss of productive life years in the workforce compared with other noncommunicable diseases,5 commonly resulting in early retirement and reduced financial security. In subsistence communities and lowand middle-income economies, impaired musculoskeletal health has profound consequences on an individual’s ability to participate in social roles and in the prosperity of communities.4