State of Musculoskeletal Health 2017 Arthritis & other musculoskeletal conditions in numbers Index 03 Introduction 04 Glossary 05 Key statistics 07 What are musculoskeletal conditions? 08 What is the impact? 09 Impact on individuals and society 10 Impact on work life 13 Impact on health and social care services 14 Impact on the wider economy 16 Life course approach to musculoskeletal health 18 Condition specific statistics (prevalence, risk factors, comorbidities, and impact) 19 Inflammatory conditions 20 Axial spondyloarthritis (including ankylosing spondylitis) 21 Gout 23 Juvenile idiopathic arthritis 25 Rheumatoid arthritis 29 Musculoskeletal pain 29 Osteoarthritis 33 Back pain 35 Osteoporosis / fragility fractures 38 References 02 Introduction Back to Index Musculoskeletal conditions are extremely common, however many Musculoskeletal conditions can have a significant impact both on are still not receiving the recognition they deserve and support they a personal and societal level. An individual’s home life, relationships and need. Millions of people across the UK are limited by the pain, work can all be affected, causing repercussions for society and the wider stiffness and fatigue caused by musculoskeletal conditions, economy, for example through the cost of treatment or lost productivity. such as arthritis or back pain. What methodology was used? These conditions affect all aspects of everyday life, by limiting what people can do and their ability to be independent. This in turn can have Evidence used in this report was gathered from the best available a devastating impact on a person’s overall quality of life. In fact, qualitative and quantitative data. Research articles were selected musculoskeletal conditions are the leading cause of years lived with through systematic literature reviews and where possible restricted disability (YLDs) and the third largest cause of disability adjusted to UK population cohorts or comprehensive meta–analyses. life years (DALYs) in the UK today.1 This compendium presents data from sound data sources, including but Musculoskeletal conditions are a costly and growing problem. not limited to: The prevalence of musculoskeletal conditions is expected to continue to increase both due to our ageing population and rising levels of 1. national datasets, surveys and audits; obesity and physical inactivity. These are two major modifiable 2. findings from observational, surveillance and modelling studies; risk factors in the development of a musculoskeletal condition. 3. musculoskeletal sector charity reports. What is the state of musculoskeletal health? Who is it for? This compendium of musculoskeletal health data is an important resource providing the best picture of the burden and impact of The State of Musculoskeletal Health 2017 is a resource for health sevena of the most prevalent musculoskeletal conditions in the UK. professionals, policy makers, public health leads and anyone Where available, data refers to the whole of the UK, however due interested in musculoskeletal health. We believe that with the to gaps in coverage some findings are restricted to England. best information you can build awareness, make more informed decisions, feel more confident and ultimately help more people with The burden of musculoskeletal illness can be defined by the number musculoskeletal conditions. of people affected by a condition and at risk of developing the disease, but also by its wider impact. a Axial spondyloarthritis (incl. ankylosing spondylitis), gout, juvenile idiopathic arthritis, rheumatoid arthritis, back pain, osteoarthritis, osteoporosis/fragility fractures. State of Musculoskeletal Health 2017 03 Glossary Back to Index Arthritis – a general term that most people use to mean painful joints. Mortality – a term used to describe the number of people who died Medically, it refers to a number of different conditions leading to within a population. A mortality rate is the number of deaths due to inflamed or damaged joints. a specific cause divided by the total population over a given period. Comorbidity – any additional health conditions that people may have, Multimorbidity – a person living with multimorbidity has two or more beyond the main condition being addressed.2 long term chronic conditions.5 Disabled – someone with a long–term condition who reports it reduces Musculoskeletal conditions – a broad range of health conditions their ability to carry out day to day activities, as defined by the Equality affecting bones, joints and muscles, pain syndromes and rarer Act 2010.3 conditions of the immune system. Disability adjusted life–year (DALY) – A single metric of overall disease Prevalence – the percentage of a population that is affected with burden combining years of life lost (YLLs) due to mortality and years a particular disease at a given time. lived with disability (YLDs). One DALY can be thought of as one lost year of healthy life.4 Risk factor – any attribute, characteristic or exposure of an individual that increases the likelihood of developing a disease or disorder. Some Finished consultant episodes (FCEs) – one episode of care within an risk factors are modifiable, because you can change them (e.g. smoking, inpatient stay under one responsible consultant. obesity, diet). Other risk factors are non–modifiable, because you can’t directly change them (e.g. age, sex, family history). Incidence – the rate of new (or newly diagnosed) cases of disease, generally reported as the number of new cases occurring within Work days lost – the number of work days lost for all people in a period of time (e.g. per month, per year). employment aged over 16 years due to sickness absence. Literature review – a review of information found in the literature related Work related musculoskeletal disorders (WRMSDs) – a self–reported to a selected area or topic of research. musculoskeletal condition which a person thinks has been caused or made worse by their current or past work. Meta–analysis – a study design that systematically combines and assess previous qualitative and quantitative studies about a particular Years lived with disability (YLD) – years of life lived with any short–term topic or research area in order to develop a single conclusion. or long–term health loss.6 State of Musculoskeletal Health 2017 04 Key statisticsb Back to Index Millions are affected by musculoskeletal 57% of people living with arthritis say Over 30 million working days are lost due to conditions in the UK. they experience pain every day. musculoskeletal conditions, each year. Ankylosing Juvenile idiopathic Rheumatoid Osteoporosis/ Gout Osteoarthritis Back pain spondylitis arthritis arthritis fragility fractures 200,000 people in 1 in 40 people in 12,000 children in Over 400,000 people 8.75 million people Around 10 million 3 million people the UK have the UK have gout. the UK have juvenile in the UK have aged 45 and over people in England in the UK have ankylosing That’s around 1.5 idiopathic arthritis. rheumatoid arthritis. in the UK have and Scotland alone osteoporosis. spondylitis. million people. sought treatment or have persistent Over 300,000 osteoarthritis. back pain. fragility fractures occur in the UK each year. Withdrawal from 23% of working–age 30 – 56% of 1/3 of people with Nearly 3/4 of people Lower back pain is 1 in 3 people who work is 3 times more people with gout children with rheumatoid arthritis with osteoarthritis the leading cause have long–term common in people say they had to give juvenile idiopathic will have stopped report constant pain. of years lived with pain from fractures with ankylosing up work because of arthritis will have working within 2 disability (YLDs) describe it as severe spondylitis than their condition. severe limitations years of onset. worldwide and in or unbearable. in the general in dexterity the UK. population. and mobility in adulthood. The cost of 30% increase in 1/3 of children with The cost of 1/3 of people with People who are £1.9 billion in ankylosing the incidence (new juvenile idiopathic rheumatoid arthritis osteoarthritis retire obese are 4 times hospital costs per spondylitis to cases) of gout in the arthritis will have to the UK economy is early, give up work more likely to year in the UK for hip the UK economy UK between 1997 ongoing active estimated at or reduce the hours develop back pain fracture alone. is estimated at and 2012. disease in adulthood. £3.8 – 4.8 billion. they work because of than those with a £3.8 billion. their condition. healthy body weight. 6 out of 10 adults over 16 years in England today are overweight or obese. b All references for the statistics in this graphic can be found on the condition specific pages. State of Musculoskeletal Health 2017 05 What are musculoskeletal conditions? Back to Index The term ‘musculoskeletal conditions’ is often used to include a broad syndromes that interfere with people’s ability to carry out their normal range of health conditions affecting the bones, joints, muscles and daily activities. Common symptoms include pain, stiffness and a loss spine, as well as rarer autoimmune conditions such as lupus. In fact, of mobility and dexterity. Broadly speaking there are three groups musculoskeletal conditions comprise over 100 different diseases and of musculoskeletal conditions:7 Group Inflammatory conditions Conditions of musculoskeletal pain Osteoporosis and fragility fractures (e.g. 1 (e.g rheumatoid arthritis) 2 (e.g. osteoarthritis, back pain) 3fracture after fall from standing height) Age Affects any age. More common with rising age. Affects mainly older people. Progression Often rapid onset. Gradual onset. Osteoporosis is a gradual weakening of bone. Fragility fractures are sudden discrete events. Prevalence Common. (e.g. over 400,000 adults in Very common. (e.g. 8.75 million people Common. (e.g. 300,000 fragility the UK have rheumatoid arthritis). in the UK have sought treatment for fractures occur in the UK each year). osteoarthritis). Impact Can affect any part of the body Affects the joints, spine and Hip, wrist and spinal bones are most common including skin, eye and internal organs.