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The Burden of Musculoskeletal Conditions

Weinstein, Stuart L. MD

Journal of Bone & Joint Surgery - American Volume: 17 August 2016 - Volume 98 - Issue 16 - p 1331
doi: 10.2106/JBJS.16.00595

Ignacio V. Ponseti Chair and Professor of Orthopaedic Surgery Professor of Pediatrics Department of Orthopaedic Surgery University of Iowa, Iowa City, IA

In 2002, the U.S. Bone and Joint Decade coalition presented compelling evidence to President George W. Bush that musculoskeletal disorders are the leading cause of physical disability. President Bush declared 2002-2011 the National Bone and Joint Decade to help bring attention to the societal impact of this increasing burden of musculoskeletal conditions1,2. The aims of the campaign were to raise awareness of the increasing societal impact of musculoskeletal injuries and disorders, to empower patients to participate in decisions about their care, to increase funding for prevention activities and research, and to promote cost-effective prevention and treatment. Despite these efforts in the U.S. and worldwide, the burden of musculoskeletal conditions continues to escalate. In fact, musculoskeletal conditions are the second leading cause of disability worldwide3. These impairments will continue to increase over the next 30 years as our population ages. The U.S. Census Bureau estimates that by 2020 there will be 54 million Americans over 65 years of age and by 2040 there will be 80 million Americans over the age of 65, with 15 million of them over the age of 85! Health-care services will be under tremendous financial strain in large part due to the escalation in the numbers of people affected by musculoskeletal conditions4.

Chronic conditions are the largest cost to society and the health-care system. Musculoskeletal conditions currently account for more than half of the chronic conditions in people over 50 years of age. In addition, 3 of the 10 most expensive conditions to manage—trauma, back pain, and osteoarthritis—are related to the musculoskeletal system4. Despite the data, musculoskeletal conditions continue to be under-recognized, underappreciated, and under-resourced5 by the general public, by those in a position to influence change, and even by the at-large medical community. Despite long-standing calls for National Institutes of Health (NIH) research dollars to be allocated in response to the burden of disease6, the funding level for musculoskeletal conditions is <2% of the NIH budget. The U.S. Bone and Joint Initiative (USBJI), in conjunction with the Global Alliance for Musculoskeletal Health, continues to advocate to “improve prevention of bone and joint disorders, and the quality of life for those affected…with increased awareness, solid information and more research.”7 The USBJI maintains prevalence and societal cost data to help patients with musculoskeletal conditions and the musculoskeletal provider community advocate for change. All members of the orthopaedic community, regardless of subspecialty, should advocate with their professional societies and the American Academy of Orthopaedic Surgeons (AAOS) to further the goals of the USBJI.

Disclosure: The author indicated that no external funding was received for any aspect of this work. The Disclosure of Potential Conflicts of Interest form is provided with the online version of the article.

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1. Weinstein SL. 2000-2010: the Bone and Joint Decade. J Bone Joint Surg Am. 2000 ;82(1):1–3.
2. Bush GW. National Bone and Joint Decade: 2002-2011. A proclamation by the President of the United States of America. J Bone Joint Surg Am. 2002 ;84(8):1297; discussion 1298.
3. Global Burden of Diseases, Injuries and Risk Factors Study 2013. Lancet. 2014;22(July). Accessed 2016 May 1.
4. WebMD. Protect yourself from medical cost and disability. Accessed 2016 May 1.
5. The burden of musculoskeletal diseases in the United States. Musculoskeletal diseases and the burden they cause in the United States. Accessed 2016 May 1.
6. Committee on the NIH Research Priority-Setting Process. Scientific opportunities and public needs: improving priority setting and public input at the National Institutes of Health. 1998. Accessed 2016 May 1.
7. United States Bone and Joint Initiative. Welcome to the United States Bone and Joint Initiative! Accessed 2016 May 1.
Copyright 2016 by The Journal of Bone and Joint Surgery, Incorporated