The burden of musculoskeletal conditions

Despite 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.

Data 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).

Overall 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%).

RMDs are highly prevalent and significantly affect activity limitations and participation restrictions. More effort is needed to improve care and research in this field.