Prevalence and types of lower limb conditions in Nepal

Lower limb conditions (LLCs) are a major cause of pain, disability, and loss of livelihood globally, yet their prevalence and functional impacts in low- and middle-income countries, including Nepal, remain poorly described.

We conducted a cross-sectional, community-based survey in three Nepali districts representing plains, hills, and mountains. Of 2525 screened households, the first 500 adults with self-selected LLCs were interviewed using structured questionnaires adapted from validated tools (Global Alliance for Musculoskeletal Health, COPCORD, Washington Group, WHODAS 2.0). Descriptive statistics summarised condition type, pain location, activity limitations, employment impact, and comorbidities. χ² tests assessed regional differences in condition types.

Of 2525 households, 671 (26.6%, 95% CI = 24.9-28.3) reported a member with an LLC; 11.2% (95% CI = 10.5-12.0) of adults were affected. Among 500 participants surveyed (mean age 57 years; 65% female), pain/discomfort was most common (97%), mainly in the knee (74%) and foot/ankle (48%). Across participants, 628 LLCs were reported; conditions included injury/trauma (19%), deformity (7%), wounds (1%), and amputation (<1%). Prevalence varied by district. Functional limitations were substantial: 82% with pain and all with amputation reported severe activity restriction. Ten percent were unemployed, mostly due to health, and >70% of those doing household work had left other jobs because of their LLC.

This study offers preliminary, population-based estimates of person-reported LLCs across three ecological zones in Nepal. Musculoskeletal pain was most common, often multi-site and substantially limiting daily activities and employment. While findings highlight the impact of LLCs on well-being and livelihoods, they remain exploratory due to limited geographic scope and self-reporting. Larger, nationally representative studies are needed to confirm these results, differentiate chronic from transient pain, and guide rehabilitation and prevention strategies.