Musculoskeletal Conditions
Introduction
Musculoskeletal (MSK) health is essential for enabling people to go about their day-to-day lives free from pain and disability, especially when entering older age where risk, severity and the number of people with MSK conditions increases significantly1.
Challenges related to an ageing population, increased levels of obesity and physical inactivity across the population risk making this issue a more challenging problem to solve2.
MSK conditions can affect joints, bones and muscles and sometimes associated tissues such as nerves. They can range from minor injuries to long-term conditions.
There are 3 groups of MSK conditions:3
- Inflammatory conditions, for example, rheumatoid arthritis
- Conditions of MSK pain, for example, osteoarthritis and back pain
- Osteoporosis and fragility fractures, for example, a fracture after a fall from standing height
Changes to some risk factors linked to MSK can help people manage their risk of developing MSK conditions, including:4,5
- Obesity
- Physical inactivity
- Smoking
- Mental health
Tackling the growing challenge of MSK is possible through action such as managing weight and stopping smoking but other action through early detection and appropriate condition management can support people who have MSK conditions to manage the risk of conditions becoming more severe6.
Why is it important to Population Health?
Disease Burden Due to MSK Conditions: Poor MSK health has a huge impact on people, their employers, the NHS and the wider economy. According to Versus Arthritis 17.3 million people have MSK conditions in England - the equivalent of almost 1 in 3 people7. MSK conditions can affect people across the life course, however, the older you become the more likely you will develop a MSK condition with 17% of people aged 20-34 affected by MSK conditions compared to 63% of people aged 75-84. Women in England are more likely to be affected by MSK related issues, with 35% of women and 28% of men living with MSK8.
Consequences of MSK Conditions: MSK and arthritis are longer-term conditions that are amongst the biggest contributors to people living with long-term disability and can have a significant impact on people’s day-to-day lives. People living with MSK conditions may live with pain and fatigue, have difficulty getting out and taking care of themselves. As a result of their condition people living with MSK conditions can also experience poor mental health, including feeling low and anxious9. A person’s mood, energy levels, ability to sleep and daily routine can all be affected. As a person changes their schedule to cope, giving up hobbies and social time, and in severe cases their work, they can lose confidence and self-esteem10.
According to the Department of Work and Pensions, nearly 20% of people on Personal Independence Payments (disability benefit) have an MSK condition11.
People with MSK conditions are more likely to take sickness absence from work with an average of 15.2 days taken each year per person with a MSK condition and may also impact on their ability to remain in work12. People with arthritis are 20% less likely to be in work than someone without arthritis13.
Health Inequalities: There are substantial differences regarding MSK related conditions in people of working age (45-64), as those in the lower income communities are nearly twice as likely to report back pain (17.7%) compared to those in more affluent areas (9.1%). Prevalence increases whilst inequalities narrow with age. For those aged 75+ prevalence in the lowest income communities 18.6% and in the least deprived 15.1%14,15
The number of people living with arthritis is more than double in lower income communities (21.5%) compared to more affluent areas (10.6%) among people aged 45-64. 40% of men and 44% of women in the most deprived households report chronic pain, compared to 24% of men and 30% of women in the richest households16,17.
Risk Factors: There are several modifiable risk factors associated with the development and exacerbation of MSK conditions including obesity, physical inactivity and smoking. When the impact of the ageing population and a growing obese population is considered, by 2035 there are expected to be 8.3 million people living with knee osteoarthritis18.
Smoking is associated with increased risk of fractures, slower healing, rheumatoid arthritis and a lower bone mineral density19.
The workplace can also be a significant driver of MSK risk, with 477,000 workers suffering from MSK conditions in 2021/2022. Of these, 139,000 workers are suffering from a new disorder that began within the 12-month period. An estimated 7.3 million working days were lost due to work-related musculoskeletal disorders in 2021/2220. This is likely to increase as the rise in pension age encourages more people to remain in the workplace for longer, which may make cases of MSK worse or risk more people developing MSK conditions21. An increase in home working may increase MSK risk due to less monitoring of working conditions22.
NHS/Healthcare Burden: Musculoskeletal disorders account for more than 22% of the total burden of ill health in the UK and the third largest area of NHS spending at £4·7 billion, with substantial costs including total joint replacement and other forms of orthopaedic surgery23.
People with arthritis and MSK conditions account for 30% of GP appointments and often take medicines to help manage their symptoms. In 2021-2022 around 30 million prescriptions were dispensed for MSK conditions and joint diseases in England, costing approximately £151 million24,25.
Social and Economic Burden: 1 in 10 current UK employees have a MSK conditions and they are the leading cause of disability at work, sickness absence from work, and presenteeism, resulting in lost productivity as high as 2% of gross domestic product and around 23 million sick days in England26. People with arthritis are also 20% less likely to be in work than someone without arthritis27,28.
The Derbyshire Population Health Approach
The Derbyshire Population Health Approach focuses on prevention, population health, evidence-informed practices, causes, and collaboration. It emphasises proactive measures to prevent health issues, tailors interventions to specific populations, incorporates evidence-informed practices, addresses underlying causes, and promotes collaboration for effective action.
When considering the topic of musculoskeletal conditions within The Derbyshire Population Health Approach:
• Prevention
Population health approaches to enable people to live and work free from the burden of MSK through prevention programmes such as losing weight, stopping smoking or becoming physically active can reduce the risk of a person developing MSK conditions and, if a person has developed an MSK condition, help in managing that condition. Supporting people to access benefits where their MSK condition has resulted in them leaving their job can help mitigate the wider impact of living with a long-term and debilitating MSK condition. Working with employers through the Healthy Workplaces Derbyshire Programme can also enable working aged people of Derbyshire to access support to reduce their risk of developing MSK conditions.
• Population
People in lower income communities are more likely than their counterparts in higher income areas to develop MSK conditions. Working with colleagues in local authorities, community and voluntary sector organisations and the NHS to enable communities at high risk of developing MSK conditions to manage lifestyle risk factors can improve the wellbeing of patients whilst supporting NHS colleagues to manage waiting lists. Additionally, working with NHS partners population health approaches can support patients whose employment or financial status has been detrimentally impacted because of their MSK condition with tailored support.
• Evidence
The NHS Long Term Plan acknowledges that MSK conditions are a leading cause of sickness absence in England. There is strong evidence that addressing risk factors such as obesity, physical inactivity and smoking can help prevent the development of MSK conditions and help manage symptoms like pain that are associated with MSK. Evidence-informed approaches to prevention through lifestyle services such as Live Life Better Derbyshire and the promotion of occupational wellbeing through Healthy Workplaces Derbyshire can support people to manage their risk of developing MSK conditions.
• Causes
Understanding and addressing the underlying causes of MSK, including obesity, physical inactivity and smoking are important in ensuring population health approaches can help manage MSK risk at a population level. Additionally, working with partners, population health can support people to manage their condition, including the negative mental health and financial consequences some people with long-term MSK conditions may experience.
• Collaboration
Our partners are key to supporting population health approaches to help manage risk factors such as obesity, physical activity and stop smoking that are associated with developing MSK, especially in communities most affected by high rates of MSK conditions. By working with our partners such as the NHS, local authorities and the community and voluntary sectors population health can enable people in Derbyshire to access support through Live Life Better Derbyshire and Healthy Workplaces Derbyshire to help manage these risks. Through collaboration we are also able to support the NHS in helping people to manage their MSK condition either through lifestyle support or by providing practical help to enable people to access appropriate benefits. Information on the support available can be found here.
Latest Derbyshire Data
Trend Data
Prevalence Maps of Derbyshire
The maps below illustrate Lower Super Output Areas (LSOAs) and Middle Super Output Areas (MSOAs) for Derbyshire. LSOAs and MSOAs are geographical divisions used for statistical purposes, allowing for more detailed analysis of local data. In these maps, you can explore various health indicators and data for Derbyshire, providing valuable insights into the area’s health and wellbeing.