Musculoskeletal diseases

Musculoskeletal conditions are a major cause of impairment, disability, health care utilization, and loss of economic productivity throughout the world. Among adults, osteoarthritis is one of the leading causes of disability worldwide. Risk factors include increasing age and the female sex, as well as obesity, malalignment and repetitive loading of joints, and previous congenital and developmental conditions and injuries involving joints. Reduction of exposure to these factors, when possible, should retard the development and progression of osteoarthritis. Rheumatoid arthritis, although less common, often results in significant disability. It is considered to be of autoimmune aetiology, with a strong genetic component. The incidence and severity are associated with a specific amino acid sequence on several human leukocyte antigen (HLA) DRB1 alleles. New drugs are helping to alleviate symptoms and inhibit structural damage.

Osteoporosis, a common condition in older people, predisposes to fractures. Among the risk factors are increasing age, the female sex, thinness, low oestrogen concentrations, frailty and poor health, and to a lesser extent, low calcium and vitamin D intake, and lack of physical activity. Prevention of falls in older people can reduce the frequency of osteoporosis-associated fractures. Low back and neck pain affect the majority of the people throughout the world at some time during their lives. Heavy manual labour and exposure to whole-body vibration are major risk factors, and reduction in these activities should reduce the frequency of low back and neck pain. Foot disorders represent a variety of structural, biomechanical, skin, and sensory conditions as well as manifestations of systemic diseases such as arthritis, diabetes mellitus, and peripheral vascular disease. Wearing appropriate shoes and weight reduction are possible preventive measures for some common structural foot problems.

Disorders of adolescents and children include conditions associated with the adolescent growth spurt such as scoliosis and slipped epiphysis, injuries such as childhood fractures, and conditions of infants such as developmental dislocation of the hip.

Musculoskeletal conditions are common in all age groups, but their greatest impact is on the elderly. The number of elderly persons is rapidly increasing worldwide, especially in developing countries. Thus, the burden of musculoskeletal conditions will become substantially greater over the next several decades. Application of known methods of prevention at all levels and development of new preventive methods are urgently needed.