Musculoskeletal diseases, which include back pain, arthritis, bodily injuries, and osteoporosis, are reported by persons in the United States more than any other health conditions. Despite this fact, funding for research to reduce the pain and suffering created by these conditions is currently less than 2 percent of the National Institutes of Health budget each year.

The Burden of Musculoskeletal Diseases in the United States: Prevalence, Societal and Economic Cost is a joint project of several musculoskeletal organizations under the auspices of the U.S. Bone and Joint Decade.

Produced by experts from rheumatology, orthopaedic surgery, physical medicine and rehabilitation, and other musculoskeletal healthcare specialties to provide a better understanding of the extent and burden of current and future musculoskeletal diseases as the proportion of the U.S. population older than age 65 increases, the full publication can be viewed at www.boneandjointburden.org

Each month, AAOS Now will feature a section of the text, taken from the Executive Summary, beginning with this overview.

The burden of musculoskeletal disease
Musculoskeletal diseases rarely are a cause of death and do not have the high visibility of conditions such as heart problems, respiratory problems, and cancer, yet they are more prevalent. They are a major cause of pain and reduced quality of life. In 2005, 107.7 million adults, one in two aged 18 and older, reported suffering from a musculoskeletal condition lasting three months or longer during the past year. This is nearly twice the number who reported any other medical condition. In addition, nearly 15 million adults reported they were unable to perform at least one common activity, such as self-care, walking, or rising from a chair, on a regular basis due to their musculoskeletal condition.

The cost of musculoskeletal diseases
In 2004, the estimated cost for treatment of patients with musculoskeletal conditions was $510 billion, the equivalent of 4.6 percent of the GDP. Indirect costs, primarily lost wages, were estimated to add another $339 billion, or 3.1 percent of the GDP, resulting in total costs attributed to patients with musculoskeletal diseases of $849 billion, or 7.7 percent of the GDP. In addition, musculoskeletal diseases accounted for the majority of both lost work and bed days due to health conditions in 2005 (Fig. 1).

Impacts of aging
Musculoskeletal diseases occur more frequently as people age. Currently, persons older than 65 years account for 12 percent to13 per­cent of the total population; by 2030 it is expected they will comprise 20 percent, an increase of more than 50 percent. Activities that place stress on bones and joints in younger years, a sedentary lifestyle, and obesity are major contributors to joint diseases. In coming decades, expectations of a healthy, active life throughout retirement years are projected to create an even greater burden on healthcare resources due to musculoskeletal diseases.

The future
Aging of the U.S. population, higher rates of diagnoses and treatment, increasing medical cost, and the cost of higher earnings loss all contribute to the rising burden of musculoskeletal diseases. A focus on preventive measures, such as education for weight loss and exercise programs, can help reduce this burden. Improvements in surgical techniques, joint replacement devices, and drugs and therapy to help return individuals to higher levels of functioning and quality of life will be imperative.