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The burden of MSK disorders on the NHS and French healthcare systems
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Musculoskeletal (MSK) conditions – disorders affecting the bones, muscles and joints – manifest themselves as pain and issues with gait and movement1. They range from those that occur suddenly and are short-lived, such as fractures, sprains and strains, to lifelong conditions associated with ongoing pain and disability, such as arthritis and carpal tunnel syndrome. Good musculoskeletal health is an important aspect of maintaining a person’s functional abilities throughout life, and it is also fundamental to healthy ageing2.
In the UK
Accounting for over 22% of the total burden of morbidity in England, MSK conditions3 – in particular neck and back problems – are a huge burden on the NHS, both in terms of costs and time. More years are lived with musculoskeletal disability than any other long term condition, and MSK conditions are the leading cause of disability worldwide.
There are over 200 known musculoskeletal conditions which:
Affect 1 in 4 people in the UK, including 12,000 children
Cost the NHS £4.76 billion annually – funded by tax-payers money
Account for 30% of GP consultations in England
Result in over 25% of total surgeries in the UK
Inflict the loss of 10.8 million working days each year
have an enormous impact on the quality of life of millions of people in the UK
are associated with a large number of co-morbidities, including diabetes, depression and obesity4
France
In an epidemiological study carried out in France in 2009 to estimate the frequency and trends of MSK disorders in the work environment it was found that in particular, upper and lower limb disorders, and back pain accounted for 65.1% of all work-related disorders. The European Foundation for the Improvement of Living and Working Conditions5 has found that MSK disorders and mental health problems are the two most prevalent work-related health problems. Interestingly, mental health problems often come hand-in-hand with suffering from MSK disorders and their impact on quality of life so this statistic is hardly surprising.
The French Institute for Public Health Surveillance implemented a policy – The French Musculoskeletal Disorders Surveillance Programme – in 20026, which has already played a significant role in informing the authorities and the public on the ongoing increasing incidence of MSK disorders. Further surveillance programmes such as this should be rolled out, both in the UK and France, with the relevant data extracted and acted upon to lessen this burden on the people and the state.
It’s not just healthcare systems and individuals who suffer at the hands (or knees!) of musculoskeletal disorders, but also any and all companies that these sufferers work for.
Common to both France and the UK, there is increased absenteeism from work, more incidents and accidents due to slower reactions caused by pain or fatigue, in addition to increased staff turnover to replace those affected (which then incurs training costs and time to adapt). Productivity objectives are not met, and there can often be a loss of quality of work and a reduction in the quantity produced, overall resulting in damage to the company’s reputation and brand image7, or even resulting in a country’s economic slowdown on a bigger scale.
Future prevention
Working in tandem with Arthritis and Musculoskeletal Alliance8, NHS England is supporting the national musculoskeletal improvement programme which includes the production of robust, cohesive care networks in order to foster local improvements in care and patients outcomes. Creating and embedding local resilience and prevention opportunities via preventative measures and defining the skills needed to provide people with MSK conditions supports this programme and vision for the future. The 5 year prevention strategic framework, published in 2019, has defined the commitments to promote MSK health and prevent MSK conditions across the health and care systems4.
Similar health policies are also being rolled out in France6, which focus in particular on preventative measures for working adults. Some of these programmes have already played a significant role in informing the authorities and the public of the state and course of the current increased number of MSDs, although the data gathered have still to be fully exploited.