Physical Activity in Long Term Musculoskeletal Conditions

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Original Editor - Caroline Hooper

Top Contributors - Wendy Walker, Kim Jackson, Lucinda hampton, Tony Lowe, Michelle Lee, Simisola Ajeyalemi, Vidya Acharya, Tarina van der Stockt, Rucha Gadgil and Lauren Lopez  

Introduction: Long Term Musculoskeletal Conditions.

In 2015, a study on the Global Burden of Disease and the worldwide impact of all diseases and risk factors included back and neck pain, osteoarthritis and other musculoskeletal disorders in the leading ten causes of adult global age-specific years lived with disability. When discussing disease-specific issues the report stated that “Musculoskeletal disorders continue to be a leading cause of disability worldwide”.  It advised that “a key component of healthy ageing is to maintain mobility, and a key public health intervention recommended for improving health outcomes for all chronic diseases is physical activity”.

ARC MUSCULOSKELETAL HEALTH A public health approach

1. Arthritis Research UK define musculoskeletal conditions as “disorders of the bones, joints, muscles and spine, as well as rarer autoimmune conditions such as lupus”.  They suggest considering three key categories.The commonest group consists of painful musculoskeletal conditions such as osteoarthritis and back pain. Risk factors include physical inactivity, obesity and injury.
2. Osteoporosis and fragility fractures. ½  women and 1/5  men over the ago of 50 will suffer at least one fragility fracture.
3. Inflammatory conditions such as rheumatoid arthritis.  The conditions in this category are much less common.

In 2013, Arthritis Research UK organized an expert workshop of epidemiologists, public health specialists and others in order to help shape a national agenda for musculoskeletal public health.

A key concept was that musculoskeletal health means more than the absence of a musculoskeletal condition, and that it is possible to have poor musculoskeletal health without having a specific musculoskeletal condition. In order to have good musculoskeletal health the muscles, joints and bones must work well together without pain in order to carry out activities with ease and without discomfort.

At the core of this approach to musculoskeletal health was physical activity. It was emphasized that “remaining active is one of the best things anyone can do for their musculoskeletal health, to help strengthen muscles, keep bones healthy, reduce pain and prolong the life of joints”.  It was recommended that initiatives aimed at increasing physical activity should always explicitly refer to the musculoskeletal health benefits, that joint or back pain is not seen as a barrier to participation, and that these activities are making a difference to people who are living with a musculoskeletal condition.

Recommendations

4 Key recommendations were made:

1. Assessment of Population Health

1When assessing local and national population health, musculoskeletal health must be included in the assessment.

2. Health Programme Design

When designing, implementing and evaluating programmes targeting lifestyle factors such as obesity and physical inactivity, impact on musculoskeletal health should be explicitly included.

3. Health Promotion

When developing health promotion messages, the benefits of physical activity to people with musculoskeletal conditions should be emphasised.

4. Health Data

All this public health activity must be underpinned by high quality data about musculoskeletal health.

References

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All this public health activity must be underpinned by high quality data about musculoskeletal health.