5Improving musculoskeletal health: Global issues
Introduction
Musculoskeletal (MSK) disorders are common in populations all over the world and they are a leading cause of disability and time off work. A wide variety of conditions are included within the spectrum of MSK disorders. They may involve a number of different anatomical structures such as bone, the structures within joints and the periarticular structures which includes muscles, tendons, ligaments or bursae. They may have an acute onset as seen with hip fracture in an elderly osteoporotic patient or multiple bone trauma associated with road traffic injuries, or chronic knee pain associated with osteoarthritis or chronic neck pain associated with cervical spondylosis. The pain may be localised to a single joint area or patients may have chronic widespread pain (CWP). The source of the MSK disorder may be mild and minor as occurs with abnormal posture or overuse, or it may be severe and demand immediate intervention as in patients with suspected septic arthritis or neurological complications after spinal injury.
Measures such as the World Health Organisation (WHO) International Classification of Functioning, Disability and Health (ICF) [1] can be used to determine the impact of a particular problem regardless of the cause. The ICF includes assessment of the body structure and function, activity limitation and any restriction to participation in life situations. The development of any impairment may also be influenced by contextual factors which also include personal and environmental factors.
Section snippets
The burden and impact of MSK disorders
A detailed discussion on the burden of MSK disorders is beyond the scope of this chapter and some of the disorders are discussed in detail in other chapters in this issue. Some of the more common conditions will be discussed briefly. The risk factors and some of the strategies to prevent or limit the consequences of these disorders are also discussed.
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MSK pain
MSK pain is one of the leading reasons for primary care consultations in industrialised countries. Community-based studies such as the
Strategies for prevention of MSK disorders
Woolf et al. have provided recommendations for the prevention of MSK conditions in the developing world [59]. The measures to improve MSK health from a public health perspective have been reported by Bergman [60].
Non-communicable diseases such as cardiovascular diseases, respiratory diseases and malignancies, and communicable diseases such as HIV, TB and malaria are the traditional focus of public health initiatives as they are among the leading contributors to mortality. As a result, less
Challenges to improving musculoskeletal health
There many challenges to achieving some of the targets for the prevention, early diagnosis and management of musculoskeletal disorders and they include the following:
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Human resources
Over a billion people in the world lack access to quality health-care services. The WHO estimates that there is a global shortage of about 4.3 million health-care workers [69] in the decade 2007–2017. However, there are no global efforts to address this shortage with potential severe consequences for improving health
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