The economic impact of musculoskeletal disorders


Musculoskeletal disorders have a major impact on society in terms of morbidity, long-term disability and economics. As populations increase and age, payment for medical care and indirect costs from loss of earnings will increase. Both rheumatoid arthritis and low back pain have a great economic impact on society, and the costs of these are escalating problems. Statistics are analysed from various studies in the United States and Canada, and these highlight the need for more rational and effective health care management strategies.

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  1. 1.

    Reynolds MD. Prevalence of rheumatic diseases as causes of disability and complaints by ambulatory patients. Arthritis Rheum 1978; 21: 377–382.

    Google Scholar 

  2. 2.

    Wood PHN, Badley EM. Rheumatic disorders. In: Miller DL, Farmer RDT (eds) Epidemiology of Diseases. Oxford: Blackwell Scientific Publications, 1982: 333–346.

    Google Scholar 

  3. 3.

    Cunningham LS, Kelsey JL. Epidemiology of musculoskeletal impairments and associated disability. Am J Public Health 1984; 74: 574–579.

    Google Scholar 

  4. 4.

    Lee P, Helewa A, Smythe HA et al. Epidemiology of musculoskeletal disorders (complaints) and related disability in Canada. J Rheumatol 1985; 12: 1169–1173.

    Google Scholar 

  5. 5.

    Kelsey JL. Epidemiology of Musculoskeletal Disorders. New York: Oxford University Press, 1982.

    Google Scholar 

  6. 6.

    Office of Population Censuses and Surveys. Morbidity Statistics from General Practice. Second National Survey 1970–71. The Royal College of General Practitioners, Office of Population Censuses and Surveys, Department of Health and Social Security, Studies on Medical and Population Subjects No. 26. London: HMSO, 1974.

    Google Scholar 

  7. 7.

    Wood PHN, Badley EM, In: Jayson MIV, Million R (eds) Locomotor Disability in General Practice. Oxford: Oxford University Press, 1983: 3–29.

    Google Scholar 

  8. 8.

    Reynolds DL, Chambers LW, Badley EM et al. Physical disability among Canadians reporting musculoskeletal disease. J Rheumatol 1992; 19: 1020–1030.

    Google Scholar 

  9. 9.

    National Cancer Institute of Canada. Canadian Cancer Statistics 1989. Toronto, Ontario, 1989.

  10. 10.

    Felts W, Yelin E. The economic impact of the rheumatic diseases in the United States. J Rheumatol 1989; 16: 867–884.

    Google Scholar 

  11. 11.

    Burkhauser RV, Butler JS, Mitchell JM, Pincus T. Effects of arthritis on wage earnings. J Gerontol 1986; 41: 277–281.

    Google Scholar 

  12. 12.

    Rice D. Estimating the Cost of illness. National Center for Health Statistics, Health Economic Series, No. 6, 1966.

  13. 13.

    Rice D, Hodgson T, Kopstein A. The economic costs of illness: A replication and update. Health Care Financing Rev 1985; 7: 61–80.

    Google Scholar 

  14. 14.

    Hochberg MC. Adult and juvenile rheumatoid arthritis. Current epidemiologic concepts. Epidemiol Rev 1981; 3: 27–44.

    Google Scholar 

  15. 15.

    Stone CE. The lifetime economic costs of rheumatoid arthritis. J Rheumatol 1984; 11: 819–827.

    Google Scholar 

  16. 16.

    Koota K, Isomaki HA, Mutru O. Death rate and causes of death in RA patients during a period of five years. Scand J Rheumatol 1977; 6: 241–244.

    Google Scholar 

  17. 17.

    Uddin J, Kraus AS, Kelly HG. Survivorship and death in rheumatoid arthritis. Arthritis Rheum 1970; 13: 125–130.

    Google Scholar 

  18. 18.

    Makisara GL, Makisara P. Prognosis of functional capacity and work capacity in rheumatoid arthritis. Clin Rheumatol 1982; 1: 117–125.

    Google Scholar 

  19. 19.

    Yelin E, Henke C, Epstein W. The work dynamics of the person with rheumatoid arthritis. Arthritis Rheum 1987; 30: 507–512.

    Google Scholar 

  20. 20.

    Reisine ST, Goodenow C, Grady KE. The impact of rheumatoid arthritis on the homemaker. Soc Sci Med 1987; 25: 89–95.

    Google Scholar 

  21. 21.

    Liang MH, Larson M, Thompson M et al. Costs and outcomes in rheumatoid and osteoarthritis.Arthritis Rheum 1984; 27: 522–529.

    Google Scholar 

  22. 22.

    Lubeck DP, Spitz PW, Fries JF et al. A multicentre study of annual health service utilization and costs in rheumatoid arthritis. Arthritis Rheum1986; 29: 488–493.

    Google Scholar 

  23. 23.

    Jacobs J, Keyserling JA, Britton M et al. The total cost of care and the use of pharmaceuticals in the management of rheumatoid arthritis: the Medi-Cal program. J Clin Epidemiol 1988; 41: 215–223.

    Google Scholar 

  24. 24.

    Hartunian NS, Smart CN, Thompson MS. The Incidence and Economic Costs of Major Health Impairments. Massachusetts: Lexington Books, 1980.

    Google Scholar 

  25. 25.

    Arthritis Foundation. Arthritis Quackery and Unproven Remedies. Atlanta: Arthritis Foundation, 1981.

    Google Scholar 

  26. 26.

    Allander E. A population survey of rheumatoid arthritis. Acta Rheumatol Scand 1970; 15 (Suppl): 1–144.

    Google Scholar 

  27. 27.

    Fox SR, Masi AT, Robinson H et al. Earnings of early diagnosed arthritis patients and matched controls. J Chronic Dis 1976; 29: 469–478.

    Google Scholar 

  28. 28.

    US DHEW, PHS, National Center for Health Statistics. Disability Days, United States, 1975. Vital and Health Statistics Series 10, Number 118, DHEW Publication No. (HRA) 78-1546., US Government Printing Office, Washington 1978A.

    Google Scholar 

  29. 29.

    US DHEW, PHS, National Center for Health Statistics, Prevalence of Chronic Skin and Musculoskeletal Conditions, United States, 1976. Vital and Health Statistics Series 10, Number 124, DHEW Publication No. (PHS) 79-1552. US Government Printing Office, Washington, 1978B.

    Google Scholar 

  30. 30.

    Bloom BS. Direct medical costs of disease and gastrointestinal side effects during treatment for arthritis. Am J Med 1988; 84 (Suppl 2A): 20–24.

    Google Scholar 

  31. 31.

    Allaire SH, De Nardo BS, Szer IS et al. The economic impacts of juvenile rheumatoid arthritis. J Rheumatol 1992; 19: 952–955.

    Google Scholar 

  32. 32.

    Gewanter HL, Roghmann KJ, Baum J. The prevalence of juvenile arthritis. ArthritisRheum 1983; 26: 599–603.

    Google Scholar 

  33. 33.

    Bloom BS, Knorr RS, Evans AE. The epidemiology of disease expenses. JAMA 1985; 253:2393–2397.

    Google Scholar 

  34. 34.

    McCollum AT. Cystic fibrosis: Economic impact upon the family. Am J Public Health 1971; 61: 1335–1341.

    Google Scholar 

  35. 35.

    Deyo RA, Cherkin D, Conrad D, Volinn E. Cost, controversy, crisis: low back pain and the health of the public. Annu Rev Publ Health 1991; 12: 141–156.

    Google Scholar 

  36. 36.

    Andersson GBJ, Svensson HO, Oden A. The intensity of work recovery in low back pain. Spine 1983; 8: 880–884.

    Google Scholar 

  37. 37.

    Biering-Sorenson F. Low back trouble in a general population of 30-, 40-, 50-, and 60-year old men and women: Study design, representativeness and basic results. Dan Med Bull 1982; 29: 289–299.

    Google Scholar 

  38. 38.

    Frymoyer JW, Pope MH, Clements JH et al. Risk factors in low-back pain. An epidemiological study. J Bone Joint Surg 1983; 65: 213–218.

    Google Scholar 

  39. 39.

    Svensson HO, Andersson GBJ. Low back pain in 40–47-year old men: I. Frequency of occurrence and impact on medical services. Scand J Rehab Med 1982; 14: 47–53.

    Google Scholar 

  40. 40.

    Valkenburg HA, Haanen HCM. The epidemiology of low back pain. In:White AA, Gordon SL (eds) American Academy of Orthopaedic Surgeons Symposium on Idiopathic Low Back Pain. St Louis, CV Mosby, 1982: 9–22.

    Google Scholar 

  41. 41.

    Frymoyer JW. Back pain and sciatica. N Engl J Med 1988; 318: 291–300.

    Google Scholar 

  42. 42.

    Deyo RA, Tsui-Wu YJ. Descriptive epidemiology of low back pain and its related medical care in the United States. Spine 1987; 12: 264–268

    Google Scholar 

  43. 43.

    Leavitt SS, Johnston TL, Beyer RD. The process of recovery: Patterns in industrial back injury. Part 4: Mapping the health care process. Indust Med Surg 1972; 41: 5–9.

    Google Scholar 

  44. 44.

    Snook SH. The costs of back pain in industry.Occup Med 1988; 3: 1–5.

    Google Scholar 

  45. 45.

    Frymoyer JW, Cats-Baril L. An overview of the incidences and costs of low back pain. Orth Clin N Am 1991; 22: 263–271.

    Google Scholar 

  46. 46.

    Kellgren JH, Lawrence JS. Osteoarthrosis and disk degeneration in an urban population. Ann Rheum Dis 1958; 17: 388–397.

    Google Scholar 

  47. 47.

    National Center for Health Statistics. Prevalence of Selected Impairments. United States-1977, Series 10, No. 132. Hyattsville, Maryland, DHHS Publication (PHS) 81-1562, 1981.

  48. 48.

    Statistics Appendix. Digest of date on the rheumatic disease 5: Morbidity and industry,and rheumatism in general practice. Ann Rheum Dis 1974; 33: 93–105.

    Google Scholar 

  49. 49.

    Klein BP, Jensen RC, Sanderson LM. Assessment of workers' compensation claims for back strains/sprains. J Occup Med 1984; 26: 443–448.

    Google Scholar 

  50. 50.

    Webster BS, Snook SH. The cost of compensable low back pain. J Occup Med 1990; 32: 13–15.

    Google Scholar 

  51. 51.

    Leavitt SS, Johnston TL, Beyer RD. The process of recovery: Patterns in industrial back injury. Part I: Costs and other quantitative measures of effort. Indust Med Sung 1971; 40: 7–14.

    Google Scholar 

  52. 52.

    Holbrook TL, Grazier K, Kelsey JL, Stauffer RN. The Frequency of Occurrence Impact and Cost of Selected Musculoskeletal Conditions in the United States. Park Ridge, IL: American Academy of Orthopaedic Surgeons, 1984: 154–156.

    Google Scholar 

  53. 53.

    Glazier KL, Holbrook TL, Kelsey JL et al. The Frequency of Occurrence, Impact, and Cost of Musculoskeletal Conditions in the United States.Chicago: American Academy of Orthopaedic Surgeons, 1984.

    Google Scholar 

  54. 54.

    Heilinger FJ. Updated forecasts of the costs of medical care for persons with AIDS. Public Health Rep 1990; 105: 1–12.

    Google Scholar 

  55. 55.

    American survey. Worrying about health. Economist, June 15, 1991.

  56. 56.

    Minnesota Dept. of Labor and Industry. Characteristics of Minnesota Work-related Injuries and Illnesses 1983–1989. Minnesota Safety Annual Report, St Paul, 1990.

  57. 57.

    Burton JF. Quoted in The Wall Street Journal, May 24, 1991.

  58. 58.

    Ring W. Back pain cure: Do nothing. Chicago Tribune, April 29, 1991.

  59. 59.

    SpineCare Medical Group Bulletin, Fall 1990 (San Francisco, CA).

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Lee, P. The economic impact of musculoskeletal disorders. Qual Life Res 3, S85–S91 (1994).

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Key words

  • Economic impact
  • health care costs
  • low back pain
  • musculoskeletal disorders
  • rheumatoid arthritis