The burden of musculoskeletal diseases in the general population of Spain: results from a national survey

Abstract

Objective-The objective of the EPISER study was to estimate the prevalence of rheumatoid arthritis (RA), low back pain, hand and knee osteoarthritis (OA), and fibromyalgia in the adult Spanish population, and to assess the impact of these diseases on function and quality of life, and use of health and social resources. Methods-2998 subjects aged 20 years or above were randomly selected by stratified multistage cluster sampling from the censuses of 20 municipalities. Trained rheumatologists carried out structured visits at which subjects were asked about rheumatic symptoms and sociodemographic characteristics, completed validated instruments for measuring function (HAQ) and quality of life (SF-12), and underwent a standardised physical examination. Cases were defined by previously validated criteria. Results-The estimated prevalences with 95% confidence intervals were as follows: RA lifetime cumulative: 0.5% (0.3 to 0.9); low back pain: 14.8% (12.2 to 17.4); symptomatic knee OA: 10.2% (8.5 to 11.9); hand OA: 6.2% (5.9 to 6.5); fibromyalgia: 2.4% (1.5 to 3.2). Most conditions significantly impaired function and quality of life. Conclusions-The EPISER study has internal and external validity for application of the results to the adult Spanish population. The diseases studied aVect a significant proportion of the population, with various degrees of impact on disability and quality of life resulting in a significant number of physician visits, work disability, and medication use. (Ann Rheum Dis 2001;60:1040-1045 Musculoskeletal diseases are one of the main causes of disability in the developed world and consume a large amount of health and social resources. The proportion of the population disabled by rheumatism ranges from 2.8% in the United States to 8% in Great Britain. [1][2][3] Nevertheless, for reasons that are not clear, these conditions are not commonly the target of epidemiologists and thus epidemiological studies on the occurrence and impact of musculoskeletal diseases compared with diseases aVecting the cardiovascular or pulmonary systems, for instance, are infrequent.Most of the epidemiological data on rheumatic diseases at the national level come either from a small number of sampling areas considered representative of the country or are secondary data from national health surveys in which information about rheumatic diseases relies mainly on self-reporting.

Incidence of Physical Disability Related to Musculoskeletal Disorders in the Elderly: Results From a Primary Care–Based Registry

“…The specific diagnoses by GPs were mostly axial and peripheral osteoarthritis, followed by soft tissue problems and inflammatory diseases, as expected (2,8,16,24,25). The presence of a high Charlson index, a high level of pain, and associated MSD comorbidities reflects the spectrum of the more prevalent diseases at this age (26) and gives a clear idea of the complex management needed to improve the situation.…”

Musculoskeletal disorders among first-year Ghanaian students in a nursing college

“…They are a major cause of severe long-term pain and disability 1,2 , productivity loss 3 and reduced quality of life 4,5 which can lead to reduced educational attainment among students. In recent years, MSDs have emerged as a public health problem among college students, with the estimated prevalence rate varying between 32.9% and 89.3% in different parts of the world [6][7][8][9][10][11][12][13][14][15][16][17][18][19] .…”

Evaluation of health-related quality of life in patients candidate for spine and other musculoskeletal surgery

“…About 10 million people are estimated to visit a doctor each year for a problem of this kind [10], which is also an major cause of temporary work disability [50]. In the Western world, physician visits for these conditions exceed all other visits.…”

“…Despite this high prevalence, in Spain, there are practically no data about how these conditions affect the quality of life (QOL) of individuals. Only Carmona [10] showed, in 2001, that musculoskeletal conditions (rheumatoid arthritis, osteoarthritis, lumbar pain, and fibromyalgia) have an effect on physical functioning in a way that affects the quality of life of patients, as compared to the ''healthy'' population. Within these musculoskeletal diseases, lumbar pain is the main and most costly problem in the age group of 20-50 years [32,46], and degenerative disease of the hip and the knee occupy this place in the over 60 years of age group [3].…”