Musculoskeletal conditions - arthritis and osteoporosis and back pain

Musculoskeletal conditions, of which arthritis and osteoporosis are most common, are one of the major causes of chronic pain and disability in Australia.

Page last updated: 16 January 2015

What are musculoskeletal conditions?
How common are musculoskeletal conditions?
What are the risk factors for musculoskeletal conditions?
Treatment or management of musculoskeletal conditions
Programmes and initiatives to address musculoskeletal conditions
Related links

What are musculoskeletal conditions?

Musculoskeletal conditions are defined as conditions of the bones, muscles and their attachments such as joints. Arthritis involves inflammation of the joints, causing pain, stiffness and disability. Other musculoskeletal conditions, such as osteoporosis and back problems, affect the muscles, bones and joints.

There are more than 150 forms of arthritis and musculoskeletal conditions, but the more common conditions include:
  • Osteoarthritis: a degenerative joint condition affecting the weight-bearing joints such as the hips, knees and ankles and well as the hands and spine.
  • Rheumatoid arthritis: an autoimmune disease where the body’s immune system attacks its own tissues, and thus differs from osteoarthritis which is characterised by wear and tear of joints. It is more severe than osteoarthritis and while not only confined to the joints, the hand joints are the most commonly affected.
  • Osteoporosis: a largely preventable condition whereby there is a progressive loss of bone density and decrease in the strength of the skeleton, such that even a minor bump or accident can cause serious fractures. Often people are not aware they have osteoporosis because the condition lacks obvious symptoms. The condition is much more common in females than in males.
  • Juvenile arthritis: A term used to describe arthritis occurring in children under the age of 16 years. Most forms are believed to be autoimmune disorders. Children with arthritis report chronic or recurrent pain with restriction in physical activity. Long periods of active arthritis can impair muscle development and lead to growth abnormalities and joint problems.
  • Back problems: Back pain and back problems can be attributed to numerous factors including muscle strain or the displacement of an intervertebral disc. These may be caused by underlying illness or injury. Top of page

How common are musculoskeletal conditions?

In 2011-12, an estimated 6.1 million Australians (14.8% of the population) had musculoskeletal conditions. In 2010, musculoskeletal conditions were the leading cause of disability in Australia.

Arthritis:

  • An estimated 3.3 million Australians (14.8% of the population) had arthritis in 2011-12.
  • The two most common types of arthritis are osteoarthritis and rheumatoid arthritis. In 2011-12, more than half (55.9%) of those with arthritis had osteoarthritis, equivalent to almost 1.9 million people. Rheumatoid arthritis affected 13.6% of arthritis sufferers, equivalent to more than 400,000 people.
  • Arthritis more commonly affects females than males, and is also more common among older Australians.
  • The rate of arthritis declined between 2007-08 and 2011-12, falling from 14.5% to 13.8%.

Osteoporosis:

  • Osteoporosis affected an estimated 726,000 people (3.3% of Australians) in 2011-12.
  • Women account for the majority of osteoporosis cases (81.9%) and the disease mostly affects people aged 55 years and over.
  • The proportion of Australians with osteoporosis has increased over the last decade (up from 1.6% in 2001) but has remained relatively stable since 2007-08.

Back pain:

  • In 2011-12, back pain affected an estimated 2.8 million people (12.7% of the population).
  • Back pain appears to affect people more consistently across all ages. Top of page

What are the risk factors for musculoskeletal conditions?

Common risk factors for many musculoskeletal conditions include ageing, overweight or obesity which places pressure on joints, and a sedentary lifestyle.

People with musculoskeletal conditions often have other diseases and long-term health conditions as comorbidities, which is most likely due to similar risk factors as described above. Musculoskeletal conditions often contribute to obesity, as painful joints and/or disability may restrict physical activity.
  • Osteoarthritis: Risk factors include ageing, overweight or obesity, joint injury or trauma, joint misalignment, and repetitive loading tasks (e.g. kneeling, squatting, heavy lifting).
  • Rheumatoid arthritis: The exact cause of rheumatoid arthritis is unknown, although family history of the disease is thought to have a role. The condition is more common in women, with almost twice as many women affected than men.
  • Osteoporosis: Risk factors include ageing, being female, menopause, significantly low body weight, poor calcium intake, smoking and Vitamin D deficiency. The condition is up to four times more common in women than in men.
  • Juvenile arthritis: The cause of juvenile arthritis and its risk factors are currently unknown. Most forms are believed to be autoimmune disorders.
  • Back problems: Risk factors include issues with posture and injuries, as well as other diseases such as osteoarthritis, disc disease, osteoporosis, and some genetic conditions. Other factors that may increase the risk of developing back problems include age, physical fitness, smoking, overweight or obesity, and the type of work a person does. Top of page

Treatment or management of musculoskeletal conditions

There is no cure for the majority of musculoskeletal conditions. Prevention and management principles are to control weight, keep fit and protect the joints in order to avoid or delay disease onset. Pain management also plays a large role in improving quality of life for many people with musculoskeletal conditions.
  • Osteoarthritis: Joint replacement is a common treatment for osteoarthritis, and this is the predominant condition leading to hip and knee replacement surgery in Australia. Weight management is important in helping to control progression of the disease.
  • Rheumatoid Arthritis: There is no known cure for rheumatoid arthritis, but evidence suggests that early pharmaceutical interventions can assist in reducing joint damage and improving health outcomes.
  • Osteoporosis: Currently there is no known cure for osteoporosis. Adequate calcium intake, healthy Vitamin D levels, physical activity and early pharmaceutical interventions can help to strengthen bones and prevent fractures for those with osteoporosis. Falls prevention is also important in preventing fractures and managing this condition.
  • Juvenile arthritis: There is no known cure for juvenile arthritis, but evidence suggests that early detection, pain management and pharmaceutical interventions are important for improving health outcomes and maintaining normal growth.
  • Back problems: Treatment of back pain varies according to the underlying cause and often spans across a variety of health care settings. Common treatments include pain management including through medication use, rehabilitation and allied health services, and in extreme cases, spinal surgery. Top of page

Programmes and initiatives to address musculoskeletal conditions

Arthritis and other musculoskeletal conditions are addressed at a national level through a range of programmes and initiatives to support treatment and management of arthritis and other musculoskeletal conditions. Significant funding is also provided to ensure that quality clinical research is conducted into arthritis and musculoskeletal conditions, and to maintain national monitoring and surveillance measures.

Programmes that support management and treatment of musculoskeletal conditions include:
  • The Medicare Benefits Schedule, which provides subsidies for patient care and includes Medicare items for the planning and management of chronic and terminal conditions. Eligible patients can also be referred by a GP for up to five Medicare subsidised allied health services that are directly related to the treatment of their chronic condition, including musculoskeletal conditions.
  • The Pharmaceutical Benefits Scheme (PBS) continues to provide subsidies for medicines used in the treatment of musculoskeletal conditions and pain management.
  • Significant investments in arthritis research through the National Health and Medical Research Council (NHMRC) for research into arthritic and rheumatoid conditions. Improving the care of patients with multiple and complex chronic diseases, including musculoskeletal conditions, has also been identified by the NHMRC as a major focus in its 2013-15 Strategic Plan.
Additionally, the Australian Institute of Health and Welfare is funded to support national surveillance and monitoring of osteoarthritis, rheumatoid arthritis, juvenile idiopathic arthritis, osteoporosis and other musculoskeletal conditions.

Funding is also provided to Arthritis Australia to improve consumer awareness and to build and implement a local exercise programme on a national level. Similarly, Osteoporosis Australia receives funding to maintain and update resource materials, improve osteoporosis management in primary care and deliver an exercise program focussing on building bone strength and density. Top of page

Related links