The burden of musculoskeletal conditions can be reduced through intervention at various points along the disease continuum including prevention, early diagnosis, prompt initiation of treatment, ongoing management and timely access to joint replacement1.
Although some chronic disease risk factors (eg family history, age or sex) are not able to be modified and so cannot be incorporated into prevention strategies, these factors can help to identify people or groups at high risk of developing a disease, enabling a targeted approach2.
- Common chronic disease risk factors
- Risk factors specific to arthritis and osteoporosis
- Early diagnosis, treatment and self management of musculoskeletal conditions
Common chronic disease risk factorsModifiable risk factors, common to all chronic disease include diet, weight, exercise, alcohol intake and smoking. It is important to understand that adopting healthy lifestyle behaviours will reduce the risk of all chronic diseases, including arthritis and musculoskeletal conditions.
Diet, weight and exerciseAdopting a healthy diet is essential for good health and well-being. Eating enough fruit and vegetables lowers the risk of developing chronic diseases. Poor nutrition and diet is linked to heart disease, type 2 diabetes and some cancers. These chronic illnesses place an enormous burden on individuals, families and society as a whole. A balanced diet will help to achieve a healthy weight and body. Increasing the intake of calcium and absorption of vitamin D will also assist in reducing the risk of developing arthritis and osteoporosis3.
Taking part in regular physical activity reduces the risk of heart disease, diabetes, stroke, high blood pressure and obesity as well as helping to build and maintain healthy bones, muscles and joints reducing the risk of injury and promoting psychological well-being. In particular, regular exercise not only aids in the prevention of musculoskeletal conditions, it helps to alleviate and reduce joint pain and stiffness and build strong muscle around the joints, and increases flexibility and endurance. Weight-bearing exercise assists in the maintenance of bone mass which helps with preventing osteoporosis.
Achieving and maintaining a healthy body weight is important. Being overweight or obese is a risk factor for most chronic diseases. People who are overweight or obese are at increased risk of arthritis or osteoporosis due to the increased load across the weight bearing joints, thus increasing the stress on cartilage and ligaments. Evidence suggests that obesity may cause metabolic changes that promote osteoarthritis4. Osteoarthritis can in turn contribute to being overweight or obese as painful joints may limit physical activity causing weight gain5. It is therefore essential for the prevention and management of osteoarthritis to exercise regularly and maintain a healthy diet to maintain a healthy body weight. Top of page
Alcohol intake and tobacco smokingAvoiding or eliminating exposure to tobacco in all its forms helps to improve health outcomes and reduce the risk of developing many chronic diseases. Reducing exposure to tobacco use reduces the risk of low bone mass, low bone strength and low body weight, all of which directly impact the development of osteoporosis. Tobacco smoking increases the risk of developing rheumatoid arthritis6.
Excessive alcohol consumption is a contributing factor to the development of many chronic diseases. It has negative impact on bone mass for osteoporosis and contributes to increased weight gain, which in turn places pressure on joints, an issue in arthritis conditions.
Further informationFurther information on chronic diseases and associated risk factors can be found at the following sites:
Australian Better Health Initiative "Measure Up"
A Healthy and Active Australia
National Tobacco Strategy 2004-2009
National Alcohol Strategy 2006-2009 Top of page
Risk factors specific to arthritis and osteoporosisThere are a number of ways of specifically reducing the risk of the onset of arthritis and osteoporosis, including avoiding joint injury, avoiding vitamin D and calcium deficiencies, and falls and falls injuries prevention strategies.
Joint traumaAvoiding joint trauma or injury is important in reducing the chance of developing osteoarthritis. Joint injuries associated with increased risk of osteoarthritis include dislocation, contusion, fracture and tears of the menisci or ligaments. Joint injury damages the tissues within the joint which can increase the stress on the cartilage. Osteoarthritis develops slowly over time, eventually leading to pain or stiffness in the previously injured joint.
CalciumAn adequate calcium intake is critical for the prevention of osteoporosis as calcium is essential for bone formation. As the body is unable to produce calcium it must be obtained from the diet. Low calcium intake is associated with low bone mineral density.
Vitamin DVitamin D is then required to help the body to absorb the calcium and regulate bone formation. Although small amounts of vitamin D can be obtained through diet, the majority is synthesised by the body via exposure of the skin to sunlight.
Falls injuries preventionFalls and falls injuries prevention strategies are critical to preventing or minimising the impact of osteoporosis. People with better posture, better balance and stronger muscles are less likely to fall and are therefore less likely to be injured and develop osteoporosis. Improving posture, balance and muscle strength through regular exercise together with a safe home environment, wearing appropriate clothing and footwear and monitoring eyesight will help to prevent falls and associated falls injuries which in turn will reduce the risk of developing osteoporosis. Top of page
Early diagnosis, treatment and self management of musculoskeletal conditionsEarly diagnosis and appropriate treatment is essential to delay progression of musculoskeletal conditions and the resultant pain, disability and loss of independence. The available treatments include:
- medications aimed at reducing pain, increasing mobility and slowing the progression of inflammation or the loss of bone mass
- physiotherapy and exercise and
- orthopaedic surgery.
Other measures that may be helpful to those with arthritis and osteoporosis include mechanical aids and modifications to houses to enhance mobility. Top of page
Self-managementSelf-management programs can provide counselling, encouragement and a support network. They allow people with musculoskeletal conditions to acquire the skills and knowledge to help them better manage their condition, which can lead to improvements in pain management, functioning and quality of life. Further information on self-management programs can be obtained through the Arthritis Australia website and the Osteoporosis Australia website.
1 Page 65, Arthritis and osteoporosis in Australia 2008, AIHW, December 2008
3 Page 100, Arthritis and osteoporosis in Australia 2008, AIHW, December 2008
4 Page 67, Arthritis and osteoporosis in Australia 2008, AIHW, December 2008
6 Page 1, A picture of rheumatoid arthritis in Australia, March 2009
Page last reviewed: 23 August 2010