Professor John Carey
Musculoskeletal diseases are the most common cause of disability and work-related disability in the European Union and Ireland.
Musculoskeletal diseases are the most common cause of disability and work-related disability in the European Union and Ireland. The Global Burden of Disease study in 2012, showed the most common cause of disability worldwide today is lower back and neck pain. Disability related to musculoskeletal diseases has risen by almost 50% over the past 2 decades, while it is only 33% for other diseases.
It is estimated approximately 30,000 osteoporotic fractures occur each year in Ireland.
A 2011 report states 40% of Irish adults experience chronic musculoskeletal pain, a number that is greater than the combined number of people with cardiovascular disease, chronic obstructive lung disease, diabetes mellitus and cancer.
An E.U. report on musculoskeletal diseases states governments and health authorities are unaware of the size of the problem, including the disability, lost productivity and economic burden.
Despite these statistics, funding for musculoskeletal diseases and research in North America and Europe is only a fraction of that provided for cancer and cardiovascular disease.
Osteoarthritis causes pain, stiffness, swelling and deformity of the joints, and most commonly affects hands, toes, knees, hips and back. However any joint can be affected. Treatment today consists of education, exercise, diet, pain control and occasionally surgery.
A recent survey of more than 600 Irish patients with moderate-severe arthritis, fibromyalgia and osteoporosis showed:
- 1 in 5 were disabled and 15% had taken early retirement due to their illness
- 60% stated their illness had moderate-severe impairment on their life
- 10% missed a medical appointment in the past year because they could not afford it
- 60% reported moderate-severe pain, and 30% reported depression.
What is osteoporosis?
Osteoporosis is a disease which results in loss of bone strength and structure making them brittle and prone to breaking. The medical term for a broken bone is a fracture. Osteoporosis does not result in any symptoms until a bone breaks, but when that happens the results can be devastating.
An American study published a decade ago, showed the annual risk of fracture for a post-menopausal woman, is greater than her annual risk of heart attack, stroke, death from heart disease and invasive breast cancer combined.
A 2017 report from the International Osteoporosis Foundation states Ireland has the 6th highest rate of hip fracture in the world. A conservative estimate suggests approximately 30,000 osteoporotic fractures occur each year in Ireland.
How can we treat it?
- A diet rich in calcium and vitamin D. Supplements are only needed in those with poor diets
- Fall prevention assessments
- Exercise programmes for strength, conditioning and weight-bearing
- Medications for those over fifty with fragility fractures or a T-score <-2.5 when indicated
- Surgery for some broken bones
- Identification and treatment of any underlying causes: e.g. arthritis, coeliac disease.
Why is early treatment and diagnosis so important?
There have been improvements over the past fifty years when it comes to osteoporosis. However, one in five Irish women and one in three men will die in the year following a hip fracture, so it is not a benign disease. Of those who survive, many will end up confined to a nursing home and never regain their pre-fracture capacity and health.
Irish fracture liaison programmes have shown that more than 80% of such patients can be identified, diagnosed and treated. Every hospital and region needs these services to close the treatment gap and quality chasm.