Musculoskeletal pain and disability
The occurrence of pain and disability from all causes
Data comes from three sources:
- Surveys of the general
population seeking current reports of any pain, and if present,
whether it is sufficient to cause interference with daily
activities
- Data on attendance at general
practice with any musculoskeletal pain disorders
- Data on the contribution of
musculoskeletal disorders to the occurrence of disability in
the population
How common is pain?
Musculoskeletal pain is very common in the population, although
much may be self-limiting and not require medical care. In answer
to the question “In the past 4 weeks have you had pain that has
lasted for one day or longer in any part of your body?”
The following are typical data by gender from a recent general
population survey in Staffordshire and nearby areas:
| Age group |
Females |
Males |
| 50 - 59 |
69% |
66% |
| 60 - 69 |
69% |
68% |
| 70 - 79 |
64% |
61% |
| 80+ |
66% |
57% |
Source1
A more robust view of the importance of such pain is an
understanding of whether it interferes with normal activities. Thus
in the same survey as above, the question “During the past 4 weeks,
how much did pain interfere with your normal work (including
housework)?”, showed that this was true for between a third and a
half of all the population aged over 50.
How commonly does pain interfere with normal activities?
| Age group |
Females |
Males |
| 50 - 59 |
32% |
33% |
| 60 - 69 |
38% |
39% |
| 70 - 79 |
43% |
37% |
| 80+ |
50% |
41% |
Source1
How common is chronic pain?
Many musculoskeletal pains are fortunately short lived but a
substantial proportion of the population complain of persistent
disabling pain. A population study of 5,000 people on chronic pain
(defined as ‘pain or discomfort that persisted continuously or
intermittently for longer than 3 months’) has shown that across all
age groups chronic pain affects at least 10% of the population.
Chronic back pain is the commonest source of pain. Pain due to
self-reported arthritis, which is mainly, though not exclusively
caused by osteoarthritis, is uncommon in young adults but becomes
increasingly common as the population ages. Nearly three in ten of
all those aged over 75 are in chronic pain due to arthritis.
| Age group |
Back pain |
Arthritis |
| 25 - 34 |
12% |
1% |
| 35 - 44 |
17% |
5% |
| 45 - 54 |
18% |
12% |
| 55 - 64 |
19% |
20% |
| 65 - 74 |
15% |
26% |
| ≥75 |
15% |
28% |
| Total population |
16% |
15.8% |
Source2
How big is the burden in general practice?
Although many sufferers, especially the elderly, do not seek
medical care for the musculoskeletal pains, data on general
practice attendees give a pointer not only of the occurrence of
‘significant’ pains but also of the workload on general practice. A
number of general practices in the UK keep a continual record of
the reason for consultation of all patients who attend. Many of
these individuals attend more than once for the same condition.
Further for musculoskeletal disorders an individual patient may
attend during a single year, for example, with more than one
individual disorder.
From these data as a good indicator of the level of
musculoskeletal problems in the community the tables below present
information on the percentages and estimated numbers in the adult
UK population who visit their general practitioner at least once
during a year with any musculoskeletal complaint. These rates have
been consistent over the past 6 years.
How many adults consult their GP with musculoskeletal problems
each year?
| Group |
Percentage
consulting |
UK estimate
(millions) |
| Males |
17% |
4.1 |
| Females |
23% |
6.0 |
| All |
20% |
10.1 |
Source3
Not surprisingly the proportion increases with age.
The influence of age on annual GP consultation rates for
musculoskeletal problems
Group
(age) |
Percentage
consulting |
UK estimate
(millions) |
| Males |
|
|
| 15 - 24 |
8% |
0.3 |
| 25 - 44 |
13% |
1.1 |
| 45 - 64 |
20% |
1.5 |
| 65 - 74 |
27% |
0.6 |
| 75+ |
30% |
0.5 |
| Females |
|
|
| 15 - 24 |
11% |
0.4 |
| 25 - 44 |
17% |
1.5 |
| 45 - 64 |
28% |
2.1 |
| 65 - 74 |
35% |
0.9 |
| 75+ |
36% |
1.0 |
Source3
References
- Thomas E, Peat G, Harris L, Wilkie R, Croft PR. The
prevalence of pain and pain interference in a general population of
older adults: cross-sectional findings from the North Staffordshire
Osteoarthritis Project (NorStOP). Pain 2004;
110(1-2):361-8.
- Elliott AM, Smith BH, Penny KI, Smith WC, Chambers WA.
The epidemiology of chronic pain in the community. Lancet
1999; 354(9186):1248-52.
- Royal College of General Practioners - Birmingham
Research Unit. Annual prevalence report 2006.