Arthritis And Long-term Musculoskeletal Pain

Dispelling The Myths And Discussing The Role Of Exercise Professionals

By Dr Inam Haq

Why Should You Know About Arthritis And Musculoskeletal Pain? From a medical point of view, arthritis refers to conditions that can lead to inflamed or damaged joints. Musculoskeletal (MSK) disease refers to a wide variety of over 200 conditions affecting bones, joints, and muscles as well as pain syndromes such as fibromyalgia and rarer diseases affecting the immune system such as lupus.

Arthritis and musculoskeletal problems are common and come under the banner of “long term conditions”. The main symptoms are pain, limitation of movement and effects on activities of daily living, both physical and psychological.

Arthritis and MSK problems can affect people of all ages, although the risk increases from the late 40s onwards. It is not an inevitable part of the ageing process. Obesity for example increases your risk of knee Osteoarthritis (OA) 14 times. Conditions such as hyper mobility (loose or bendy joints) are common in children and adolescents and often present alongside fatigue and joint or muscle pain.

The impact of MSK conditions on the individual and society are significant. Over 1/3 of the population over 50-years-old have arthritis pain that interferes with normal activities . OA is the most common form of arthritis (often known as “wear and tear”). Studies show that over 70% of people with OA have some form of constant pain. Knee OA causes pain and disability in 20% of people in their 50s and a third of people in their mid 70s.

MSK pain is the second most common reason for time off work after stress and other mental health problems, leading to 7.6 million working days lost annually. 20% of the population consult a GP about an MSK problem, mainly OA and back pain. The cost to the health service of treating patients with OA is £5.2 billion pounds per year (82,000 knee replacements in 2010), excluding additional social care costs. Living with long-term pain and disability leads to an increased risk of depression that also affects quality of life and ability to work. With an ageing and increasingly obese population such as we have at the moment, MSK problems will become even more common. It is important that health and

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exercise professionals are able to give good advice to patients to manage their MSK condition.

Work carried out by Arthritis Research UK showed that patients with arthritis wanted good quality advice on how to maximise their physical function with exercise, but that health professionals were not confident on what advice to give. There is also a myth amongst many people and health professionals that “nothing can be done” about arthritis and that rest rather than exercise is the best treatment. This approach can be counterproductive, leading to loss of independence, further reductions in muscle strength and balance, and an increase in pain, creating a vicious circle of pain and loss of mobility.

As REPs members you will encounter many people in your daily work with long-term MSK pain. You have a key role with other health and social care professionals to destroy the myth that exercise is harmful or of no use in order to empower people to manage their condition actively with exercise. This can lead to physical and psychological benefits.

This article will focus on the most common form of arthritis and MSK pain, Osteoarthritis (OA).

The REPs Journal 2013;27(May):14-15