Many diseases that cause disability and pain are included in this category, so mortality is not really a very good indicator of the actual burden of this category of disease. Musculoskeletal disorders are the most frequent cause of physical disability for people in developed countries.1 The prevalence of musculoskeletal disorders increases with age. Internationally, musculoskeletal conditions are the most common causes of chronic disability and have increased by 25 per cent in the last 10 years.
The economic burden is high, although it seems to have decreased in Canada since 1993 mainly because of a decrease in disability costs. A 1998 analysis pegged the total cost of illness in Canada at $159 billion, of which
50 per cent could be attributed to specific diseases. Musculoskeletal diseases ranked second (after cardiovascular ones) at $15 billion, of which $4.4 billion was for arthritis alone.
Musculoskeletal diseases include rheumatoid arthritis, osteoarthritis, osteoporosis, major limb trauma, and spinal disorders.
The World Health Organization and the United Nations are calling the years 2000–2010 the Bone and Joint Decade, as rheumatic diseases cause more pain and disability than any other disease group. They have identified osteoarthritis, rheumatoid arthritis, osteoporosis, and low back pain as the four major musculoskeletal conditions causing the largest burden. Injuries to the musculoskeletal system also fall within this category, particularly sports injuries. The burden of these diseases is measured by the pain and disability caused.
People aged 50 and over who suffered a hip or spine fracture are at much greater risk of early death, according to a recent study published by the Canadian Medical Association. Nearly 25 per cent of people over 50 who break a hip die within five years of the injury.2
Risk factors vary, but typically include age and genetics. Women seem to be more prone to conditions such as osteoarthritis and osteoporosis. Men with jobs that involve heavy lifting or manual labour are at risk for back pain. As with many other chronic diseases, obesity, stress, and smoking are also risk factors.
The mortality rate due to diseases of the musculoskeletal system dropped in the 1970s in Canada, then remained fairly constant until 2000, when it jumped sharply.
Japan has improved the most. Its mortality rate fell steadily, from 6 deaths per 100,000 population in 1970 to 2 deaths in 2007.
Use the pull-down menu to compare the change in Canada’s mortality rate due to musculoskeletal system diseases with that of its peers.
1 World Health Organization, The Burden of Musculoskeletal Conditions at the Start of the New Millenium, WHO Technical Report Series #919 (Geneva: Author, 2003), p. 103, [online, cited June 22, 2009].
2 George Ioannidis et al., “Relation Between Fractures and Mortality: Results from the Canadian Multicentre Osteoporosis Study,” Canadian Medical Association Journal, 181 (5), p.5, [also online, cited September 10, 2009].