The Burden of Musculoskeletal Diseases in the United States (BMUS)

253 Pages·2015·5.54 MB·English

The Burden of Musculoskeletal Diseases in the United Project Coordinator
Statesis a joint project of the American Academy of Sylvia I. Watkins-Castillo, PhD
Orthopaedic Surgeons, American Academy of
Physical Medicine and Rehabilitation, American Staff
College of Rheumatology, American Society for Bone Robert H. Haralson, III, MD, MBA, Medical Director,
and Mineral Research, Arthritis Foundation, AAOS
National University of Health Sciences, Orthopaedic Toby R.W. King, CAE, Executive Director, USBJD
Research Society, Scoliosis Research Society, and the Amy Miller, Senior Director, Research, Training and
United States Bone and Joint Decade. Quality, ACR
Thomas E. Stautzenbach, MA, MBA, CAE, Executive
Management Oversight Team and Director, AAPM&R
Major Contributing Organizations Charles M. Turkelson, PhD, Director, Research and
Scientific Affairs, AAOS
Joshua J. Jacobs, MD
Marilyn Fox, PhD, Director, Publications, AAOS
Chair, Management Oversight Team, The Burden of
Mary Steermann Bishop, Senior Manager, Production
Musculoskeletal Diseases in the United States
& Archives, AAOS
Gunnar B. J. Andersson, MD, PhD
John-Erik Bell, MD Courtney Astle, Assistant Production Manager, AAOS
Stuart L. Weinstein, MD
American Academy of Orthopaedic Surgeons (AAOS) Cover Design
Rick Cosaro, Cosaro & Associates, Ltd.
John P. Dormans, MD
Scoliosis Research Society (SRS)
The material presented in The Burden of Musculoskeletal Diseases in the
United Statesis made available for informational purposes only. This
Steve M. Gnatz, MD, MHA
material is not intended to suggest procedures or course of
American Academy of Physical Medicine and
treatment, only to provide an interpretation of available data on the
Rehabilitation (AAPM&R) incidence and prevalence of most major musculoskeletal conditions.
Nancy Lane, MD
All rights reserved. No part of this publication may be reproduced,
United States Bone and Joint Decade (USBJD) stored in retrieval system, or transmi(cid:3)ed, in any form, or by any
means, electronic, mechanical, photocopying, recording, or
J. Edward Puzas, PhD
otherwise, without prior wri(cid:3)en permission from the publisher.
Orthopaedic Research Society (ORS) Copyright © 2008 by the American Academy of Orthopaedic
President, United States Bone and Joint Decade Surgeons.
(USBJD) ISBN 978-0-89203-533-5
E. William St. Clair, MD The Burden of Musculoskeletal Diseases in the United States
Edward H. Yelin, PhD 6300 N. River Road
American College of Rheumatology (ACR) Rosemont, IL 60018
United States of America
1-800-626-6726
Additional Contributing Organizations
Suggested citation: United States Bone and Joint Decade: The Burden
American Society for Bone and Mineral Research of Musculoskeletal Diseases in the United States. Rosemont, IL:
(ASBMR) American Academy of Orthopaedic Surgeons;2008.
Arthritis Foundation
Visit www.boneandjointburden.orgfor
National University of Health Sciences
upcoming new chapters and an electronic version of
this publication.
ii The Burden of Musculoskeletal Diseases in the United States - Copyright © 2008
Authors and Reviewers Steven M. Kurtz, PhD
Gunnar B. J. Andersson, MD, PhD Nancy Lane, MD
Jeannette Bouchard Assia Miller, MD, MPH
Kevin J. Bozic, MD, MBA Reba L. Novich, MSW
Robert M. Campbell, Jr., MD Richard Olney, MD, MPH
Miriam G. Cisternas, MS Peter Panopalis, MD
Adolfo Correa, MD. MPH, PhD David J. Pasta, MS
Felicia Cosman, MD Andrew N. Pollak, MD
Janet D. Cragan, MD, MPH J. Edward Puzas, PhD
Kristen D’Andrea, BA B. Steven Richards, III, MD
Nancy Doernberg John P. Sestito, JD, MS
John P. Dormans, MD, FACS Csaba Siffel, MD, PhD
Ann L. Elderkin, PA Paul D. Sponseller, MD
Zarina Fershteyn, MPH E. William St. Clair, MD
Aimee J. Foreman, MA Andrew Stuart, MA
Steven Gitelis, MD Kimberly J. Templeton, MD
Steve M. Gnatz, MD, MHA George Thompson, MD
Robert H. Haralson, III, MD, MBA Laura Tosi, MD
Charles G. (Chad) Helmick, MD William G. Ward, Sr., MD
Serena Hu, MD Sylvia I. Watkins-Castillo, PhD
Jeffrey N. Katz, MD Stuart L. Weinstein, MD
Toby King, CAE James G. Wright, MD, MPH, FRCSC
Ron Kirk, MA, DC Edward H. Yelin, PhD
Bone and Joint Decade
The Bone and Joint Decade is an international collaborative movement sanctioned by the United Nations/World
Health Organization and working to improve the quality of life for people with musculoskeletal conditions and
to advance the understanding, prevention and treatment of these conditions.
Officially proclaimed by the U.S. President, the United States Bone and Joint Decade (USBJD) 2002-2011 has been
endorsed by all 50 States and more than one hundred national health care professional, patient and public
organizations, all 125 U.S. medical schools and many colleges of medicine.
The goal of the United States Bone and Joint Decade is to improve bone and joint health by enhancing
collaborative efforts among individuals and organizations in order to raise awareness of the growing burden of
musculoskeletal disorders on society, to promote wellness and prevent musculoskeletal disease, and to advance
research that will lead to improvements in prevention, diagnosis and treatment.
www.usbjd.org
[email protected]
Phone: [phone]
The Burden of Musculoskeletal Diseases in the United States - Copyright © 2008 iii
iv
Table of Contents
vii Preface
ix Foreword
1 Chapter 1: Burden of Musculoskeletal Disease Overview
21 Chapter 2: Spine: Low Back and Neck Pain
55 Chapter 3: Spinal Deformity and Related Conditions
71 Chapter 4: Arthritis and Related Conditions
97 Chapter 5: Osteoporosis and Bone Health
123 Chapter 6: Musculoskeletal Injuries
163 Chapter 7: Congenital and Infantile Developmental Conditions
of the Musculoskeletal System
175 Chapter 8: Neoplasms of Bone and Connective Tissue
195 Chapter 9: Health Care Utilization and Economic Cost
of Musculoskeletal Diseases
227 Appendices
243 Index
The Burden of Musculoskeletal Diseases in the United States - Copyright © 2008 v
vi
Preface
It is with pleasure that I introduce you to this neoplasms, and health care utilization and
publication of the Burden of Musculoskeletal costs. The biomedically inclined reader will
Diseases in the United States, the timely result find within these pages both food for thought
of a partnership between the American and a call to action.
Academy of Orthopaedic Surgeons and a
number of other organizations supporting The plight of millions of Americans whose
the U.S. Bone and Joint Decade (2002-2011). lives are affected by the physical, financial,
The level of disease recognition that the and emotional demands of musculoskeletal
Decade has provided has done much to push conditions make the findings of Burden
the state of the science forward, and this new difficult to ignore. I encourage you to read
publication presents a snapshot of how far and digest its contents, and to appropriate for
we have come since its predecessor, the 1999 yourself those parts within your specific
Musculoskeletal Conditions in the United States, areas of interest or expertise.
was released.
Although many advances have been made,
musculoskeletal conditions remain common,
chronic, and costly—and potentially
disabling—to an increasingly graying
population with high expectations of the Stephen I. Katz, MD, PhD
health system. With the National Center for Director
Health Statistics’ 2005 National Health National Institute of Arthritis and
Interview Survey as a solid base, this Musculoskeletal and Skin Diseases
publication examines such issues as spinal National Institutes of Health
problems, arthritis and joint pain, Bethesda, Maryland
osteoporosis, injuries, congenital conditions, January 10, 2008
The Burden of Musculoskeletal Diseases in the United States - Copyright © 2008 vii
viii
Foreword
Musculoskeletal disorders and diseases are the musculoskeletal diseases to educate health care
leading cause of disability in the United States professionals, policy makers, and the public. The
and account for more that one-half of all chronic information presented here is an update of two
conditions in people over 50 years of age in previous editions entitled Musculoskeletal
developed countries. The economic impact of Conditions in the United States, published in 1992
these conditions is also staggering. In 2004, the and 1999 by the American Academy of
sum of the direct expenditures in health care Orthopaedic Surgeons. The present volume,
costs and the indirect expenditures in lost wages renamed The Burden of Musculoskeletal Diseases in
for persons with a musculoskeletal disease the United States,represents a true collaboration of
diagnosis has been estimated to be $849 billion a coalition of professional organizations
dollars, or 7.7% of the national gross domestic committed to the mission of the U.S. Bone and
product. Joint Decade.
Beyond these statistics, the human toll in terms of These data should stimulate increased investment
the diminished quality of life is immeasurable. in basic, translational, clinical, and health policy
This situation is unlikely to improve in the research to delineate the underlying mechanisms
foreseeable future and will likely be intensified of these diseases and their response to treatment.
by current demographic trends, including the Through such research, novel preventive and
graying of the baby boomer population, the therapeutic approaches with protential to
epidemic of morbid obesity, and the higher mitigate the societal and personal impact of
recreational activity levels of our elderly musculoskeletal disease will emerge.
population.
Joshua J. Jacobs, MD
Despite these compelling facts, the investment in Chair, Management Oversight Team, Burden of
musculoskeletal research in the United States lags Musculoskeletal Diseases in the United States,
behind other chronic conditions. While American Academy of Orthopaedic Surgeons
musculoskeletal diseases are common, disabling
and costly, they remain under-appreciated, under John P. Dormans, MD
recognized, and under-resourced by our national Scoliosis Research Society
policy makers.
Steve M. Gnatz, MD, MHA
In March 2002, President George W. Bush American Academy of Physical Medicine and
declared the years 2002–2011 the National Bone Rehabilitation
and Joint Decade. The mission of the U.S. Bone
and Joint Decade is to “promote and facilitate Nancy Lane, MD
collaboration among organizations committed to United States Bone and Joint Decade
improving bone and joint health through
education and research.” J. Edward Puzas, PhD
Orthopaedic Research Society
This volume serves the mission of the decade in
that several professional organizations concerned E. William St. Clair, MD
with musculoskeletal health have collaborated to American College of Rheumatology
tabulate up-to-date data on the burden of
The Burden of Musculoskeletal Diseases in the United States - Copyright © 2008 ix