STATE OF MUSCULOSKELETAL HEALTH 2018 - Arthritis and other musculoskeletal conditions in numbers - Arthritis Research UK
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STATE OF MUSCULOSKELETAL HEALTH 2018 Arthritis and other musculoskeletal conditions in numbers
Table of contents 03 Introduction 04 Glossary 05 What are musculoskeletal conditions? 06 What is the scale of the problem? 08 Key factors affecting musculoskeletal health 09 Physical activity 10 Obesity 11 Multimorbidity 12 What is the impact? 13 Years lived with disability 14 Work 15 Health and social care services 16 Economy 17 Economic benefits of musculoskeletal research 18 Condition specific statistics 19 Axial spondyloarthritis (including ankylosing spondylitis) 22 Gout 25 Juvenile idiopathic arthritis 27 Rheumatoid arthritis 30 Osteoarthritis 33 Back pain 36 Fibromyalgia 38 Osteoporosis and fragility fractures 41 References
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Introduction
Musculoskeletal conditions are extremely What is the state of What methodology was used?
common, however many people whose musculoskeletal health? Evidence used in this report was gathered
lives affected by them are still not receiving
This compendium of musculoskeletal health from the best available qualitative and
recognition they deserve and support they
data is an important resource providing the quantitative data. Research articles were
need. Millions of people across the UK are
best picture of the burden and impact of selected through systematic literature
limited by the pain, stiffness and fatigue
eight of the most prevalent musculoskeletal reviews and where possible restricted to
caused by musculoskeletal conditions,
conditions in the UK. Where available, UK population cohorts or comprehensive
such as arthritis or back pain.
data refers to the whole of the UK, however meta–analyses. This compendium presents
These conditions affect all aspects of due to gaps in coverage some findings are data from sound data sources, including
everyday life, by limiting what people can restricted to England. but not limited to:
do and their ability to be independent. This
The burden of musculoskeletal illness can 1. national datasets, surveys and audits;
in turn can have a devastating impact on
be defined by the number of people affected 2. findings from observational, surveillance
a person’s overall quality of life. In fact,
by a condition and at risk of developing the and modelling studies;
musculoskeletal conditions remain the
disease, but also by its wider impact. 3. musculoskeletal sector charity reports.
leading cause of years lived with disability
(YLDs) and the third largest cause of disability Musculoskeletal conditions can have a Who is it for?
adjusted life years (DALYs) in the UK today.1 significant impact both on a personal and
societal level. An individual’s home life, The State of Musculoskeletal Health 2018
Musculoskeletal conditions are a costly is a resource for health professionals,
relationships and work can all be affected,
and growing problem. The prevalence of policy makers, public health leads and
causing repercussions for society and the
musculoskeletal conditions is expected to anyone interested in musculoskeletal health.
wider economy, for example through the
continue to increase, due to our ageing We believe that with the best information
cost of treatment or lost productivity.
population, rising levels of obesity and you can build awareness, make more
physical inactivity. The latter two are major informed decisions, feel more confident
modifiable risk factors in the development and ultimately help more people with
of a musculoskeletal condition. musculoskeletal conditions.
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Glossary
Arthritis - a general term that most people use Fit note - issued to patients by doctors following Musculoskeletal conditions - a broad range
to mean painful joints. Medically, it refers to an assessment of their fitness for work. People of health conditions affecting bones, joints and
many different conditions leading to inflamed or who are off work sick for more than seven days muscles, pain syndromes and rarer conditions of
damaged joints. will normally need to provide their employer the immune system.
with a fit note.
Comorbidity - any additional health conditions Prevalence - the percentage of a population
that people may have, beyond the main condition Inactive - Participating in less than 30 minutes that is affected with a disease at a given time
being addressed.2 of moderate intensity physical activity (any
Risk Factor - any attribute, characteristic or
activity where the effort put in is enough to
Disabled - someone with a long-term condition that exposure of an individual that increases the
raise your breathing rate) per week.
reports it reduces their ability to carry out day-to- likelihood of developing a disease or disorder.
day activities, as defined by the Equality Act 2010.3 Incidence - the rate of new (or newly diagnosed) Some risk factors are modifiable, because you can
cases of disease, generally reported as the change them (e.g. smoking, obesity, diet) other
Disability adjusted life-year (DALY) -
number of new cases occurring within a period risk factors are non-modifiable, because you can’t
A single metric of overall disease burden
of time (e.g. per month or year). directly change them (e.g. age, sex, family history).
combining years of life lost (YLLs) due to mortality
and years lived with disability (YLDs). One DALY Literature review - a review of information Unemployment - unemployment refers to people
can be thought of as one lost healthy life year.4 found in the literature related to a selected without a job who were able to start work in the
area or topic of research. two weeks following their Annual Population Survey
Employment - People aged 16 or over who did
(APS) interview and who had either looked for work
some paid work in the reference week (whether Meta-analysis - a study design that
in the four weeks prior to interview or were waiting
as an employee or self-employed); those who systematically combines and assesses previous
to start a job they had already obtained.5
had a job that they were temporarily away from qualitative and quantitative studies about a
(e.g. on holiday); those on government-supported topic or research area in order to develop a Work days lost - the number of work days lost
training and employment programmes and single conclusion. for all people in employment aged over 16 years
those doing unpaid family work (e.g. working in due to sickness absence.
Mortality - a term used to describe the number of
a family business).5
people who died within a population. A mortality Work related musculoskeletal disorders
Finished Consultant Episodes (FCEs) - rate is the number of deaths due to a specific cause (WRMSDs) - a self-reported musculoskeletal
one episode of care within an inpatient divided by the total population over a given period. condition which a person thinks has been caused
stay under one responsible consultant. or made worse by their current or past work.
Multimorbidity - a person living with
multimorbidity has two or more long-term Years lived with disability (YLD) - years of life
chronic conditions.2 lived with any short-term or long-term health loss.4
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What are musculoskeletal conditions?
The term ‘musculoskeletal conditions’ is often used to include a broad range of health conditions affecting the
bones, joints, muscles and spine, as well as rarer autoimmune conditions such as lupus. In fact, musculoskeletal
conditions comprise over 100 different diseases and syndromes that interfere with people’s ability to carry out
their normal daily activities. Common symptoms include pain, stiffness and a loss of mobility and dexterity.
Broadly speaking there are three groups of musculoskeletal conditions:6
Age Progression Prevalence Impact Main treatment Treatment location Risk factors
Inflammatory Common. (e.g. Can affect and Urgent specialist
over 400,000 part of the body Treated by treatment needed Genetic factors,
conditions Affects any age. Often rapid onset. adults in the UK including skin, supressing the usually provided sex, smoking,
(e.g rheumatoid have rheumatoid eye and internal immune system. in hospital obesity and diet.
arthritis) arthritis). organs. outpatients.
Treated with Age (late 40’s
Conditions Very common.
physical activity onwards), sex,
(e.g. 8.75 million
of musculo- More common people in the
Affects the joints, and pain
Treatment based
genetic factors,
skeletal pain with rising age.
Gradual onset.
UK have sought
spine and pain management,
in primary care.
physical injury,
system. and in severe obesity and
(e.g osteoarthritis, treatment for
cases joint previous joint
back pain) osteoarthritis).
replacements. illness or injury.
Osteoporosis Osteoporosis
Prevention is
Age, genetic
is a gradual factors, smoking,
and fragility weakening of
Common. (e.g. Hip, wrist and Medication to based in primary
alcohol,
fractures Affects mainly
bone. Fragility
300,000 fragility spinal bones are strengthen bones, and ambulatory
inflammatory
older people. fractures occur in most common falls prevention care; fractures
(e.g. fracture fractures are disorders, poor
the UK each year). sites of fractures. fracture treatment. may require
after fall from sudden discrete nutrition and low
surgery.
standing height) events. physical activity.
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What is the scale of the problem?
An estimated 17.8 million people live with a musculoskeletal condition in the UK. Of the total who have musculoskeletal conditions:1
That’s around 28.9% of the total population.a, 1
7.7 million males have 10.1 million females have 2.7m 9.1m 6.0m
musculoskeletal conditions musculoskeletal conditions are aged are aged are aged 65
(male prevalence 25.9%).1 (female prevalence 31.8%).1 under 35 years 35 to 64 years and over
(15.4%) (51.1%) (33.5%)
Scotland UK estimates by condition:
1,469,593
Inflammatory conditions
Northern (28.5%)
• Over 400,000 people have rheumatoid arthritis.7
Ireland
465,637 • 12,000 children have juvenile idiopathic arthritis.8
(26.6%) • 200,000 people have ankylosing spondylitis.6
• 1.5 million people have gout.7
Conditions of musculoskeletal pain
• Over 8.75 million people aged 45 and over have
sought treatment for osteoarthritis.10
Wales • 10 million people in England and Scotland alone
England
856,782 14,987,194
have persistent back pain.7
(29.2%) (29.0%) • Up to 2.8 million people in the UK have
fibromyalgia.11
Osteoporosis and fragility fractures
• Around 3 million people in the
a
It is difficult to accurately determine how many people have arthritis only or arthritis and other musculoskeletal conditions in the UK. The data UK have osteoporosis.12
currently available on specific conditions comes from several different sources (e.g. hospital records, national survey’s, statistical models, and
registers) and doesn’t always cover the same time periods. Additionally, when people have more than one condition there is a risk of double counting • Over 300,000 fragility fractures
or of people being missed from the data if arthritis is not recorded as their primary condition. As a result, you cannot simply add the estimates above
together and have an accurate total of the number with arthritis or musculoskeletal conditions. For these reasons we currently rely on the Global
occur each year.13
Burden of Disease study to provide us with an estimate of the total number of people with any musculoskeletal condition in the UK today.
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What is the scale of the problem
The relationship between deprivation, Among people aged 45–64 the prevalence of arthritisc is more than
age and prevalence.b double in the most deprived areas (21.5%) compared to the least
deprived areas (10.6%).2
People in the most deprived areas are much more likely to report
arthritis or back pain than people in equivalent age groups who live 50
Prevalence of arthritis (%)
in less deprived areas.2
40
Long-term conditions are associated with social class and type of 30
occupation. People in the poorest communities have a 60% higher
44.4
prevalence of long-term conditions than those in the richest.14 20 36.2 33.6
10 21.5 23.1
40% of men and 44% of women in the poorest households report 10.6
chronic pain, compared to 24% of men and 30% of women in the 0
45-64 65-74 75+
richest households.15
Least deprived Most deprived
The following tools contain musculoskeletal health metrics to Those people in the most deprived areas experience back painc at a
help local government and health service professionals plan relatively young age: people of working age (45–64 years) are almost twice
for musculoskeletal care and services: as likely to report back pain (17.7%) as those from least deprived areas.2
25
Prevalence of back pain (%)
20
15
Arthritis Public Health NHS RightCare Local
Research UK England’s CCG focus Government 10 17.7 19.3 18.6
15.1
Musculoskeletal Fingertips Tool pack tool Association’s 5 9.1 11.8
Calculator LG Inform
0
45-64 65-74 75+
b
Findings based on England data only. Least deprived Most deprived
Based on Wave 2 of the England GP Patient Survey (June-September 2014) analysed by Arthritis Research UK.
c
Back to index | 8 Key factors affecting musculoskeletal health
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Physical activity
Inactive people are at increased risk of developing
Percentage of people (16+) inactive with long-lastinge
a painful musculoskeletal condition in later life.
musculoskeletal conditions20, 21
21-32% of adults (19+) in the UK do less than 30 minutes
of physical activity per week.16, 17, 18, 19 44.6
England
% inactive
19.9
Around 16% of people aged 16-64 in England and Scotland
are inactive vs. 40% of people aged over 65.20 41.2
Scotland
10.4
Physical activity levels of adults (19+ years) in 2016 d
0 10 20 30 40 50
Musculoskeletal condition No condition
Active Some Low Inactive
150+ minutes 60-159 min 30-59 min 30 min
33.4% of adults (40-60 years) % inactive22
in England with a limiting
Mobility 41.2%
disability or illness are physically
11% 4% 23% Dexterity 38.8%
inactive, compared to 16.7% Long term pain 37.9%
England: 62%
of ablebodied adults.22 None 16.7%
11% 5% 21% Keeping physically active
Scotland: 64% is important for musculoskeletal health.
Physical activity reduces the risk of developing joint and back
14% 32% pain by 25%.23
Wales: 54%
Exercise generally reduces overall pain for people with a
musculoskeletal condition.2 People who are physically active are
Northern 13% 6% 26% less likely to report chronic musculoskeletal pain.23
Ireland: 55%
Low bone density can lead to a higher risk of osteoporosis and
d
UK physical activity guidelines for adults 19+: Minimum of 150 mins of moderate intensity activity per week in bouts of 10 result in fractures – up to 50% of hip fractures could be avoided
mins or more OR 75 mins of vigorous intensity activity spread across the week, or a combination of moderate and vigorous;
Physical activity levels in Wales include people aged 16+ with regular physical activity.24
Illnesses lasting or expected to last 12 months or more.
e
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Obesity
Musculoskeletal problems constitute one of the greatest
threats to the health of people who are obese. Percentage of people (16+) overweight or obese with
long-lastingf musculoskeletal conditions20, 21
Over half (62%) of adults (16+) in the UK are classified as being
overweight or obese. 16, 17, 18, 19 73.7
England
58
Adult (16+ years) BMI (kg/m ) levels in 2016:
2
74.6
Overweight Obese Morbidly obese Scotland
25 to 30 30 to 40 30 to 40
60.2
0 10 20 30 40 50 60 70 80
35% 23% 3% % overweight or obese
England
Musculoskeletal condition No condition
36% 25% 4%
In 2016, the average BMI of hip and knee replacement patients
Scotland
in the UK was 28.8 (overweight) and 31.0 (obese) respectively.30
36% 23% Obesity increases the risk of developing other
Wales musculoskeletal conditions.
People who are obese are four times more likely to develop back pain
36% 27% than those with a healthy body weight.31,32
Northern Ireland
Adolescents who are obese are more likely to experience persistent
Obesity increases the risk of developing osteoarthritis and or recurrent joint pain, including knee pain, and obesity is also
need for joint replacement. associated with more severe pain overall.33
Obesity directly damages weight-bearing joints such as knees and Obese people are twice as likely to develop gout and tend to develop
hips because of the abnormally high loads they have to carry.25 it at a younger age.34
Obese people are more than twice as likely to develop osteoarthritis For reasons not well understood, being overweight or obese also
of the knee than those of normal body weight26, with many estimates significantly increases the risk of developing rheumatoid arthritis.35, 36
putting the risk between four and six times greater.27, 28, 29 Illnesses lasting or expected to last 12 months or more
fBack to index | 11
Multimorbidity
The number of people living with multimorbidity is growing. Musculoskeletal conditions are very common in
By 65 years of age, most people have multimorbidity. Over half multimorbidity.
(54.0%) of the population aged over 65 in England have two or Nearly four out of ten people (36%) with multimorbidity are living
more long-term chronic conditions (multimorbidity).37 with a physical and a mental health condition.2
In Scotland, the prevalence of people with multimorbidityg increases Among people over 45 years of age who report living with a major
from 64.9% among those aged 65–84 years to 81.5% among those long-term conditionh, more than three out of 10 also have a
aged 85 years or over.38 musculoskeletal condition.2
There is a strong association between multimorbidity and deprivation: By age 65 years, almost five out of 10 people with heart, lung or
people in the most deprived areas develop multimorbidity 10–15 mental health problemsh also have a musculoskeletal condition.2
years earlier compared to those in the least deprived.39
By the year 2025 the number of people living with one or more 100
Percentage of people aged over 45 years (%)
serious long-term conditions in the UK will increase by 90
nearly one million, rising from 8.2 million to 9.1 million.40 80
70 55.0 56.9 58.4
63.8 67.6
Multimorbidity increases with age and over time37 60
2035 67.8% (65-74) 50
2025 64.4% (65-74) 40
2015 45.7% (65-74) to 68.7% (85+)
30
20 45.0 43.1 41.6
36.2 32.4
Pain and functional limitations of arthritis make it harder to 10
cope with multimorbidity, causing fatigue and depression. 0
Diabetes Heart Lung Mental Cancer in the
Four out of five people with osteoarthritis have at least one other problem problem health last 5 years
long-term condition such as hypertension, cardiovascular disease
or depression.2 Musculoskeletal conditions Neither arthritis nor back pain
Depression is the most common comorbidity among people with Based on data extracted from 314 medical practice in Scotland in March 2007.
g
rheumatoid arthritis, affecting one in six people.41 h
Based on Wave 2 of the England GP Patient Survey (June-September 2014) analysed by Arthritis Research UK.Back to index | 12 What is the impact
Back to index | 13
Years lived with disability
The pain and disability Many people with musculoskeletal conditions rely on welfare
caused by arthritis and other benefits to cover the extra costs resulting from their condition.
musculoskeletal conditions 42.4% of people (608,168) in ‘receipt of’ or Of people receiving PIP in GB recorded
result in a substantial loss in ‘entitled to’ Attendance Allowance in GB were with a musculoskeletal condition:46
quality of life. recorded with a musculoskeletal condition as
20.5%
their primary disability condition.45
Other
One third 33.3% of people (549,614) 14.2%
receiving Personal Independence 41.8%
Chronic pain Arthritis
78% 41% Payment (PIP) in GB are recorded with
musculoskeletal disease as their primary
syndrommes
23.6%
disability condition.46 Back pain
of people with of people with arthritis
arthritis experience can’t stand up for long Musculoskeletal conditions People with arthritis and
pain most days.43 periods of time.43
such as low back pain are related conditions are not
the top causes of years that always aware of the welfare
people live with disability. benefits they are entitled to.
In 2016, 23.3% of years Nearly three out of 10 (27%) people with
53% lived with disability were arthritis are not aware of their entitlements.43
attributable to musculoskeletal Less than two out of 10 (17%) people with
Depression is four conditions in the UK.1 arthritis believed they were claiming all the
times more common
of people with among people in Over half (52.4%) of all working benefits they were entitled to.43
arthritis feel they persistent pain age (16-64 years) disabled Around four out of 10 (42%) people with
are a nuisance to compared to those people in the UK experience arthritis believed they did not have welfare
their family.43 without pain.44 musculoskeletal conditions.42 entitlements.43Back to index | 14
Work
Being in good employment is protective of People with musculoskeletal conditions are less
health. Conversely unemployment likely to be in work than people without health
contributes to poor health.47 22.4% conditions, and more likely to retire early.
One in eight of the working age population 63% of working age 100
Employment rate %
reported having a musculoskeletal problem.48 adults with a 80 18% employment gap
30.8m musculoskeletal 60
Musculoskeletal conditions are a leading working
condition are in work 40 81
cause of sickness absence. 30.8 million days lost 63 51
compared to 81% 20
working days were lost in 2016, accounting 0
for 22.4% of total sickness absence.49 of people with no Musculoskeletal Mental health No health
health conditions.52 conditions conditions conditions
Many people with musculoskeletal conditions
Some musculoskeletal conditions can be caused
want to work, but they need the right support.
or made worse by work over time.
One in five fit notesi (466,556) issued to patients by GPs in
England in 2015-16 were for musculoskeletal conditions, 39% (507,000) of all work–related illness cases in GB in 2016-17
second to mental health and behavioural disorders.50 are due to work related musculoskeletal disorders (WRMSDs),
resulting in 8.9 million working days lost (17.5 days/case).53
41.9% of fit note episodesj for musculoskeletal
conditions last 5 or more weeks.50
25.4% (6,360) of people receiving The prevalence of musculoskeletal conditions
Access To Work to support them to be in the workforce is set to increase.
in work had a musculoskeletal problem,
By 2030, 40% of the working age population will have a
but many more could benefit.51
long-term condition.48
In the coming years the workforce is projected to get older:48
Not including fit notes with an unknown diagnosis/ICD-10 code
i
j
the fit note duration does not cover the initial 7 days were employers Average age 2016: 39 Average age 2030: 43
allow staff to self-determine need for sick leave.Back to index | 15
Health and care services
Musculoskeletal conditions are largely managed The mean average wait times for hip and knee
in primary and community based care, however replacements in 2015 in England:58
services are accessed across all levels of care. Hip - 105.2 days (103.2 days in 2014, +1.4% change)
One in five people (20%) consult a GP about a musculoskeletal Knee - 105.4 days (107.0 days in 2014, –1.5% change)
problem every year.54
Musculoskeletal problems are addressed in one in eight (12%) In the UK, about 75,000 hip fractures occur annually. The incidence is
GP appointments.55 projected to increase by 34% in 2020, with an associated increase in
annual expenditure.59
In primary care, people with multimorbidity are frequent users
of services: six out of 10 (58%) patients have multimorbidity, Rate of hip fractures in people aged 65 and over in England is
but account for eight out of 10 (78%) GP consultations.56 575 per 100,000 population in 2016-17.60
1.36 million admissions to consultant care were due to
musculoskeletal conditions in England in 2016-17, resulting in 2.27 Fracture Liaison Half (51%) of gross local
million bed days. That’s 8.2% of all admissions to consultant care.57 Services (FLS) authority expenditure on
reduce the risk of adult social care is on people
subsequent fractures over 65 years, of which a
Osteoarthritis is the primary cause by up to 50% in substantial number will have a
of 90% and 99% of primary hip people with fragility musculoskeletal condition.63
and knee replacements.27 fractures.61
Only 42% of
101,651 hip replacementsk carried out in 201630 healthcare
(+3.5% since 2015) organisations in
the UK provide an 51%
108,713 knee replacementsk carried out in 201630 FLS to routinely
(+3.8% since 2015) assess people who
have broken a bone
k
England, Wales, Northern Ireland and the Isle of Man. for osteoporosis.62Back to index | 16
Economy
Musculoskeletal ill-health results in significant costs that fall on
individuals, employers, the health service and the wider economy.
Musculoskeletal conditions account for including direct health costs and indirect (lost Approximately 33.5 million prescriptions
the third largest area of NHS programme productivity, sickness absence, informal care) (+0.2% in 2015) were dispensed for
spending at £4.7 billion in 2013-14.64 costs was estimated to be £103–129 billion.65 musculoskeletal and joint diseases in
England in 2016, costing approximately
In 2007, the total annual cost to the UK Treating the two most common forms of
£205.8 million (+8.0% in 2015).69
economy of working-age ill health, arthritis-osteoarthritis and rheumatoid
arthritis-is estimated to cost the economy Conditions such as back pain account for
£10.2 billion in direct costs to the NHS around 40% of all sickness absence in the
and wider healthcare systeml this year. NHS and costs around £400 million per year.70
10 Cumulatively the healthcare cost will reach The cost of working days lost due to
9 £118.6 billion over the next decade.66 osteoarthritis and rheumatoid arthritis was
8 estimated at £2.58 billion in 2017 rising to
Back pain cost the UK economy an estimated
7 £1.6 billion direct and £10 billion indirect £3.43 billion by 2030.66
6
Billions
costsm in 2000.67 Costs of presenteeism (attending work while
5
The hospital costs of hip fractures alone are ill) are estimated to be £30 billion annually.48, 65
4
estimated at £2 billion per year in the UK.59
3
2 The cost of ankylosing spondylitis in the
Public Health England’s
1 UK was estimated at roughly £19,016 per
Return on Investment
0 person per year in direct and indirect costsn
(ROI) tool for cost-effective
in 2010. That’s an estimated total cost of
interventions for the
10.2bn £3.8 billion.68
prevention and treatment of
in direct costs to the NHS l
This includes direct costs (NHS healthcare and other medical musculoskeletal conditions.
costs (i.e. prescriptions, home care).
and wider healthcare n
This includes direct costs (NHS healthcare and other
m
This includes direct costs (NHS healthcare, community care
system this year and private services) and indirect costs (work loss, absenteeism,
health costs) and indirect costs (work loss, absenteeism,
presenteeism, early retirement, and informal care)
reduced productivity and informal care).Back to index | 17
Economic benefits of musculoskeletal research
Every £1 invested in medical research delivers a £1.6 billion of research funding in the UK was invested by medical
return equivalent to around 25p every year, forever.71 research charities in 2016.72
Government and charity research funding dedicated to musculoskeletal
Investment into musculoskeletal research is money well spent. conditions remains disproportionally small compared to the disease
A new study estimating the returns generated by public and charitable burden attributed by conditions like arthritis and back pain.
investment for musculoskeletal research in the UK has found that Although musculoskeletal conditions account for around 9% of
research into musculoskeletal conditions, such as osteoarthritis, Disability Adjusted Life Years (DALYs) in the UK they received only
rheumatoid arthritis and back pain, not only results in improved 2.8% of research funding in 2014.73
health outcomes but also generates economic gain for the UK.
Every £1 invested in musculoskeletal research leads to 7p Research spend vs. burden of diseaseo
of direct health benefits with a further 15-18p in benefits
to the wider economy (i.e. spill over) every year, forever.71 Cancer
Infection
Yearly return for £1 of public or charity investment.
30 Total estimated return of 25p per year Neurological
UK DALY rate
25 (2012)
Net health gain
10p 9p Cardiovascular
20 7p 7p from What’s it
worth studies
15 Mental Health
Proportion of 2014
10 spend (64 funders)
15-18p 15-18p 15-18p 15-18p Musculoskeletal
GDP (or spillover)
5 gain from 2016
0 study Metabolic and Endocrine
Musculoskeletal Cancer Cardiovascular Mental
research research research health 0% 5% 10% 15% 20% 25%
research*
o
This graph represents the top health research spend categories, excluding Inflammatory and Immune System,
*Figure for mental health research subject to greater uncertainty than others, due to methodology. Generic Health Relevance and other which have no equivalent health categories in the Global Burden of Disease StudyBack to index | 18 Condition specific statistics Prevalence, risk factors, comorbidities, and impact
Condition specific data Back to index | 19 Inflammatory conditions Axial spondyloarthritis (including ankylosing spondylitis) Axial spondyloarthritis (axSpA) is an umbrella term used to describe a spectrum of long-term (chronic) inflammatory conditions primarily affecting the spine and/or sacroiliac joints, resulting in the main symptom of chronic back pain. It includes both people who have the visible changes or damage of the sacroiliac joints as seen on x-ray (ankylosing spondylitis) as well as people who have the symptoms of chronic back pain without the classic changes or damage seen on ordinary x-rays of the sacroiliac joints (non-radiographic axSpA). Inflammation of the spinal joints and surrounding structures causes pain, stiffness and limitation in the flexibility of the back and causes new bone to grow at the sides of the vertebrae. Eventually the individual bones of the spine may link up and fuse. Non-radiographic axial spondyloarthritis progresses to ankylosing spondylitis at a rate of about 12% over 2 years.74 To understand more about the causes, diagnosis and treatment of ankylosing spondylitis download our information booklet. Read more
inflammatory conditions Back to index | 20
Axial spondyloarthritis (incl. ankylosing spondylitis)
Who is affected? Common risk factors
Prevalence Age Genetics
Estimates suggest 0.3-1.2% of the adult Ankylosing spondylitis usually occurs Ankylosing spondylitis
(18–80 years) UK primary care population between 20–30 years of age, the average is more common in
has axial spondyloarthritis, depending on age of onset is 24 years.78 90–95% of people with the human
the classification criteria used.75 people are aged less than 45 years at leukocyte antigen HLA–
disease onset.75 B27 gene. A person who
Approximately 200,000 people in the UK
Sex is HLA–B27 positive
have ankylosing spondylitis.76
Approximately 50% of non-radiographic has a 5–6% chance of
axial spondyloarthritis patients are developing ankylosing
female,79, 80 however, males are more spondylitis and this risk
likely to progress to have the structural is increased if a first
changes of ankylosing spondylitis degree relative has
compared to females.81 the disease.82,83
Smoking
males are more Smoking is associated with higher disease
likely to progress 50% activity, increased structural damage
to have the of non- on MRI and as a result lower physical
structural changes radiographic axial
of ankylosing spondyloarthritis functioning in people with ankylosing
spondylitis patients are female spondylitis.84, 85
89%
of patients with axial spondyloarthritis
(non-radiographic axial spondyloarthritis
and ankylosing spondylitis) have
inflammatory back pain.77inflammatory conditions Back to index | 21 Axial spondyloarthritis (incl. ankylosing spondylitis) Common comorbidities Impact on quality of life Osteoporosis and fragility fractures 10% of people with ankylosing spondylitis and work capacity People with ankylosing spondylitis are at have doctor–diagnosed depression Disability increased risk of experiencing loss in bone compared to 6% of the general population The most prevalent quality of mineral density (BMD) and osteoporosis, seeking healthcare during a 13–year life concerns in people with which can lead to spinal fractures. observation period.91 ankylosing spondylitis include 1–9% of people with ankylosing stiffness, pain, fatigue and spondylitis experience spinal fractures, poor sleep.92 thus increasing the need for surgery.86 Work 19–62% of people with ankylosing Withdrawal from work is three spondylitis have decreased BMD. High times more common in people rates have even been reported in patients with ankylosing spondylitis with
Inflammatory conditions Back to index | 22 Gout Gout is a painful inflammatory condition, caused by the build-up of uric acid in the bloodstream. This is partly inherited, but lifestyle factors such as alcohol consumption, diet and obesity are major risk factors. High uric acid levels lead to crystals forming in the joints. These crystals can trigger sudden painful episodes of severe joint inflammation (‘attack’). If untreated these attacks get more common, spread to involve new joints and can cause long-term cartilage and bone damage. To understand more about the causes, diagnosis and treatment of gout, download our information booklet. Read more
Inflammatory conditions Back to index | 23
Gout
Who is affected? Common risk factors
Prevalence Age Alcohol
Around one in 40 people 3–6% of people with gout experience Regular consumption of alcohol
(2.49%) in the UK have gout. That’s disease onset before 25 years of age.95 (predominantly beer but also spirits) has
equivalent to around 1.5 million people.9 Men can develop gout as early as their been associated with a threefold higher risk
Between 1997–2012, both the prevalence mid–20s and it becomes more common of new cases of gout among women and
and incidence (new cases) of gout in women after menopause.96 twofold higher risk in men, compared to
increased significantly in the UK by those with no alcohol intake or ≤1 ounce/
64% and 30% increases respectively.9 week.90, 91 Moderate wine consumption has
not been linked to an increased risk.
Risk of gout through regular
alcohol consumption compared
with no alcohol intake
30% Men
Sex
Gout is generally three to four times Women
more common in men than women.89
The prevalence of gout is highest in the Obesity
l
k
k
k
North East 3.11% and Wales 2.98% and Obese people are twice as likely to
ho
ris
ris
ris
co
er
er
er
lowest in Scotland 2.02% and Northern develop gout and tend to develop it
al
gh
gh
gh
No
hi
hi
hi
Ireland 2.15%.86 at a younger age.31
1x
2x
3xInflammatory conditions Back to index | 24
Gout
Impact on quality of life and Common comorbidities
work capacity 54% of people with gout are expected to 22% 71%
Work have one or more comorbidities within Men Women
23% of working–age people with gout five years of first being diagnosed.100
say they had to give up work and 18% Cardiovascular diseases
had taken early retirement.104
People with gout are 50% more likely to
develop high blood pressure than people Men and women
23% without gout putting them at higher risk with gout are
give up
of stroke.100 more likely to
work
develop type
The incidence of heart failure and reduced
2 diabetes
ability of the heart’s ventricles to contract
working– is two to three times higher in people with
age people gout compared to people without gout.101
with gout
Kidney disease
Liver disease
People with gout are three times more
18% People with gout are almost
likely to develop kidney disease than
early two times more likely to
retirement people without gout.100
develop liver disease than
Type 2 diabetes people without gout.100
Quality of life There are almost 3.6 million people who Depression
Gout is significantly have been diagnosed with type 2 diabetes People with gout are
associated with poor in the UK.102 19% more likely to
overall quality of life, Women and men with gout are 71% have diagnosed
even after adjusting and 22% more likely to develop type 2 depression than people
for comorbidities.105 diabetes.103 without gout.100Inflammatory conditions Back to index | 25 Juvenile idiopathic arthritis Juvenile idiopathic arthritis affects children under the age of 16 and is an autoimmune disease that causes inflammation in the joints. It’s one of the most common rheumatic diseases of childhood. There are six different types of juvenile idiopathic arthritis and symptoms vary between the different types. To understand more about the causes, diagnosis and treatment of juvenile idiopathic arthritis visit our website. Read more
Inflammatory conditions Back to index | 26
Juvenile idiopathic arthritis
Who is affected? Common risk factors Impact on quality of life
Prevalence Genetics Quality of life
An estimated 12,000 children (one in Risk factors for juvenile idiopathic arthritis Children with juvenile idiopathic arthritis
1,000) under the age of 16 have juvenile are not clear, however studies have shown have significantly lower physical well–
idiopathic arthritis in the UK.8 strong evidence for genetic susceptibility. being and psychosocial health (mental,
Incidence The probability that identical twins will emotional, social and spiritual well–
One in 10,000 children are being both have the same genetic component being) compared to those without.
diagnosed with juvenile idiopathic fundamental to the susceptibility of Intensity of pain has the greatest
arthritis in the UK each year. That’s juvenile idiopathic arthritis ranges between influence on their psychosocial health.112
around 1,000–1,500 children.8 25–40%.106
Common comorbidities
Eye inflammation
10–20% of children with juvenile idiopathic Adulthood
arthritis will develop an inflammatory eye 10-20% At least one third of children with
condition called uveitis, which can cause inflammatory juvenile idiopathic arthritis will have
reduced vision and blindness if not treated. eye condition ongoing active disease in adulthood.113
107, 108, 109, 110
Between 30% and 56% of people
Fragility fractures 41% with juvenile idiopathic arthritis will
41% and 34% of children with juvenile low bone experience severe limitations in dexterity
idiopathic arthritis have low bone mineral mineral content and mobility in adulthood because of
content and low bone mineral density their arthritis, such as finding it very
respectively, putting them at increased difficult or not possible to grasp small
fracture risk.111 objects or walk 400 meters.114Inflammatory conditions Back to index | 27 Rheumatoid arthritis Rheumatoid arthritis is an autoimmune disease that causes inflammation in the joints. As a result, the joint becomes painful, stiff and swollen. This inflammatory activity can ultimately cause irreversible damage. The sooner one starts treatment for rheumatoid arthritis, the more effective it’s likely to be, so early diagnosis and intensive treatment is important. To understand more about the causes, diagnosis and treatment of rheumatoid arthritis, download our information booklet. Read more
Inflammatory conditions Back to index | 28
Rheumatoid arthritis
Who is affected? Common risk factors
Prevalence Age Studies have shown that:
There are over 400,000 adults aged 16 Rheumatoid arthritis affects adults of any BMI ≥25 kg/m2
and over living with rheumatoid arthritis age yet prevalence increases with age, with (overweight/obese) significantly
in the UK.7 peak age of onset between 40–60 years and increased the risk of developing
is highest at age 70 years and over.116, 117 rheumatoid arthritis by 15%, compared
The Musculoskeletal Calculator p Around three quarters of people with to BMIInflammatory conditions Back to index | 29
Rheumatoid arthritis
Common comorbidities Impact on quality of life and work capacity
Cardiovascular disease their disease, putting them at Mortality sevenfold increase in depression
Cardiovascular disease is the increased risk of death. 127, 128 People with rheumatoid over the subsequent year.134
main cause of premature Osteoporosis & fragility arthritis have a 47% increased Work
mortality and sudden death fractures risk of death compared to the A third of people with
in patients with rheumatoid Rheumatoid arthritis itself, general population.133 rheumatoid arthritis will have
arthritis.122 along with reduced mobility 31% of early death from stopped working within two
Around one in 20 people (6%) and steroids used to treat rheumatoid arthritis is due to years of onset and half are
with rheumatoid arthritis have rheumatoid arthritis increase cardiovascular disease, followed unable to work within 10 years.135
cardiovascular disease. 123,124 the risk of developing by pulmonary problems Physical inactivity
The risk of heart attack is osteoporosis and falls.129 (including respiratory infection Approximately 68% of
doubled for people with The rate of osteoporosis can and lung cancer) responsible rheumatoid arthritis patients
rheumatoid arthritis compared be up to twice as high among for 29% of all deaths.128 in the UK are physically
to the general population.125 rheumatoid arthritis patients Depression inactive. Low physical activity
The risk of stroke is 30% higher compared to the general Around one in six people in patients with rheumatoid
for people with rheumatoid population.130 (16.8%) with rheumatoid arthritis becomes a vicious
arthritis than the general Around 36% of people with arthritis have major cycle of disease progression
population.126 rheumatoid arthritis aged over depressive disorder.41 and increased pain, thus
18 report falling at least once Depression in rheumatoid affecting both physical and
Lung disease mental health.136
Lung disease is a major annually.131 arthritis patients is associated
contributor to morbidity and People with rheumatoid arthritis with increased levels of pain
mortality in rheumatoid arthritis. have 2 times the risk of hip and functional disability.134
Evidence suggests one in 10 fracture and 2.4 times the risk A 10% reduction in the ability to 16.8%
people with rheumatoid arthritis of vertebral fracture, compared perform activities important to 1 in 6 people with
rheumatoid arthritis have
will be diagnosed with interstitial to those without a history of an individual with rheumatoid
major depressive disorder
lung disease over the lifetime of rheumatoid arthritis.132 arthritis may be followed by aCondition specific data Back to index | 30 Musculoskeletal pain Osteoarthritis Osteoarthritis is a condition in which the joints of the body become damaged, stop moving freely and become painful. Osteoarthritis results from a combination of the breakdown of the joint and the body’s attempted repair processes. Pain is the main symptom of osteoarthritis and can have a devastating impact on people’s lives. The knee is the most common site in the body for osteoarthritis, followed by the hip and hands/wrists. To understand more about the causes, diagnosis and treatment of osteoarthritis, download our information booklet. Read more
Muskuloskeletal pain Back to index | 31
Osteoarthritis
Who is affected? Common risk factors
Prevalence Age
An estimated 8.75 million people aged 45 years and over Risk of developing osteoarthritis increases with age. A third of
(33%) in the UK have sought treatment for osteoarthritis. women and almost a quarter of men between 45 and 64 have
60% female, 40% male.10 sought treatment for osteoarthritis, this rises to almost half of
people aged 75 and over.10
The Musculoskeletal Calculator estimates:7
Sex
The prevalence of osteoarthritis is generally higher in women
England
than men. The difference is most apparent for hand and knee
4.11 million (18.2%) of adults aged over 45
osteoarthritis and among people over 50 years of age.137
years in England have osteoarthritis of the knee.
6.1% of whom are affected by the severe
form of the condition.
18.2% Women accounted for roughly 60% of hip and knee replacement
operations over 90% of whom are due to osteoarthritis.30
2.46 million (10.9%) of adults aged over 45
years in England have osteoarthritis of the hip. Consultation prevalence of Osteoarthritis (%)10
3.2% of whom are affected by the severe form of the condition.
50
Scotland
40
420,000 (16.6%) of adults aged over 45 years
in Scotland have osteoarthritis of the knee. 30
4.1% of whom are affected by the severe
form of the condition. 16.6% 20
256,000 (10.1%) of adults aged over 45 years
in England have osteoarthritis of the hip. 2.5% 10
of whom are affected by the severe form of the condition.
0
Do you want to know how many people have osteoarthritis 45-64 65-74 65-74 Females Males
in your area? Visit the MSK Calculator online tool. years years yearsMuskuloskeletal pain Back to index | 32
Osteoarthritis
Common risk factors Common comorbidities
Obesity Joint abnormalities Cardiovascular disease to 23% of people without
The risk of developing People with abnormal hip shape Women and men over 65 years osteoarthritis, putting them
osteoarthritis throughout life caused by developmental of age who have osteoarthritis at increased risk of developing
increases with rising BMI.138 problems, have greatly increased are at 17% and 15% increased cardiovascular disease and
People who are overweight or risk of developing osteoarthritis. risk of hospitalisation for diabetes.145
obese are approximately 2.5 Abnormal hip shape accounts cardiovascular disease.144 Depression
and 4.6 times more likely to for nearly one in 10 primary Metabolic syndrome Around 20% of people with
develop knee osteoarthritis hip replacements in adults, Metabolic syndrome is osteoarthritis experience
than those of normal body rising to nearly one in three hip prevalent in 59% of people symptoms of depression
weight.139,140 replacements in people under with osteoarthritis compared and anxiety.146
the age of 60 years.142
The average BMI of hip and
knee replacement patients in
2016 was 28.8 (overweight)
Genetic factors Impact on quality of life and work capacity
Genetic factors account
and 31.0 (obese) respectively.30 Pain After joint replacement
for 60% of hand and hip
Occupation Nearly three quarters of people surgery only 21.4% of knee
osteoarthritis and 40% of
Knee osteoarthritis is more with osteoarthritis report some replacement and 17.5% of hip
knee osteoarthritis.143
frequently observed in people form of constant pain, with one replacement patients reported
with occupations that require 60% in eight describing their pain as moderate or severe pain in the
squatting and kneeling, hip hand and hip often unbearable.147 past four weeks, compared to
osteoarthritis is associated with Joint replacements 93.9% and 93.0% of patients
prolonged lifting and standing. Osteoarthritis was recorded as before they received surgery.148
Hand osteoarthritis is more the main indication for surgery Work
frequent in people with in 90% of primary hip and 99% A third of people with
occupations requiring 40% of primary knee replacement osteoarthritis retire early, give
knee
increased manual dexterity.141 patients in 2016.30 up work or reduce hours.10Muskuloskeletal pain Back to index | 33 Back pain Back pain is a common condition often caused by a simple muscle, tendon or ligament strain and not usually by a serious problem. Back pain can be acute, where the pain starts quickly but then reduces after a few days or weeks, or chronic (severe), where pain might last on and off for several weeks or even months and years. To understand more about the causes, diagnosis and treatment of back pain, download our information booklet. Read more
Muskuloskeletal pain Back to index | 34
Back pain
Who is affected? Common risk factors
Prevalence Deprivation
Back pain affects around
one third of the UK adult
20% People aged 45–64 years of age
(working age) in the most
of all musculoskeletal
population at some point deprived areas are almost twice
consultations are related
each year.149, 150 as likely to report back pain
to the back (14%
Between one in four and Obesity (17.7%) as those from the least
for the lower back
one in seven young people People who are obese are four deprived areas (9.1%).2
specifically).150
have long–term low times more likely to develop
back pain.151, 152 back pain than those with a
healthy body weight.31, 32
17.7%
Depression
The Musculoskeletal calculatorr estimates:7 The odds of back pain in people
with symptoms of depression of people aged 45-64 in
have been shown to be 50% the most deprived areas
9.11 million (16.9%) people in England
higher than in those without are twice as likely to
have back pain, 5.5 million of whom 16.9% symptoms of depression.153 report back pain.
have severe back pain.
Smoking
The prevalence of low back pain
910,000 (19.1%) of adults aged over is approximately 50% higher
18 years in Scotland have back pain, 19.1% in daily smokers compared to
564,000 of whom have severe back pain. non–smokers.154, 155
The MSK Calculator is a local estimates prevalence model developed by Imperial College London in partnership
r
Do you want to know how many people have back pain in your with Arthritis Research UK. Prevalence estimates for Wales and Northern Ireland are currently not available.
area? Visit the MSK Calculator online tool.Muskuloskeletal pain Back to index | 35
Back pain
Impact on quality of life and work capacity Common comorbidities
Disability Work limitation Musculoskeletal and mental health
Low back pain Back pain is the second most common conditions
was the top cause cause of short–term absences after minor People with chronic low back pain have
of years lived with illnesses (such as colds, flu and sickness).159 been shown to have a significantly
disability (YLDs) 68.3% of people return to work one higher frequency of musculoskeletal
in the UK in both month after an episode of back pain, and neuropathic pain conditions and
1990 and 2016.1 rising to 85.6% at one to six common sequelae
Low back pain patients months and 93.3% of pain such as
generally stop seeking at more than depression (13.0%
medical attention within six months.160 vs. 6.1%), anxiety
68.3%
three months, however (8.0% vs. 3.4%)
60% to 80% of people and sleep disorders
still report pain or disability of people return to (10.0% vs. 3.4%),
a year later and up to work one month compared to people
40% of those who have after an episode without low back
taken time off work will of back pain pain.156
have future episodes of
work absence.157, 158Muskuloskeletal pain Back to index | 36 Fibromyalgia Fibromyalgia is a long-term (chronic) condition causing many symptoms including widespread body pain and fatigue. It’s quite common – up to one person in every 25 people may be affected. The exact causes of fibromyalgia are still not known, but research suggests that there’s an interaction between physical, neurological and psychological factors. Fibromyalgia in itself doesn’t cause any lasting damage to the body’s tissues. However, it’s important to build up and maintain physical activity levels to avoid and address weakening of the muscles (deconditioning) which could lead to worsening pain and fatigue. To understand more about the causes, diagnosis and treatment of fibromyalgia, download our information booklet. Read more
Muskuloskeletal pain Back to index | 37
Fibromyalgia
Who is affected? Common risk factors Comorbidities
Prevalence Age and Gender Depression and anxiety
It’s not entirely clear how many people Fibromyalgia prevalence increases with Depression and anxiety are more
are affected by fibromyalgia alone, as it age, reaching a peak around 75 years, prevalent in people with fibromyalgia
can be a difficult condition to diagnose. and is more common in women than in than individuals without.163, 164, 165, 166
Estimates suggests around 1.2-5.4% men at every age.11 Lifetime prevalence of depression and
of adults in the UK are affected by Genetics anxiety in people with fibromyalgia
fibromyalgia depending on the Fibromyalgia develops because of a go up to 70%
classification criteria used. That’s combination of biological, psychological and 60%,
equivalent to up to 2.8 million people.11 and social factors. Family studies have respectively.163, 167
identified a link between genetic markers, High levels of
2.8m people supporting the genetic background of the depression and
disease, however key hereditary factors anxiety in people
have not yet been identified.161 with fibromyalgia are associated with
Other musculoskeletal conditions more physical symptoms and poorer
Fibromyalgia commonly co-occurs with a functioning than lower levels.168
number of physical conditions, including Post-traumatic stress disorder
rheumatoid arthritis and systemic lupus People with Fibromyalgia are six times
UK adults erythematosus.162 more likely to report post-traumatic
affected by stress disorder compared to people
with two stomach conditions
fibromyalgia Impact on quality of life (achalasia and dyspepsia).169
and work capacity Irritable Bowel Syndrome (IBS)
People with fibromyalgia often experience Studies have shown fibromyalgia and
mental and physical disabilities and a irritable bowel syndrome coexist in
significantly impaired quality of life.172 many patients.170, 171Condition specific data Back to index | 38 Osteoporosis & fragility fractures Osteoporosis means spongy (porous) bone. Everyone has some degree of bone loss as we get older, but the term osteoporosis is used only when the bones become quite fragile. When bone is affected by osteoporosis, the holes in the honeycomb structure become larger and the overall density is lower, which is why the bone is more likely to fracture. To understand more about the causes, diagnosis and treatment of osteoporosis & fragility fractures, download our information booklet. Read more
Condition specific data Back to index | 39
Osteoporosis & fragility fractures
Who is affected? Common risk factors
More than 3 million people in the UK Age mineral density osteoporotic fractures.180
are estimated to have osteoporosis.12 After the third decade of life, bone People who smoke are at 25% increased
More than 300,000 fragility fractures naturally begins to decline at the rate fracture risk compared to those who
occur each year in the UK.13 In England of 0.3% of bone per year.175 had never smoked.181
and Wales, around 180,000 of the Prevalence of osteoporosis increases Low vitamin D and calcium levels
fractures presenting each year are the markedly with age, from 5% at 50 Elderly patients who consume adequate
result of osteoporosis.173 years to over 30% at 80 years.176 vitamin D and Calcium supplements are
In 2016, over 65,000 people aged 60 or Sex at decreased fracture risk.182
older presented to hospital with a hip One in two women and one in five men Previous fracture
fracture in England, Wales and Northern over the age of 50 are expected to People who have had one fracture
Ireland.174 break a bone during their lifetime.177 remain at greater risk of sustaining a
Genetics secondary fracture. After a first fracture
3 million 300,000 Parental history of fracture is associated the risk of fracturing again is increased
in UK have fragility fractures in with an increased risk of fracture, by two to threefold.183, 184
osteoporosis the UK each year. independent of bone mineral density.178 Alcohol
Menopause People who consume more than two
After the onset of menopause, women alcoholic drinks per day are associated
can lose an average of 2.5% of their with higher risk of hip fracture compared
bone per year for the first five years, with those who don’t drink.185
due to the decrease in oestrogen Low BMI
production, putting them at increased People with a BMI of less
risk of developing osteoporosis.179 than 18.5 kg/m2 are at
Smoking increased fracture risk.
Smoking is associated with low bone 186, 187Condition specific data Back to index | 40
Osteoporosis & fragility fractures
Common comorbidities Impact on quality of life
Diabetes compared to the general population.130 and work capacity
People with type 1 diabetes have a six Around 36% of people with rheumatoid Mortality
times greater risk of hip fracture compared arthritis aged over 18 report falling at least A month after suffering a hip fracture,
to those without.188, 189 once annually.131 one in 15 people (6.7%) died in 2016
Chronic inflammatory bowel disease (7.1% in 2015) and over half (66.1%)
People with rheumatoid arthritis are at 2
Chronic inflammatory bowel disease returned home by 120 days.174
times the risk of hip fracture and 2.4 times
(IBD) has been shown to be associated the risk of vertebral fracture, compared to
with an increased risk of fractures.190 people without rheumatoid arthritis.132
The incidence of fractures among
patients with chronic inflammatory
bowel disease is approximately 40% People with One in four people (28.7%) die within a
higher than in the general population.191 type 1 diabetes IBD has been year of suffering a hip fracture.194
have a six times associated with
Coeliac disease greater risk of an increased risk
Patients with coeliac disease are at a hip fracture of fractures
higher risk of fractures compared to the
general population.192
Pain
Hyperthyroidism
One in three people who have long–term
Mild (subclinical) hyperthyroidism is
pain from fractures describe it as severe
associated with an increased risk of hip
36% of people or unbearable.195
and other fractures, especially among with rheumatoid
those with thyroid–stimulating hormone arthritis report People with Disability
rheumatoid
(TSH) levels of less than 0.10 mIU/L.190.193 falling at least Research has found that 43% of people
once annually arthritis are at
2 times the risk who were previously independent are
Rheumatoid arthritis
of hip fracture unable to walk independently in the year
The rate of osteoporosis can be up to twice
after a hip fracture.196
as high among rheumatoid arthritis patientsYou can also read
