Arthritis and musculoskeletal conditions

NHPA Arthritis and Musculoskeletal Conditions

What are arthritis and musculoskeletal conditions?
Why do arthritis and musculoskeletal conditions constitute a National Health Priority Area?
Arthritis and musculoskeletal conditions indicators?

What are arthritis and musculoskeletal conditions?

Arthritis is a group of musculoskeletal conditions in which there is inflammation of the joints, causing pain, stiffness, disability and deformity. Other joint problems and disorders of the bones, muscles and their attachments to each other are covered under the rubric of musculoskeletal conditions.

There are more than 100 forms of arthritis and musculoskeletal conditions, which include fractures, other injuries due to trauma and various forms of arthritis. The focus of the NHPA initiative is on osteoarthritis, rheumatoid arthritis and osteoporosis.

Osteoarthritis

Osteoarthritis is one of the most common forms of arthritis. It is a degenerative condition that is caused mainly by accumulated wear of the cartilage. Cartilage cushions the ends of bones where they meet to form a joint. As the cartilage degenerates, the normal function of the joint is disrupted causing pain. The disease affects mainly the hands, spine and weight-bearing joints such as the hips, knees and ankles.

In the 2001 National Health Survey, 9.2% of the female respondents reported osteoarthritis, compared with 5.7% of the males. This equates to a prevalence rate of 75 per 1,000 Australians.
Osteoarthritis most commonly develops between the ages of 45 to 90 years. Females are more commonly affected than males.
Osteoarthritis was the seventh most frequently managed problem by general practioners in Australia in 2003-04.

Rheumatoid arthritis

Rheumatoid arthritis is a chronic inflammatory disease that mainly affects the joints and is characterised by joint swelling and destruction. It is an autoimmune disease in which the immune system attacks the tissues lining the joints. The inflammed joints often cause pain, heat and swelling. Rheumatoid arthritis most often affects the hand joints and commonly produces deformities.

Rheumatoid arthritis is more common among females. In the 2001 National Health Survey, 2.7% of females respondents reported having rheumatoid arthritis compared with 2.0% of males. The prevalence of rheumatoid arthritis increases sharply with age but is higher in females at nearly all ages.
Rheumatoid arthritis most commonly develops between the ages of 25 and 50, but can also begin at any age. A form of the disease, known as juvenile rheumatoid arthritis, affects children.

Osteoporosis

Osteoporosis meaning "porous bones" is a musculoskeletal disorder where the bone density thins and weakens, resulting in an increased risk of fracture. The most common sites of fracture are the bones of the spine, the hip and the wrist. However other bones are also affected, including the shoulder, ribs and the pelvis.

In the 2001 National Health Survey, 1.6% of respondents reported osteoporosis. The prevalence was 10.5% among females aged 65-74, increasing to 12.3% among female respondents aged 75 and above. In comparison, the prevalence of osteoporosis in males was much lower, at 1.2% and 1.5% in the two age groups respectively.
Osteoporosis occurs more frequently in older persons as the bone tissue is progressively lost with ageing. Osteoporosis is more common in females as after menopause there is a sharp decline in the female hormone oestrogen, which plays a vital role in maintaining bone mass density. This decrease in the production of oestrogen accelerates calcium loss in bones.

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Why do arthritis and musculoskeletal conditions constitute a National Health Priority Area?

Arthritis and musculoskeletal conditions are highly prevalent and large contributors to illness, pain and disability. They place a significant burden on the community, both economic and personal, including the use of hospital and primary care services, disruptions to daily life and lost productivity through disability.

In view of this high burden, arthritis and musculoskeletal conditions were declared a National Health Priority Area in July 2002. The initial focus in this priority area is on osteoarthritis, rheumatoid arthritis and osteoporosis, as these three conditions are the most prevalent forms of musculoskeletal disease within Australia and have been found to place a high burden on the community.

Based on the 2001 National Health Survey, more than six million Australians are estimated to have had arthritis and musculoskeletal conditions that year. This included some types of swelling in their joints, limitations in their motion or pain when they moved. Arthritis and musculoskeletal conditions were the second most frequently managed problem (17 per 100 encounters) by GPs in 2003-04, accounting for almost 12% of all problems managed that year.

Arthritis and musculoskeletal conditions cause more disability than any other group of medical conditions with around 1.2 million Australians (about 32% of all persons with a disability) reporting that they had a disability due to these conditions in 2003. About 83% of these reported at least one core activity restriction. These restrictions were mainly in mobility, followed by self-care, and in both cases the restrictions were higher among females than males.

Arthritis and musculoskeletal conditions were estimated to account for 4% of the disease burden in Australia in 1996, in terms of disability-adjusted life years (DALYs). In monetary terms, the direct costs of arthritis and musculoskeletal conditions has been estimated at $4.7 billion in 2000-01.

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