Musculoskeletal Disorders. Sean Gallagher

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2 Common Musculoskeletal Disorders

      Overview

      For the purpose of this book, the term “musculoskeletal disorders” (MSDs) refers to “conditions involving the experience of pain, discomfort, and/or disability in the human musculoskeletal system, usually as the result of cumulative damage to one or more of the components of this system, including muscles, tendons, ligaments, nerves, cartilage, ligaments, bone, and/or fascia.” Note that this definition excludes musculoskeletal injuries that might occur due to slips, trips, or falls (acute injuries). Instead, MSDs are viewed to be the consequence of exposure to repetitive stress resulting from occupational tasks, athletic pursuits, and other physical activities.

      Terms used to describe MSDs over the past several decades include “repetitive stress injuries,” “repetitive strain injuries,” “cumulative trauma disorders,” and “cumulative trauma injuries” (National Research Council – Institute of Medicine, 2001). These labels seem to imply that musculoskeletal injuries/disorders result from (a) exposure of musculoskeletal tissues to stress/strain, (b) the stress/strain application is repetitive in nature, and (c) that the repetitive stress/strain results in the development of cumulative trauma to the tissues. Thus, the very terms used to describe these disorders over the years seem to intuit the presence of a fatigue failure process in the development of MSDs. In fact, the terms above may actually be better descriptors of the actual injury process, as opposed to the all‐encompassing (but vague) term “MSDs.” However, in this book, we will use the latter term due to its standard current usage.

Burden of MSDs

      MSDs account for a large societal and economic burden throughout the world. The burden associated with low back pain (LBP) was particularly notable, as its prevalence can be up to 20% in some countries (Fatoye, Gebrye, & Odeyemi, 2019). MSDs, as a whole, accounted for an average of 16% of years lived with disability (YLDs) worldwide in 2017 (Global Burden of Disease 2017 Disease and Injury Incidence and Prevalence Collaborators, 2018). These disorders were seen as a major reason for rising YLD rates per person in this analysis. These increases were attributed to tendencies toward greater age, obesity, and physical inactivity. MSDs were also seen to be an important driver of health care expenditures in middle‐ to high‐income countries (Global Burden of Disease 2017 Disease and Injury Incidence and Prevalence Collaborators, 2018).

In an earlier analysis, a considerable proportion of LBP worldwide was attributed to occupational exposure (Punnett, 2005). On average, 37% of LBP was determined to be workplace related, with considerable variation across different regions of the world. Men had a higher attributable proportion than women, ostensibly due to higher exposure to occupations involving occupational lifting tasks and whole‐body vibration. Approximately 818,000 disability‐adjusted life years were lost annually due to the occupationally related LBP (Punnett, 2005).

      The global burden associated with upper extremity MSDs is somewhat less clear due to the lack of a systematic method of defining cases. Studies have shown that the percentage of office workers who suffer from MSDs ranges from 20 to 60% worldwide (Global Burden of Disease 2017 Disease and Injury Incidence and Prevalence Collaborators, 2018). One older study from the United States reported lifetime prevalence of upper extremity (UE) MSDs of 29% in dentists (Stockstill, Harn, Strickland, & Hruska, 1993). Unfortunately, case definitions used by different researchers differed dramatically; thus, global estimates were not possible (Huisstede, Bierma‐Zeinstra, Koes, & Verhaar, 2006). In Europe, MSDs are the leading cause of loss of productivity, sickness absence, and work disability across all European Union (EU) member states. Lost productivity due to MSDs is estimated to represent approximately 2% of the EU gross domestic product (Bevan, 2015).

      Clearly, MSDs exact a significant toll on individuals throughout the globe. Not only do these afflictions result in terrible burdens with respect to human disability and suffering, but there are also enormous economic and societal prices to be paid. Any attempt to reduce the effects of these MSD sequelae is clearly more than just a formidable challenge. It should be apparent that the complete control of these disorders, or even a sizable portion of them, is currently well beyond СКАЧАТЬ