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What we know
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| What we know | ||||||||||||||
| Musculoskeletal diseases are extremely common and include more than 150 different diseases and syndromes, which are usually associated with pain and/or inflammation. The main types of musculoskeletal conditions manifest as rheumatoid arthritis, osetoarthritis, osteoporosis, spinal disorders, major limb trauma, gout, fibromyalgia, and sprains and strains. Rheumatoid arthritis is a chronic systemic disease that affects the joints and soft tissues. It tends to strike between the ages of 20 and 40, and is a chronic disabling condition often causing pain and deformity. There have been recent advances in the drug treatment for severe rheumatoid arthritis. Osteoarthritis is a non-inflammatory joint disease, which increases with age and is due largely to ‘wear and tear’. It will most likely attack the joints that have been continually stressed throughout the years including the knees, hips, finger joints and lower back. Osteoporosis is caused by a reduction in bone mass leading to an increased risk of fracture particularly of wrist or hip. Risk factors include genetic predisposition (family history), inadequate dietary intake of calcium and vitamin D, lack of weight-bearing exercise and early menopause. Hip fracture is a major cause of morbidity and mortality in the elderly. Falls risk assessments have been shown to be effective in reducing the risk of hip fracture. |
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| What information do we have about the Eastern Board area? | ||||||||||||||
| In the Eastern Board we have
information on deaths due to musculoskeletal diseases and data on
inpatient admissions, outpatient referrals and operative procedures
for musculoskeletal diseases .
In 2002/2003 there were 1890 EHSSB inpatient admissions with a primary diagnosis and 1754 with a secondary diagnosis of diseases of the musculoskeletal system and connective tissue. Most of the admissions with a primary diagnosis were admitted to general medicine, geriatric medicine, rheumatology and trauma and orthopaedics. |
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| What is the result of this on our health locally? | ||||||||||||||
| In the UK at least
8 million people consult their GP annually with musculoskeletal symptoms
and 1.5 million are referred for a specialist opinion.
Musculoskeletal diseases are not a major cause of death but cause significant morbidity and disability. In 2002 there were 10 male deaths and 31 female deaths due to diseases of the musculoskeletal system and connective tissue within Eastern Board residents. Most of these deaths occurred in the over 75s. Knee and hip replacement operations are the most common joint replacement operations. In 2002/2003 398 hip replacement operations and 272 knee replacement operations were performed on Eastern Board residents. There are large volumes of patients seen at outpatients for musculoskeletal diseases. In 2002/2003 there were 8851 orthopaedic outpatient referrals and 1390 rheumatology outpatient referrals for EHSSB residents. The prevalence of musculoskeletal conditions will rise based on the increasing numbers of elderly people in the population and increasing life expectancy. Musculoskeletal disorders are the most frequent
causes of physical disability and are a common cause of absenteeism
from work. |
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| What is happening in the Eastern Board area? | ||||||||||||||
| In order
to address the long waiting lists for orthopaedic outpatients a musculoskeletal
working group was set up in 2000 within the Eastern Board to explore
ways of improving the service. The following projects for patients
with musculoskeletal conditions have been successfully piloted and
are now being rolled out across the Eastern Board area.
Orthopaedic
triage Rheumatology pilot
The project consisted of community and hospital based clinics, a patient telephone helpline, a GP fast access service, patient education programmes and staff development programmes. The evaluation of the pilot showed that there had been a reduction in the number of new patients waiting to be seen at Rheumatology clinics and that it provided a locally accessible high quality service with high levels of GP and patient satisfaction. Chronic pain pilot
Spinal triage clinic References Improving Orthopaedic Services. A guide
for clinicians, managers and service commissioners. Action on Orthopaedics
and the Orthopaedic Service Collaborative. NHS Modernisation Agency
2002.
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For further information on this topic please contact us at publichealth@ehssb.n-i.nhs.uk Eastern Health and Social Services Board Champion
House, 12-22 Linenhall Street, Belfast BT2 8BS Telephone: (028)
9032 1313 Fax: (028) 9055 3681 Text Phone:(028) 9032 4980 Website:
www.ehssb.org
E-mail: pr@ehssb.n-i.nhs.uk |
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