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Getting active for better musculoskeletal health

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Musculoskeletal conditions affect over 10 million people and are the leading cause of disability in England, according to the Global Burden of Disease project – an international study ranking the diseases and risk factors that cause death and disability.

For many years there has been a perception that arthritis and back pain are unavoidable and part of the ageing process and the focus has been on conventional treatments to alleviate pain and discomfort.

However, increasingly we are seeing that unhealthy lifestyles contribute to the cause of musculoskeletal conditions, and an ageing population, rising obesity rates and reduced level of physical activity will only increase the prevalence of these conditions, and result in rising costs to the health and social care system.

We need to change how we view musculoskeletal conditions with a focus on prevention, early detection and treatment using the life course whole systems approach.

Around 19% of men and 26% of women across different age groups in England are damaging their health through a lack of physical activity, costing an estimated £7.4 billion every year.

In response to this, Public Health England launched the Everybody Active Every Day framework in 2014, which identifies a role for everyone across the sector to support communities in improving access to physical activity and creating environments that make physical activity the norm.

A new report from the Department of Health, Public Health England, NHS England and Arthritis Research UK highlights the outcomes of programmes that offer physical activity interventions for musculoskeletal conditions that are effective across care pathways, cost effective and provide long term health benefits for individuals across the life course.

By becoming more physically active, many people with musculoskeletal conditions can reduce pain and improve their quality of life and independence.

This means they will rely less on health and care services and remain able to work – with 32.4 million working days lost to musculoskeletal health conditions in the UK in 2015, there are also significant benefits for the wider economy.

We need to focus our collaborative efforts on addressing the rising tide of musculoskeletal ill health and acting earlier to prevent, detect and treat musculoskeletal conditions with targeted public health interventions across the life course.

PHE has commissioned the development of economic tools to help demonstrate the return on investment of interventions for the prevention of major musculoskeletal conditions and the prevention of falls and fractures, and we are also committed to working with partners to develop a systematic approach for the use of existing and new data.

The MSK Calculator developed by Arthritis Research UK is an excellent example of how partners are working to support national and local system leaders to commission services effectively based on quality outcome measures.

We also want to scale up evidence-based programmes such as Escape-pain, which supports rehabilitation and self-management for individuals who have chronic joint pain.

It is good to see a growing consensus across the sector for an upstream approach targeting early interventions across the life course to promote healthier ageing and protect future generations.

How we live, work and spend our leisure time is integral to health, and we need to build on the evidence that informs how the built environment and wider social factors impact on musculoskeletal health.

PHE is supporting individuals, employers and those commissioning and delivering services to improve musculoskeletal health, and this requires commitment from many different stakeholders.

For example, a consensus statement published by the National Falls Prevention Coordination Group outlines ways to support and encourage effective and integrated commissioning of interventions to help prevent falls, while programmes such as our Workplace Wellbeing Charter are there to help employers provide workplace environments that support and encourage a healthy workforce – 1 in 10 employees report having a musculoskeletal condition.

We will be monitoring and reviewing how these resources are used to evaluate their effectiveness and their impact on public health outcomes, and will continue working with partners to identify health interventions that really work, supported by world-class knowledge and data, and to work collaboratively to shape future policy and strengthen the evidence base.

Image: Sport England

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