Physiotherapy UK 2018: Musculoskeletal disorders must be a public health priority

This was according to physiotherapist Anna Lowe, physical activity clinical champion for Public Health England.

She said it was important that musculoskeletal disorders were recognised as long-term conditions which could impact on people’s overall health and wellbeing.

‘By defining them as long-terms conditions we are moving away from the idea of episodic care, towards lifelong support and enabling people to self-manage,’ she told delegates.

‘Caring for these needs requires partnership with patients over the long term, rather than single, unconnected episodes of care.’

She told delegates that an estimated 17.8 million people in the UK have a musculoskeletal condition, about 28.9 per cent of the population. People from the most deprived communities have a far greater prevalence of musculoskeletal disorder than those in the most affluent areas.

Ms Lowe explained that long-term conditions account for

• 50 per cent of GP appointments
• 64 per cent of outpatient appointments
• 70 per cent of inpatient bed days

‘£7 in every £10 spent on the health and care budget is related to long term conditions – so there is a compelling rational for them to be an essential task for the NHS and for services and systems to be built around that,’ she said.

Associated conditions

Ms Lowe said a recent systematic review showed that osteoarthritis increased the risk of a chronic condition later in life, such as cardiovascular disease, metabolic syndrome and arterial stiffness.

‘So we are not just dealing with something that is potentially confined to one joint or a number of joints, as osteoarthritis is linked to a number of systemic, chronic and life-shortening condition,’ she said.

‘Musculoskeletal disorders have the potential to affect our relationships, our work, our hobbies and everything we hold dear – so they can have a significant impact on our mental health as well.

‘And we know that almost half the people with heart and lung or mental health conditions will also have musculoskeletal condition by the age of 65.’

Prevention opportunities

Ms Lowe said physiotherapists should be striving to positively influence their patients’ behaviour and embed prevention into every contact with musculoskeletal patients.

Smoking was a good example of a modifiable risk factor and a prevention opportunity for physiotherapists. They could offer brief advice that could help stop the escalation from one condition to many conditions.

She highlighted advice from the London Clinical Senate that helping people stop smoking is the highest value contribution to health that any clinician can make.

Delegates heard about a Public Health England survey of allied health professionals (AHPs) that asked how often they gave brief advice about smoking to their patients. The survey revealed that 23 per cent of AHPs never offered such advice.

‘That was because they didn’t feel confident to do it and didn’t think it was their role,’ Ms Lowe explained.

‘But there is a gold standard about how to deliver a brief advice on smoking. It’s a really easy, short online course that I suggest the whole workforce would benefit from taking.’