Читать книгу Musculoskeletal Disorders - Sean Gallagher - Страница 16

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 our grasp. Gaining a better understanding of the processes associated with the development of damage in musculoskeletal tissues and physiological mechanisms associated with both damage and repair of these tissues may help our ability to exert some modest degree of control over injury risk (or improved healing) in some circumstances. However, we clearly need to understand our adversary better. To start this process, we will begin by providing a brief review of some of the more common MSDs, providing descriptions and characteristic features of the disorders, prevalence and incidence data, relevant anatomy and pathology, and the risk factors or activities associated with the development of the disorders.

As can be seen below, this review focuses on MSDs affecting the low back, hands/wrists, elbows, and shoulders. While disorders affecting the hips, knees, and ankles are of interest to many musculoskeletal researchers, our emphasis is on the occupational setting, in which the former disorders tend to predominate.