Reducing arthritis pain through physical activity: a new public health, tiered approach

The burden of arthritis is a massive, growing problem. In the UK, there are 8.75 million people who have sought treatment for arthritis, with osteoarthritis affecting one in three people aged >45 years.¹ In any given year, an estimated one in six adults aged >25 years has back pain lasting more than 3 months.² The personal impact of living with long-term pain and disability is great, including on mental health, wellbeing, and the ability to remain independent. In terms of burden on the NHS, one in eight (12%) general practice consultations includes a musculoskeletal component.³ The National Joint Registry recorded over 200 000 hip and knee replacements in 2015, >90% of which were for osteoarthritis.⁴ Collectively, musculoskeletal conditions account for the largest number of years lived with disability in this country,⁵ and comprise the third largest NHS England programme budget £4.7 billion annual spend.⁶ Musculoskeletal conditions accounted for 30.8 million working days lost in the UK in 2016, second only to minor illnesses as a cause.⁷ People with musculoskeletal conditions are less likely to be in paid work than those with other long-term conditions, and tend to retire early.⁸

An ageing, increasingly overweight/obese population means this burden will continue to increase. Critically, musculoskeletal conditions are major contributors to multimorbidity because of their prevalence, impact on quality of life, and because they deprive people of their mobility and independence, …