Evidence for interventions
It is difficult to summarise the evidence for interventions for MSK conditions as the term covers such a range of conditions with multiple treatments and patients with very different needs to each other. There is a lot of research in the field, but we still need bigger and better designed studies to draw firm conclusions.
Over half of people with MSK conditions reported to Versus Arthritis that they cannot do anything to lessen the impact of the condition on their lives. There are also steps that all residents can take throughout their life course to reduce the risk of developing these conditions. Physical activity can be beneficial for musculoskeletal health, despite many people with MSK conditions mistakenly believing that it can make their condition worse. Activities to strengthen bones and muscles can improve mobility, reduce the risk of a fall and fractures, reduce pain and also improve mental wellbeing, which is important in people with co-occurring depression etc.
Other interventions that can help reduce the risk of developing MSK conditions include those that support people to maintain a healthy weight and to stop smoking (see relevant JSNA chapters).
The National Institute for Health and Care Excellence (NICE) produces evidence-based guidance, advice and clinical standards for healthcare professionals to aid decisionmaking in specific MSK conditions. More detail is provided in Appendix 2.
The Cochrane Library is a collection of databases that contain high quality, independent evidence to inform healthcare decision-making. In Cochrane Systematic reviews authors bring together all evidence that meets pre-specified eligibility criteria to answer a specific question. They also comment on the quality of available evidence. Appendix 2 summarises some recent Cochrane reviews into interventions for some common MSK conditions. In summary, whilst some studies showed some positive effects, at least in the short term, a lot of the evidence was not conclusive, or of low quality. Some drug-based treatments have short-term effects on pain and some exercise-based interventions appear better than doing nothing.