Those at risk
Whilst there is a common misconception that conditions such as back pain and arthritis are unavoidable, there are some factors that increase the risk for individuals and populations. Figure 1 below summarises some of the main contributory factors for key MSK conditions and Figure 2 provides more detail by risk factor.
Figure 1 – Factors contributing to MSK health (source, Versus Arthritis)
| MSK pain conditions (e.g. osteoarthritis) | Osteoporosis and associated fractures | Inflammatory conditions (e.g. rheumatoid arthritis) |
|---|---|---|
| Age (late 40s onwards), gender (more common in women), genetic factors, obesity, low levels of physical activity, physical injury, previous joint issues | Age (risk increases with age), genetic factors, gender (women more likely to be affected by hip fractures), inflammatory disorders, smoking, alcohol, poor nutrition, low levels of physical activity | Genetic factors, smoking, obesity. Can affect any age |
Figure 2 – Impact of risk factors on MSK conditions
| Contributory factor | Impact on MSK conditions |
|---|---|
| Deprivation | People from the most deprived areas in England are more likely to report long-term MSK problems than those from the least deprived areas. People living in more deprived areas also report experiencing more severe pain.. There are higher rates of hip fractures in more deprived wards in North Tyneside (see Appendix 1) |
| Ethnicity | In England, people from some ethnic groups were most likely to report a long-term MSK problem in 2022 (e.g., White Gypsy or Irish Traveller, White Irish, White British, Black Caribbean), whereas people in other ethnic groups were less likely (e.g. Chinese, Bangladeshi, Black African). There is insufficient local data to understand this at a local level. |
| Obesity | Maintaining a healthy weight across the life course can reduce the risk of developing MSK conditions such back pain and knee/hip osteoarthritis. Weight loss at every stage of life reduces the risk of developing osteoarthritis and can reduce the associated pain and disability, even when damage to joints is irreversible. Nationally, 64% of the population are overweight or obese, but this rises to 69% of those with a long-term MSK condition. More adults are classified as obese in North Tyneside than England overall (35.8% vs 25.9%) |
| Physical inactivity | Maintaining physical activity levels across the life course can reduce the risk of developing MSK conditions. Nationally, 27% of the population are physically inactive, but this increases to 38% of people with long-term MSK conditions. Adults in North Tyneside are less likely to be physically active than adults in England overall (64.0% vs 67.3% in 2021/22) and more likely to be physically inactive (26.8% vs 22.3% in the same period). |
| Smoking | Smoking increases the risk and impact of MSK conditions. For example, smokers experience higher levels of pain and smoking is associated with an increased risk of fractures and slower healing, and particular risks for postmenopausal women..Smoking also reduces the impact of treatment for rheumatoid arthritis and is a significant cause of the condition. The prevalence of smoking is decreasing locally and nationally. In 2022, 11.2% of adults were current smokers, but there is variation in this and people in more deprived areas, those in routine and manual jobs and people with a severe mental illness are more likely to smoke. |
| Mental health conditions | Living with a chronic pain and disability from a MSK condition can impact on mental health. However, the body’s pain system is complex, and conditions such as depression can also increase the risk of developing back pain etc. and make that pain worse. The association between MSK conditions and mental health is thought to be stronger in people in more deprived areas, leading to further inequalities. In 2021/22 14.3% of the population of North Tyneside had a diagnosis of depression recorded on their GP record, which is higher than the 12.7% in England. In the same period, 0.95% of people in North Tyneside had a recorded diagnosis of severe mental illness, which is similar to the England value. |