3 The need to address the burden of musculoskeletal conditions Anthony D. Woolf, BSc, MBBS, FRCP a, * , Jo Erwin, MSc, MPH, PhD b,1 , Lyn March, MD, MSc, PhD, FRACP, FAFPHM c, 2 a Department of Rheumatology, Royal Cornwall Hospital, Truro TR1 3LJ, UK b Bone and Joint Research Group, Royal Cornwall Hospital, Truro TR1 3LJ, UK c University of Sydney Institute of Bone & Joint Research, Royal North Shore Hospital, St Leonards NSW 2065, Australia Keywords: Musculoskeletal conditions Prevalence Prevention Treatment Rehabilitation Public health Musculoskeletal conditions are common in men and women of all ages across all socio-demographic strata of society. They are the most common cause of severe long-term pain and physical disability and affect hundreds of millions of people around the world. They impact on all aspects of life through pain and by limiting activities of daily living typically by affecting dexterity and mobility. They affect one in four adults across Europe [1]. Muscu- loskeletal conditions have an enormous economic impact on society through both direct health expenditure related to treating the sequelae of the conditions and indirectly through loss of productivity. The prevalence of many of these conditions increases markedly with age, and many are affected by lifestyle factors, such as obesity and lack of physical activity. The burden of these conditions is therefore predicted to increase, in particular in developing countries. The impact on individuals and society of the major musculoskeletal conditions is reviewed and effective prevention, treatment and rehabilitation considered. The need to recognise musculoskeletal conditions as a global public health priority is discussed. Ó 2012 Published by Elsevier Ltd. * Corresponding author. Tel.: þ44 1872 253792; fax: þ44 1872 222857. E-mail addresses: Anthony.Woolf@btopenworld.com (A.D. Woolf), josephine.erwin@rcht.cornwall.nhs.uk (J. Erwin), lyn. march@sydney.edu.au (L. March). 1 Tel.: þ44 1872 255175; fax: þ44 1872 222857. 2 Tel.: þ61 299267351; fax: þ61 299061859. Contents lists available at SciVerse ScienceDirect Best Practice & Research Clinical Rheumatology journal homepage: www.elsevier.com/locate/berh 1521-6942/$ – see front matter Ó 2012 Published by Elsevier Ltd. doi:10.1016/j.berh.2012.03.005 Best Practice & Research Clinical Rheumatology 26 (2012) 183–224