Introduction

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Stuart Weinstein, MD

Musculoskeletal disorders and diseases are the leading cause of disability in the United States and account for more than one-half of all chronic conditions in people older than age 50 years in developed countries. The economic impact in the United States of these conditions is also staggering: the estimated sum of the direct expenditures in healthcare costs and the indirect expenditures in lost wages was $980 billion in 2014, up from $874 billion in 2011. Over the last 18 years, costs associated with musculoskeletal conditions have risen from the equivalent of 3.4% to 5.8% of the GDP (national gross domestic product).

Beyond these statistics, the human toll in terms of the diminished quality of life is immeasurable. This situation is unlikely to improve in the foreseeable future and will likely be intensified by current demographic trends, including the graying of the baby boomer population, the epidemic of morbid obesity, and the higher recreational activity levels of our elderly population.

Despite these compelling facts, the investment in musculoskeletal research in the United States lags behind other chronic conditions. While musculoskeletal diseases are common, disabling, and costly, they remain under-appreciated, under-recognized, and under-resourced by our national policy makers.

The mission of the U.S. Bone and Joint Initiative, publisher of this publication, is to advocate for and promote multidisciplinary, coordinated, and patient-centered care to improve the prevention, diagnosis, and treatment of musculoskeletal conditions.

New to the 4th Edition is inclusion of an Overview of each chapter, an interpretation of the data and what it means in lay-friendly terms, along with Fast Facts, slide sets and videos. These may be freely downloaded and used. Reference to the source is appreciated. 

Edward Yelin, PhD, MCP

This volume serves the mission of the Initiative in that several professional organizations concerned with musculoskeletal health have collaborated to tabulate up-to-date data on the burden of musculoskeletal diseases to educate healthcare professionals, policy makers, and the public. In this fourth edition of The Burden of Musculoskeletal Diseases in the United States (BMUS), information presented has been updated to reflect the most current data available. This book represents a true collaboration of a coalition of professional organizations committed to the mission of the U.S. Bone and Joint Initiative.

The content in this edition has been expanded to include new chapters on Neuromuscular Disorders, and on Ethnic and Racial Differences and Disparities. Ethnic and Racial Differences and Disparities are also an integral part of each condition-based chapter. Chapters now include sections on Key Challenges for the Future, and Unmet Needs.

The website includes features and functionality to facilitate use of the data. Graphs can and may be downloaded for use in presentations. Tables are linked directly from the text content and can be downloaded as PDF files or as CSV/Excel files. All the graphs and tables under each topic can be viewed together and downloaded if desired. A suggested citation is included on the site. The Report Builder tool allows users to produce tailored reports on the latest available data provided by some of the original data sources used to produce the edition.

These data should stimulate increased investment in basic, translational, clinical and health policy research to delineate the underlying mechanisms of these diseases and their response to treatment. Through such research, novel preventive and therapeutic approaches with potential to mitigate the societal and personal impact of musculoskeletal disease will emerge.

We thank the authors and reviewers of the chapters, Sylvia Watkins-Castillo who undertook and coordinated development of the content and is so dedicated to this publication, the BMUS Steering Committee members who have guided the publication, and to the organizations which have provided support to make this edition possible.

Stuart Weinstein, MD
Edward Yelin, PhD, MCP
Co-Chairs, Steering Committee, Burden of Musculoskeletal Diseases in the United States (BMUS)
United States Bone and Joint Initiative