Key Challenges To Future


Lead Author(s): 

Edward H. Yelin, PhD

Supporting Author(s): 

Sylvia I. Watkins-Castillo, PhD

Society has the option of passively accepting the increasing economic impact of musculoskeletal diseases, or it can seek to alleviate this impact by the use of primary, secondary, and tertiary preventive measures with strong evidence of effectiveness. Such measures run the gamut from weight loss and exercise programs to reduce the prevalence of arthritic conditions, to self-management classes designed to reduce the impact of existing conditions, to surgical and medical interventions that return the individual to higher levels of functioning and quality of life.1,2,3,4,5

In the discussion of demographic variations, disparities in medical care expenditures were identified, especially those associated with lack of health insurance. This suggests the need for equal access to effective interventions and treatment modalities to keep individuals participating in society through work and other meaningful activities.  It also suggests that if health reform reduces the ranks of the uninsured, there may be benefits in reduced health care expenditures for services like total joint replacement, as well as reduced earnings losses if functional status does not decrease as profoundly after onset of musculoskeletal conditions.


  • 1. Yelin E, Callahan L: The economic cost and social and psychological impact of musculoskeletal conditions. Arthritis Rheum 1995;38:1351-1362.
  • 2. Yelin E, Katz P: Labor force participation among persons with musculoskeletal conditions, 1970-1987: National estimates derived from a series of cross-sections. Arthritis Rheum 1991;34:1361-1370.
  • 3. Kruger J, Helmick C, Callahan L, Haddix A: Cost-effectiveness of the arthritis self-help course. Arch Int Med 1998;158:1245-1249.
  • 4. Minor M: 2002 Exercise and Physical Activity Conference, St. Louis, Missouri: Exercise and arthritis “We know a little bit about a lot of things". Arth Rheum 2003;49:1-2
  • 5. Redelmeier D, Lorig K: Assessing the clinical importance of symptomatic improvements: An illustration in rheumatology. Arch Int Med 1993;153:1337-1342.


  • 2014

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