Special article the economic cost and social and psychological impact of musculoskeletal conditions


  • Edward Yelin PhD,

    Corresponding author
    1. University of California, San Francisco
    • Arthritis Research Group, University of California, San Francisco, 1388 Sutter Street, Suite 700, San Francisco, CA 94109
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  • Leigh F. Callahan,

    1. Aging Studies Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
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    • The National Arthritis Data Work Group has been convened by Reva Lawrence, MPH, of the National Institute of Arthritis and Musculoskeletal and Skin Diseases. The members are Frank Arnett, MD; Leigh Callahan, PhD; David Dennis, MD, MPH; Richard Deyo, MD, MPH; David Felson, MD, MPH; William Felts, MD; Edward Giannini, DrPH, MSc; Charles Helmick, MD; Stephen Heyse, MD, MPH; Rosemarie Hirsch, MD, MPH; Marc Hochberg, MD, MPH; Gene Hunder, MD; Reva Lawrence, MPH; Matthew Liang, MD, MPH; Stanley Pillemer, MD; Lawrence Shulman, MD, PhD; Virginia Steen, MD; Frederick Wolfe, MD; and Edward Yelin, PhD


Objective. To provide an indication of the economic, social, and psychological impact of musculoskeletal conditions in the United States.

Methods. Review of the literature combined with estimates of data concerning health care utilization and acute and chronic disability due to musculoskeletal conditions, from the 1990–1992 National Health Interview Survey.

Results. The cost of musculoskeletal conditions was $149.4 billion in 1992, of which 48% was due to direct medical care costs and the remainder was due to indirect costs resulting from wage losses. This amount translates to ˜2.5% of the Gross National Product, a sharp rise since the prior studies, even if part of the increase is an artifact of improved accounting methods. Each year, persons with musculoskeletal conditions make 315 million physician visits, have more than 8 million hospital admissions, and experience ˜1.5 billion days of restricted activity. Approximately 42% of persons with musculoskeletal conditions–more than 17 million in all–are limited in their activities.

Conclusion. The economic and social costs of musculoskeletal conditions are substantial. These conditions are responsible for a sizable amount of health care use and disability, and they significantly affect the psychological status of the individuals with the conditions as well as their families.