title: The burden of musculoskeletal conditions.
abstract: OBJECTIVE
  Despite the burden of rheumatic and musculoskeletal diseases (RMDs), these conditions probably deserve more attention from public health authorities in several countries including developed ones. We assessed their contribution to disability.
  
  
  METHODS
  Data on disabilities associated with RMDs were extracted from the national 2008-2009 Disability-Health Survey of 29,931 subjects representative of the population in France. We used the core set of disability categories for RMDs of the World Health Organization's International Classification of Functioning, Disability and Health for analysis. Diagnosis and disabilities were self-reported. We assessed the risk of disability associated with RMDs using odds ratios (ORs) and the societal impact of RMDs using the average attributable fraction (AAF).
  
  
  RESULTS
  Overall 27.7% (about 17.3 million people) (95% CI 26.9-28.4%) of the population reported having RMDs. The most prevalent RMDs were low back pain (12.5%, 12.1-13.1) and osteoarthritis (12.3%, 11.8-12.7). People reporting osteoarthritis were more disabled in walking (adjusted OR 1.9, 1.7-2.2) than those without. People reporting inflammatory arthritis were more limited in activities of daily living (from 1.4, 1.2-1.8 for walking to 2.1, 1.5-2.9 for moving around). From a societal perspective, osteoarthritis was the main contributor to activity limitations (AAF 22% for walking difficulties). Changing jobs was mainly attributed to neck pain (AAF 13%) and low back pain (11.5%).
  
  
  CONCLUSIONS
  RMDs are highly prevalent and significantly affect activity limitations and participation restrictions. More effort is needed to improve care and research in this field.
authors.affiliation: U1153, Institut National de la Santé et de la Recherche Médicale, Paris, France; Centre d'Épidémiologie Clinique, Hôpital Hôtel Dieu AP-HP, Paris, France; Université Paris Descartes, PRES Sorbonne Paris Cité, Paris, France; Service de rééducation et réadaptation de l'appareil locomoteur et des pathologies du rachis, Hôpital Cochin AP-HP, Paris, France.
authors.forename: Clémence
authors.initials: C
authors.lastname: Palazzo
authors.affiliation: Institut fédératif de recherche sur le handicap, Institut National de la Santé et de la Recherche Médicale, Paris, France; U988, Institut National de la Santé et de la Recherche Médicale, Villejuif, France; UMR 8211, Centre national de la recherche scientifique, Villejuif, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Ravaud
authors.affiliation: Service de rééducation et réadaptation de l'appareil locomoteur et des pathologies du rachis, Hôpital Cochin AP-HP, Paris, France; Institut fédératif de recherche sur le handicap, Institut National de la Santé et de la Recherche Médicale, Paris, France.
authors.forename: Agathe
authors.initials: A
authors.lastname: Papelard
authors.affiliation: U1153, Institut National de la Santé et de la Recherche Médicale, Paris, France; Centre d'Épidémiologie Clinique, Hôpital Hôtel Dieu AP-HP, Paris, France; Université Paris Descartes, PRES Sorbonne Paris Cité, Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Ravaud
authors.affiliation: U1153, Institut National de la Santé et de la Recherche Médicale, Paris, France; Université Paris Descartes, PRES Sorbonne Paris Cité, Paris, France; Service de rééducation et réadaptation de l'appareil locomoteur et des pathologies du rachis, Hôpital Cochin AP-HP, Paris, France; Institut fédératif de recherche sur le handicap, Institut National de la Santé et de la Recherche Médicale, Paris, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Poiraudeau
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001168:Arthritis / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D004185:Disability Evaluation; D005260:Female; D005602:France / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D017116:Low Back Pain / Q000150:complications; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D009140:Musculoskeletal Diseases / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D016138:Walking