Rheumatic and Musculoskeletal Diseases (RMDs)

also termed: Musculoskeletal Disorders

Backgrounder

Muscle and joint pain costs European economies up to €240 billion a year. (Fit for Work,
EUROSTAT)

Chronic diseases, such as rheumatoid arthritis and lower back pain, are responsible for
preventing thousands of people from going to work in countries across Europe.

Rheumatic and musculoskeletal diseases (RMDs) is an umbrella term covering over 200
conditions that affect the muscles, joints, tendons, ligaments, peripheral nerves and supporting
blood vessels, causing pain and functional impairment to sufferers. (PUNNETT et al, 2004)

The impact of RMDs goes beyond the immediate physical symptoms; the conditions affect a
person's self-esteem, quality of life, family life and financial situation. Early diagnosis and
intervention can help sufferers of RMDs to stay fit and stay in work longer, which will have not
only a positive impact on them, but also on Europe’s economy and society in general.

Facts
• At least 100 million people report chronic musculoskeletal pain in 2008 (Veale et al, 2008)
• Up to 80% of the adult population will be affected by a RMD at some time in their life (WHO
2003)
• Over 44 million (1 in 6) members of the EU workforce have a long-standing health problem
or disability which affects their ability to work (Eurostat, 2003).
• RMDs affect more than 40 million workers in the EU and account for about half of all work-
related disorders in EU countries (ETUI, 2007), representing an estimated cost to society of
between 0.5 and 2 per cent of gross domestic product (GDP) annually
• Up to 40 % of sufferers are out of work at some time in their life. (BEVAN et al, 2007)
• The European Commission estimates that RMDs account for almost 50% of all absences
from work lasting three days or longer and for 60 per cent of permanent work incapacity
(EC, 2007)
• Reported unemployment rates are three times higher among people with RMDs than in the
general population (BEVAN et al, 2007)

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Impact and Costs
• Early intervention is crucial to individual recovery and self-management; it may contribute to
reduced number of working days lost and reduced productivity caused by RMDs
• Direct costs of RMDs include the cost of prevention, detection, treatment, rehabilitation and
long term care
• Indirect costs of RMDs include lost work output attributable to a reduced capacity for activity,
lost productivity, lost earnings, lost opportunities for family members and lost tax revenue
• Intangible costs include psychosocial burden resulting in reduced quality of life, such as job
stress, economic stress, family stress and suffering (WHO, 2003)
• In the UK, total costs associated with RMDs in 2007 were estimated at £7 billion. (HSE
2007)

Making Europe Fit for Work

• Patients
o must be supported in their right to early diagnosis, appropriate intervention and
effective rehabilitation
o need an open and informed dialogue with health professionals, actively taking control
of care and ensuring early diagnosis, and need access to the safest, most effective
treatment, including the most appropriate therapy, structured self-management
support and rehabilitation

• Healthcare professionals
o should be more aware of the fact that poor management of RMDs has a severe
impact on the ability to work of those affected, looking beyond just treating the signs
and symptoms of RMDs
o work participation, return to work and maintaining work productivity should be explicit
clinical targets, and in this respect, the benefits of early diagnosis, appropriate
intervention and effective rehabilitation in managing RMDs are clear

• Employers
o should be aware of the symptoms, such as periodic 'flares' of inflammation and
severe pain so they can adopt a helpful approach to return to work
o can play an active role by supporting workers and helping them to stay at work by
offering rehabilitation and return to work services

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• Policy-makers
o must ensure that health and work agendas promote health, positive health
outcomes, labour market retention and active inclusion.
o should recognise that early diagnosis, appropriate intervention and effective
rehabilitation are core to the effective management and prevention of RMDs.

• Joint action is needed. Policy-makers, employers, health professionals, patients and

payers must act together if active participation in work and society and a high quality of life
is to become a reality.

Call to Action
• For policymakers:
o To raise MSDs as EU and National public health priorities, specifically with a
view to the development of National MSD Plans and dedicated resources
• For payers:
o To ensure the allocation of adequate health resource and funding for early
intervention and appropriate treatment in MSDs
• For health technology assessment professionals:
o To establish work productivity and wider clinical and societal costs as health
economic evaluation targets
• For clinicians and healthcare professionals:
o To establish work productivity as a clinical outcome
• For patients and their relatives:
o To make the voice of MSDs patients heard and to provide illustrations of best
practices, which can make a difference in the lives of patients and their relatives
• For employers:
o To promote policies that allow for reasonable workplace accommodations for
workers with MSDs to maximize employees workability and wellbeing

Many of these facts and figures are reflected in the Fit for Work pan-European study,
undertaken by The Work Foundation. For more information visit www.fitforworkeurope.eu, and
www.eular.org . 

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References

• Fit for Work Europe Report, The Work Foundation, 2009.

• EUROSTAT. Europe in Figures –yearbook 2009, published 18 September 2009
o RMDs cost the EU from 0.5%-2% of GDP annually. EU27 GDP in 2007 was €12.3 trillion. A loss of 2
% is approximately €240bn. Figures calculated from Europe in Figures – Eurostat yearbook 2009,
published 18 September 2009.

• Bevan, S., Passmore, E., Mahdon, M. (2007). Fit for Work? Musculoskeletal Disorders and
Labour Market Participation. UK: The Work Foundation
• European Parliament (2005). Working Together for Growth and Jobs, Communication to the
Spring European Council - Com (2005) 24
• European Parliament (2008). Together for Health: A Strategic Approach for the EU 2008-
2013. European Parliament Resolution of 9 October 2008 - P6_ta(2008)0477
• HSE (2007). Self-Reported Work-Related Illness Module of the Labour Force Survey
2005/06. Health and Safety Executive
• Punnett, l., Wegman, d. (2004). Work-related Musculoskeletal Disorders: The Epidemiologic
Evidence and the Debate. Journal of Electromyography and Kinesiology, 14 (1), 13-23
• WHO Scientific Group (2003). The Burden of Musculoskeletal Conditions at the Start of the
New Millennium
 

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