Chronic Conditions – Musculoskeletal

Stand up straight!
Don’t slouch!
Look where you are going!
Look up from your phone!
Has anyone ever said any of these things to you?  It was probably your mother, and she was looking out for you with good advice that can actually help.  Many times bad habits like these lead to chronic musculoskeletal (MSK) conditions that can be painful and debilitating, affecting quality of life, daily activities, work productivity, and lost days at work and in school.  While the causes of musculoskeletal pain are varied, many times it is due to changes in posture or poor body mechanics. (Do you look at a screen all day?  How about your phone?  Slouch in your chair?  Sit all day?)  These poor habits bring about spinal alignment problems and muscle shortening, therefore causing other muscles to be misused and become painful.  Other causes of musculoskeletal conditions include the wear and tear of daily activities such as repetitive movements, overuse, or even prolonged immobilization.
Tech Neck
Have you ever heard of “Tech Neck”?  It is a real thing.  If you suffer from any of the following four signs, you might be suffering from Tech Neck, because we’re all spending too much time staring at screens.
  • Neck pain
  • Numbness and tension in your fingers
  • Headaches
  • Poor posture
Many people hold their tech devices, like cell phones and e-readers, at chest or waist level, not eye level. This causes you to look down at your device by bending your neck and rounding your shoulders forward, both of which are terrible for your posture.  Health experts claim that by bending your neck, you’re essentially shortening and tightening your neck muscles and putting your spine in a dangerous position.  This is just one example of poor body mechanics that can lead to musculoskeletal conditions.  Others include poor chair posture and looking down at a computer screen, issues you find within most office environments.  Do you sit all day?  The average American sits for roughly 7 hours per day between work, commuting, eating, and leisure activities.  Prolonged sitting can have dramatic effects on our bodies and has been linked to increased prevalence in back pain, neck pain, headaches, and other musculoskeletal conditions.
Cost and health care impact of Musculoskeletal Conditions Nationally
And while musculoskeletal issues are painful for the individual, they also plague employers every day.  An estimated 126.6 million Americans (half of all adults) are affected by a musculoskeletal condition, potentially half your work force.  Additionally, the cost to treat musculoskeletal conditions is greater than for treatment of many other chronic health conditions.  According to a report from Science Daily, $213 billion is spent annually on treatment, care and lost wages due to musculoskeletal conditions.  That’s a huge number that equates to 1.4 percent of the country’s gross domestic product (GDP).  These conditions were responsible for 18 percent of all health care visits, with an average cost per person of $7,800 annually.
Most Common Musculoskeletal Conditions
  • Back and neck pain
    • Affects nearly 1 in 3 adults (75.7 million people)
    • Average of 11.4 lost work days
    • 52 million office visits due to low back pain
  • Arthritis
    • Most common cause of disability, with 51.8 million — including half of U.S. adults age 65 and older — suffering from the disease
    • Two-thirds of arthritis sufferers are younger than 65
    • Arthritis prevalence is projected to increase to 25 percent of the adult population (67 million people) by 2030
    • 6.7 million annual hospitalizations due to arthritis
    • 66 million office visits due to bone and joint injuries
  • Osteoporosis
    • Affects 10 million Americans, with 19 million more (mostly women) at risk for the disease
    • 1 in 2 women and 1 in 4 men over the age of 50 will have an osteoporosis-related fracture
    • 20% of hip fracture patients over age 50 will die within one year of their injury
  • Injuries from work, military service, falls or sports
MB Clients and the $100 Million Problem
We have seen the costs on a national level, but what about locally?  McGohan Brabender clients in our data analytics system had 44,609 patients (39.5 percent of the total population) spent over $100.2 million dollars in the past 12 months on musculoskeletal conditions.  That is an increase of 0.5 percent in the number of patients and 3.8 percent increase in the average cost per patient from the prior 12-month period.  This equates to 15.1 percent of the total health care spend being spent on musculoskeletal conditions.  Back pain alone was responsible for $21.3 million in spend.
Another issue that goes hand-in-hand with musculoskeletal conditions is painkillers.  Opioid addiction in Ohio is out of control, and it oftentimes begins with pain due to a musculoskeletal condition.  The good news is that MB clients had an 8.4 percent decrease in the number of members taking a prescription drug for MSK issues.  The not-so-good news is that the cost of those prescriptions increased 13.3 percent over the 12-month period, with the average cost of MSK drugs up to $682/patient.
What can Employers do to Lower Costs?
As it has been with all of the other chronic conditions we have discussed in previous posts, PREVENTION is a key factor in musculoskeletal conditions.  Implementing proven prevention strategies for workplace injuries can dramatically lower the incidence and/or severity of injury.  More importantly, behavior changes including proper posture, correct body mechanics, exercise, stretching and weight loss are all keys in preventing musculoskeletal conditions.
Starting with an appropriate health care provider who knows how to screen, diagnose, treat and/or refer musculoskeletal conditions can have a huge cost savings to both the employee and employer.  Providers that incorporate evidence-based treatments and care pathways, utilize alternative treatments, have better care coordination between physicians and other health care providers (primary care physicians, specialists, physical therapists, chiropractors, etc.) result in savings not only to your wallet, but your time as well.  These providers can often eliminate unnecessary imaging, costly and potentially dangerous painkillers and opioids, injections, and surgeries by determining the root cause of the pain.
And there are easy things that everyone can do as well.
  • Take a break and go for a walk around the office
  • Stretch
  • Purchase a standing desk if you sit all day
  • Make a conscious effort to not stare down at your phone
  • Ensure your monitor is at eye level, if not, stack books under it to raise it up
For stretches and more tips to combat a sedentary lifestyle, check out Airrosti’s website.
Musculoskeletal conditions are painful, expensive and oftentimes debilitating.  Making an effort to ensure your well-being is time well spent.