Musculoskeletal Disorders

This topic area covers statistics and information relating to musculoskeletal disorders in Hull including local strategic need and service provision.

This page contains information from the Office for Health Improvement & Disparities’ Fingertips. Information is taken ‘live’ from the site so uses the latest available data from Fingertips and displays it on this page. As a result, some comments on this page may relate to an earlier period of time until this page is next updated (see review dates at the end of this page).

Headlines

• Musculoskeletal conditions can have a severe detrimental effect on quality of life, and is one of the largest causes of disability resulting in poor quality of life.
• In 2016/17, 10.9% of survey responders in the GP Patient Survey (patients aged 16+ years registered with a Hull GP) reported a long-term back problem and 13.6% reported arthritis or long-term joint problem. From the same survey in 2023, 21.4% reported a long-term musculoskeletal problem (“arthritis or ongoing problem with back or joints”). These percentages were all higher in Hull compared to England (9.4%, 12.2% and 18.4% respectively).
• With a resident population of around 217,500 adults aged 16+ years and a prevalence of 21.4%, this would equate to around 46,500 people in Hull affected by musculoskeletal conditions.
• Among those who did report a long-term musculoskeletal problem in 2023, 16.3% of them in Hull also reported having at least one other long-term condition compared to 13.4% in England.
• There were 1,962 patients aged 16+ years who were registered with Hull GPs in 2023/24 who had been diagnosed with rheumatoid arthritis representing 0.8% of all patients aged 16+ years. The prevalence in Hull was the same as for England for 2022/23. The numbers had increased between 2013/14 and 2017/18 from 2,068 to 2,133 patients as patients, but subsequently decreased to a low of 1,899 patients in 2022/23, with a small increase to 1,962 patients in the last year.
• From the Global Burden of Disease 2021, musculoskeletal conditions account for one-fifth of all disability in Hull as measured in relation to the years of living with a disability with low back pain accounting for 9.8%, neck pain for 3.0%, osteoarthritis for 3.0%, rheumatoid arthritis for 0.5%, gout for 0.2% and other musculoskeletal conditions for 3.4%. Musculoskeletal conditions account for a higher percentage of this disability in Hull among women (21.3%) compared to men (18.5%) and musculoskeletal conditions account for a higher percentage among people aged 50-69 years (23.8% for men and 29.0% for women).
• From the Global Burden of Disease 2021, musculoskeletal conditions account for 8.2% of all disability in Hull as measured in relation to the disability-adjusted life years with low back pain accounting for 3.9%, neck pain for 1.2%, osteoarthritis for 1.2%, rheumatoid arthritis for 0.3%, gout for 0.1% and other musculoskeletal conditions for 1.5%. Musculoskeletal conditions account for a higher percentage of this disability in Hull among women (10.3%) compared to men (6.4%) and musculoskeletal conditions account for a higher percentage among people aged 15-49 years (8.6% for men and 13.4% for women) and 50-69 years (7.9% for men and 14.0% for women).

The Population Affected – Why Is It Important?

Musculoskeletal (MSK) conditions affect many people and can affect joint, bones and muscles, and sometimes associated tissues such as nerves. They can range from minor injuries to long-term conditions. According to the NHS, over 20 million people in the UK – almost one-third of the population – have a MSK condition such as arthritis or back pain. Symptoms can include pain, stiffness, limited movement, and disability which affects quality of life and independence.

Musculoskeletal conditions not only has a huge impact on individuals, but a massive impact on employers, the NHS and wider economy. It is estimated that over 30 million working days are lost due to musculoskeletal conditions every year and they account for up to 30% of GP consultations in England.

Back pain and musculoskeletal conditions are one of the main causes of disability and condition with the highest impact on poor quality of life in terms of years of healthy life lost due to a disability or years lived with a disability, and disability-adjusted life years.

People are also living longer with complex musculoskeletal conditions resulting in a longer life in poor health. Musculoskeletal conditions are more common in areas of greater poverty and may affect certain people from minority ethnic backgrounds more than others. How different people experience musculoskeletal can differ among different people as well as access to services.

Arthritis is a common musculoskeletal condition that causes pain and inflammation in a joint. It affects people of all ages – including children – but it is more common in older people.

Osteoarthritis is the most common type of arthritis in the UK and often develops in people in their mid-40s or older. It is more common in women and people with a family history of the condition, and can also occur as a result of an injury or be associated with other joint-related conditions such as gout or rheumatoid arthritis. It initially affects the smooth cartilage lining of the joint, which makes movement more difficult, painful and to stiffness. Once the cartilage lining starts to roughen and thin out, the tendons and ligaments need to work harder, and this can cause swelling and bony spurs. Severe loss of cartilage can lead to bone rubbing on bone, altering the shape of the joint and forcing bones out of their normal position. The hands, spine, knees and hips are most commonly affected.

Rheumatoid arthritis is less common, and often starts when a person is aged 30-50 years with women more likely to be affected than men. In rheumatoid arthritis, the body’s immune system targets affected joints, which leads to pain and swelling. The outer covering of the joint is affected first, but it can spread across the joint, leading to further swelling and a change in the joint’s shape which in turn can cause the bone and cartilage to break down. People with rheumatoid arthritis can also develop problems with other tissues and organs in their body.

There are a number of other less common types of arthritis with different causes affecting different types of people with a greater or lesser extent. Children can also be affected by arthritis and the most common type in childhood is juvenile idiopathic arthritis.

There is no cure for arthritis, but there are many treatments that can help slow the progression down which include lifestyle changes, medicines, supportive treatments surgery.

The diagnosed prevalence of rheumatoid arthritis can be examined from data collected as part of the Quality and Outcomes Framework within primary care. Quality of care indicators are also included, and it means that high percentage of the patients diagnosed with rheumatoid arthritis have annual reviews which gives medical staff the opportunity to provide information and encourage their patients to improve their lifestyle behaviours to improve their health, and lower their risk of morbidity and mortality from their condition. Local analysis of the QOF data has been completed with prevalence calculated for each GP practice and Primary Care Network group.

The Hull Picture

Prevalence of All Musculoskeletal Conditions

From the GP Patient Survey, in 2016/17, 10.9% of all patients registered with Hull GPs aged 18+ years reporting a long-term back pain and 13.6% reported arthritis or a long-term joint pain. Both of these percentages were higher in Hull compared to England (9.4% and 12.2% respectively).

The GP Patient Survey involved a relatively large sample in 2016/17 of around 3,500 to 4,000 patients, and more recently the numbers have decreased sharply. For the GP Patient Survey in 2024, 9,842 questionnaires were sent out with 2,537 returned (26%) compared to 12,458 questionnaires were sent out with 4,224 (34%) returned in 2021. The questions have also changed over time with survey responders asked more recently if they had “arthritis or ongoing problem with back or joints”. Whilst the separate information on back pain and arthritis is relatively old, it nevertheless does give an idea of the scale of the problem of musculoskeletal conditions in Hull. In 2016, there were around 208,000 adults in Hull aged 18+ years so this would equate to 22,700 people with long-term back pain and 28,300 with arthritis or a long-term joint pain.

In the GP Patient Survey in 2023, more than one in five of those surveyed reported a long-term musculoskeletal problem. With an estimated 217,500 residents aged 16+ years, this equates to around 46,500 adults affected in Hull.

The prevalence of reported a musculoskeletal condition in Hull is 16% higher than England.

The percentage of people reporting that they had a long-term musculoskeletal problem has been around 21-22% in Hull with a slight reduction in 2021 and 2022.

With a resident population of around 217,500 adults aged 16+ years and a prevalence of 21.4%, this would equate to around 46,500 people in Hull affected by musculoskeletal conditions.

Presence of Other Medical Conditions

A relatively high percentage of people participating in the GP Patient Survey who stated they had a long-term “arthritis or ongoing problem with back or joints” also reported at least one other long-term condition. As arthritis and other MSK conditions increase with age, as does the prevalence of other health conditions, it is not surprising that the percentages are relatively high with 16.3% of people with at least one other long-term condition in 2023. The percentage in Hull was higher than England (13.4%).

The percentage of people in Hull with a long-term musculoskeletal problem who also reported at least one other long-term condition has consistently been higher in Hull than England.

Prevalence of Rheumatoid Arthritis

The Office for Health Improvement & Disparities’ Fingertips gives the percentage of patients registered with Hull GPs who are diagnosed with rheumatoid arthritis among patients aged 16+ years. The sub Integrated Care Board areas which include Hull are within the Humber and North Yorkshire Integrated Care Board. In Fingertips, the sub-ICB area referenced by 03F relates to Hull (see Integrated Care Board for the codes relating to the other local sub-ICB areas).

In 2023/24, the prevalence of diagnosed with rheumatoid arthritis among patients aged 16+ years was 0.8% in Hull which was the same as for England, but lower than the Humber and North Yorkshire Integrated Care Board (0.9%).

In 2023/24, there were 1,962 patients aged 16+ years who had been diagnosed with rheumatoid arthritis in Hull. The numbers increased from 2,068 patients to a peak of 2,133 patients between 2013/14 and 2017/18 as patients were included in the new indicator, but the numbers have deceased reasonably consistently in Hull to a low of 1,899 patients for 2022/23. There has been a slight increase to 1,962 patients for 2023/24.

From the local analysis of the national Quality and Outcomes Framework datasets, there was a statistically significant association between average age of the practice patients and the prevalence of diagnosed rheumatoid arthritis among patients aged 16+ years across the 28 practices in Hull for 2023/24. If the practices were divided into five approximately equal sized groups based on average age of patients (with each fifth having approximately one-fifth of the total registered patients in Hull) then the prevalence increased from 0.52% for the practices serving the youngest practice patients to 0.99% for the practices serving the oldest practice patients. For every increase in the average age of the patients of 10 years, the prevalence of rheumatoid arthritis increased by 0.49 percentage points. Further analysis of diagnosed disease by the average age of practice patients is within the file above and within Local Analysis of Quality and Outcomes Framework Data.

There was no statistically significant association between the prevalence of diagnosed rheumatoid arthritis and the average deprivation score of registered patients (using the Index of Multiple Deprivation 2019) across the 28 practices.

Impact on Health

Musculoskeletal conditions can have a profound impact on a person’s quality of life, but there is limited information on the impact specifically in relation to residents of Hull, although the Global Burden of Disease presents information on the impact of musculoskeletal conditions on quality of life with data modelled for Hull for 2021.

Global Burden of Disease presents information on the years of healthy life lost due to a disability (YLD), with the percentage that each disease and disability accounts towards the total years of life with a disability presented.

Overall, musculoskeletal conditions accounts for one-fifth of all disability as measured in relation to years of living with a disability with low back pain accounting for 9.8%, neck pain for 3.0%, osteoarthritis for 3.0%, rheumatoid arthritis for 0.5%, gout for 0.2% and other musculoskeletal conditions for 3.4%.

Musculoskeletal conditions do not account for any disability among under fives, but the percentages generally increase with age, although the components of musculoskeletal conditions differ with age.

Lower back pain accounts for just under three-quarters of all musculoskeletal conditions among those aged 5-14 years, but just over half of all musculoskeletal conditions among those aged 15-49 years, and just under half of all musculoskeletal conditions among those aged 50+ years. Neck pain accounts for around one-fifth of all musculoskeletal conditions among those aged 15-49 years, but around 14% among 50-69s and 10% among those aged 70+ years. Osteoarthritis accounts for around 28% of all musculoskeletal conditions among those aged 70+ years, and one-fifth of all musculoskeletal conditions among those aged 50-69 years.

Females tend to have a higher percentage of disability due to musculoskeletal conditions compared to males except for gout. Musculoskeletal conditions account for 21.3% of all disability as measured in relation to years of living with a disability for females compared to 18.5% for males.

Gender	Age	Low back pain (% YLD)	Neck pain (% YLD)	Osteoarthritis (% YLD)	Rheumatoid arthritis (% YLD)	Gout (% YLD)	Other MSK (% YLD)	All MSK (% YLD)
Males	5-14	4.4	1.3	0.0	0.1	0.0	0.1	5.9
Males	15-49	8.9	3.2	0.6	0.2	0.2	3.8	16.9
Males	50-69	10.8	3.1	4.6	0.5	0.6	4.1	23.8
Males	70+	7.9	1.9	4.9	0.5	0.6	2.1	17.9
Males	All ages	9.0	2.8	2.7	0.3	0.4	3.3	18.5
Females	5-14	4.9	1.8	0.0	0.1	0.0	0.2	6.9
Females	15-49	9.0	3.5	0.6	0.4	0.0	4.0	17.5
Females	50-69	13.3	4.0	5.6	1.1	0.1	4.9	29.0
Females	70+	11.1	2.2	6.5	0.9	0.2	1.6	22.5
Females	All ages	10.4	3.3	3.3	0.7	0.1	3.5	21.3
Persons	5-14	4.6	1.6	0.0	0.1	0.0	0.2	6.4
Persons	15-49	8.9	3.3	0.6	0.3	0.1	3.9	17.2
Persons	50-69	12.1	3.6	5.1	0.8	0.3	4.5	26.6
Persons	70+	9.8	2.1	5.8	0.7	0.4	1.8	20.5
Persons	All ages	9.8	3.0	3.0	0.5	0.2	3.4	20.0

The Global Burden of Disease also presents information on disability-adjusted life years (DALYs) in a similar manner by presenting the percentage each disease or disability contributes towards the total disability-adjusted life years.

The percentages to which musculoskeletal conditions contributed to disability-adjusted life years is relatively small in relation to others diseases, mental health conditions and external causes that contribute towards disability-adjusted life years. The impact on life is significant for the people affected with musculoskeletal conditions, but there are more people affected more severely with other fatal and non-fatal conditions. Nevertheless, musculoskeletal conditions account for 8.2% of disability-adjusted life years out of the total disability-adjusted life years, and the percentage is higher among women compared to men (10.3% versus 6.4%). The percentages are higher for men and women aged 15-69 years being 8.6% for men aged 15-49 years, 7.9% for men aged 50-69 years, 13.4% for women aged 15-49 years and 14.0% for men aged 50-69 years.

Gender	Age	Back pain (% DALY)	Neck pain (% DALY)	Osteoarthritis (% DALY)	Rheumatoid arthritis (% DALY)	Gout (% DALY)	Other MSK (% DALY)	All MSK (% DALY)
Males	5-14	4.3	1.3	0.0	0.1	0.0	0.1	5.8
Males	15-49	4.5	1.6	0.3	0.1	0.1	2.0	8.6
Males	50-69	3.5	1.0	1.5	0.2	0.2	1.4	7.9
Males	70+	1.5	0.4	0.9	0.1	0.1	0.5	3.5
Males	All ages	3.0	0.9	0.9	0.2	0.1	1.2	6.4
Females	5-14	4.3	1.6	0.0	0.0	0.0	0.2	6.2
Females	15-49	6.8	2.6	0.5	0.3	0.0	3.1	13.4
Females	50-69	6.3	1.9	2.7	0.6	0.1	2.5	14.0
Females	70+	2.8	0.6	1.7	0.4	0.1	0.6	6.1
Females	All ages	4.9	1.5	1.6	0.4	0.0	1.8	10.3
Persons	5-14	4.3	1.4	0.0	0.1	0.0	0.2	6.0
Persons	15-49	5.6	2.1	0.4	0.2	0.1	2.5	10.8
Persons	50-69	4.8	1.4	2.0	0.4	0.1	1.9	10.6
Persons	70+	2.2	0.5	1.3	0.3	0.1	0.5	4.8
Persons	All ages	3.9	1.2	1.2	0.3	0.1	1.5	8.2

Current and Projected Numbers in Hull with Self-Care Needs

The Projecting Adult Needs and Service Information (PANSI) and the Projecting Older People Population Information Service (POPPI) provide current estimates and future projections at local authority level of the number of people with different health needs including people with mobility problems and self-care needs. These will not be limited to people with musculoskeletal conditions, but some people with mobility problems and self-care needs will have musculoskeletal disorders.

These estimates are available under Physical Health under Health Factors under Adults.

Further definitions and information is available from www.pansi.org.uk and www.poppi.org.uk.

Strategic Need and Service Provision

This section is currently being drafted.

Resources

The Office for Health Improvement & Disparities’ Fingertips. https://fingertips.phe.org.uk/

Global Burden of Disease, 2021. https://vizhub.healthdata.org/gbd-compare/

Updates

This page was last updated / checked on 16 October 2024.

This page is due to be updated / checked in March 2025.