February 2013

Director's Update

Dear all,

As we prepare to say goodbye to the “old” NHS before the “new” NHS bursts onto the scene from 1 April, much of the public discourse around the NHS in England of late has been dominated by the Francis Report, concerns around forcible competitive tendering and whether David Nicholson should keep his job. These are perhaps some of the reasons why we are still awaiting the announcement of who the new National Clinical Director (NCD) for MSK will be.

As you know, we have been calling for this post for many years, and the fact that ARMA was invited to help interview for this post in January is a strong indication that the NHS Commissioning Board rightly regards our Alliance as a key stakeholder.

What is certain, in any event, is that the new NCD will have a key role in shaping the national agenda on MSK, and ARMA will be looking to work very closely with them from the very beginning.

One of the very top priorities in our new strategic plan for this year – and one where we particularly wish to have the active input and involvement of the new NCD -  involves running a year-long project focused on MSK clinical networks in England, as part of a strategic partnership with the DH. On this point, I am very pleased to say that ARMA recently appointed an excellent candidate to the post of Project Manager who will be able to hit the ground running when this project starts off in April.

This week saw another important development for MSK, with the publication in The Lancet on 5 March of UK-specific data derived from December’s Global Burden of Disease study.

Whereas most of the media coverage has focused on mortality and the somewhat predictable recommendations around smoking and alcohol, ARMA put out a statement emphasising how the real challenge – and the big wins – lie in tackling the rising burden of disability, of which MSK is squarely the single biggest cause in the UK. This data provides us with a very strong platform from which to help shape and influence the public health agenda throughout the UK: public health is of course a key plank of the NHS reforms in England in particular, and we hope to discuss the findings in more detail with Public Health England very soon.

By actively engaging with the “big issues”, and highlighting the centrality of MSK in areas like public health and prevention, we demonstrate that we are relevant, informed, engaged - and able to provide some answers to the questions which everyone is currently grappling with. We do so not simply in order to influence the debate, but because this will benefit those whom we are all ultimately here for: the many millions of people living with musculoskeletal disorders in the UK. And by continuing to speak with one voice, we help ensure that all of our voices get heard.

In November last year, Dr. Martin McShane, Domain lead for Long-Term Conditions at the NHS commissioning Board, was the keynote speaker at our 2012 ARMA Lecture. This week he tweeted: Could do better on prem mortality, MUST do better on Mental Health and MSK

It is only one “tweet” amongst many in the vast Twitter sea, and I am by no means complacent. But I think our voice is starting to get heard. It’s up to us to keep this voice strong.


Members' News and

Tightrope - February 2013

The Scleroderma Society have put together a new copy of their Tightrope newsletter for February 2013, and are welcoming feedback about its name and content.

This Tightrope issue includes: an article on the psychological impact of scleroderma, including a discussion about the impact of fatigue; a description by the Royal Free Hospital’s Principal Pharmacist of the more common medications that are used in scleroderma; regional contacts and useful numbers; and many other articles.

Read full details online.

Call for proposals: Patient Reporting; Musculoskeletal Calculator

Call for proposals to further develop and validate a generic Musculoskeletal Patient-Reported Outcome Measure: the Arthritis Research UK M-PROM

Arthritis Research UK is committed to developing with all key musculoskeletal stakeholders a generic musculoskeletal patient-reported outcome measure (M-PROM) which can be used as a tool within the NHS at all stages in the pathway of care...

Read full details on the ARMA website.

RA-Awareness, Sky Diving and Tea Parties


NRAS is pleased to announce the first ever Rheumatoid Arthritis Awareness Week in the UK, a week dedicated solely to raising awareness of RA. The week will be held from Monday 24th June to Sunday 30th June ...

Read post online.

Arthritis Care - Three Nations


Arthritis Care is collaborating with Physiotherapists from the Nottingham University Hospitals Trust in a project on the need for continuation of exercise post physiotherapy intervention. AC is running a workshop with people with arthritis to explore what prevents people from exercising post physiotherapy.

Read full article online.

Ankylosing Spondylitis in the media

NASS have been working hard to raise awareness about Ankylosing Spondylitis. In the last month AS was discussed on Express FM, in The Guardian in relation to the closure of hydrotherapy pools, in the Portsmouth News and in the Irish News.  Click on the links to read the coverage.

Read about the NASS GP Back Pain seminars.

Portsmouth Walk with NASS & AC

From our Portsmouth ARMA network comes this notification about a sponsored walk on Sunday 12th May 2013, in association with Arthritis Care and the National Ankylosing Spondylitis Society. Click on the image to see the full poster for the event.

Read online.

Hypermobility Symposium

The Hypermobility Syndrome Association (HMSA) will be present at the Hypermobility Symposium on the 23rd March 2013 at the University of Hertfordshire and will also be attending the BSR in April (23rd-25th).

If you are attending either venue, come along and have a chat with us ...

See full HMSA article online to read about their kite mark accreditation to the Information Standard and their development of an Hypermobility database.

Scleroderma Society Rebrand

Message from Mike Rich of the Scleroderma Society:

We have just gone through a rebranding exercise which sees both a change in logo and a generally different approach to our publications.  We are currently planning for Wear Your Gloves Day 2013 which will be held on Friday 29th June, which is also World Scleroderma Day.  Last year we had support ...

Read full message online.

Bone and Joint Decade

Musculoskeletal Burden of Disease - UK Focus

Musculoskeletal conditions are the greatest cause of disability in the UK according to a report by international experts, published in The Lancet on 5th March 2013.

In the first comprehensive study of the impact of all diseases and risk factors worldwide, musculoskeletal (MSK) conditions have the third greatest impact on the overall health of the population, considering both death and disability. This landmark study of the burden of all diseases provides indisputable evidence that musculoskeletal conditions are an enormous and increasing problem in the UK as well as globally, and need to be given the same priority for policy and resources as other major conditions like cancer, mental health and cardiovascular disease.

In particular, the report found that musculoskeletal disorders account for nearly one third of the entire burden of disability in the UK, which is increasing rapidly as a proportion of overall burden of disease due to our ageing population. Low back pain is the single biggest cause of disability, followed closely by osteoarthritis.

The report states that “musculoskeletal disorders will only increase in importance given current trends and require more urgent policy attention. Falls prevention is another area where there are demonstrable intervention strategies, which have yet to be implemented on a wide scale.”

Federico Moscogiuri, Director of the Arthritis and Musculoskeletal Alliance (ARMA), said, “This data provides the clearest evidence to date of the huge and increasing burden on people’s health from musculoskeletal conditions. It provides a compelling case for making musculoskeletal disorders a national health priority, particularly at a time when the NHS is required to do “more for less” and make services much more patient-centred. When it comes to improving public health, providing cost-effective care and keeping people with long-term conditions independent and in work, the treatment and management of musculoskeletal disorders is clearly where the big wins are, and that’s where the attention needs to be.”

Professor Anthony Woolf, Chair of the Bone and Joint Decade (BJD) International Co-ordinating Council, from the Royal Cornwall Hospital, Truro, UK, said: “Health policy across the world has ignored diseases which affect the quality of lives and independence of people living with them and focused on those with high mortality such on cancer, heart disease and diabetes. Now with people living longer it is time for priority to be placed on dealing with this enormous burden from arthritis, back pain and other musculoskeletal conditions to prevent unnecessary pain and disability and enable people to keep independent. Despite effective ways of preventing and treating these conditions, many people do not have access to them because they are not a priority. This data justifies what the BJD has been campaigning for over the past ten years.

Dr Brian Hammond, Chairman of BackCare, said, “The finding that back pain is the leading cause of disability in the UK reaffirms BackCare's mission to decrease the impact of back and neck pain on society by providing preventative advice to individuals and industry, as well as help and information for those already afflicted with spinal problems.”

Professor Alan Silman, Medical Director of Arthritis Research UK, added, “This new analysis clearly shows musculoskeletal conditions account for the largest proportion of years lived with disability in the UK. Over the last twenty years, these conditions have increased in burden and will continue to do so, particularly due to our ageing population.”

Click here to visit The Lancet for articles and comment related to the study.

Click here to visit the Institute for Health Metrics and Evaluation, the organisation responsible for the study, where you can also see related charts, graphs, data and discussion of the GBD study.



Musculoskeletal conditions include joint diseases such as osteoarthritis and rheumatoid arthritis; back and neck pain; osteoporosis and fragility fractures; soft tissue rheumatism; injuries due to sports and in the workplace; and trauma commonly related to road traffic accidents.

  • They cause pain, physical disability and loss of personal and economic independence
  • They affect millions of people of all ages in all cultures and in all countries
  • They are the greatest cause of disability, as measured by years lived with disability (YLDs) in the UK (Lancet 9 March 2013) and second greatest worldwide (Lancet 15 December 2012)
  • As a group musculoskeletal disorders cause 31.3% of all years lived with disability (YLDs) (mental and behavioural disorders are second accounting for 21.1% of YLDs)
  • The main contributors are low back pain (1,538 thousand YLDs), neck pain (429 thousand YLDs), osteoarthritis (217 thousand YLDs) and the other musculoskeletal category (399 thousand YLDs).
  • The leading cause of disability in the UK is low back and neck pain contributing 23% of total YLDs (major depression contributes 5.2%, Alzheimers disease 2%).
  • They have the third greatest impact on the health of the UK population, considering both death and disability (DALYs) (Lancet 9 March 2013)
  • Musculoskeletal disorders account 15.6% DALYs
  • Low back pain accounts for 55%, neck pain 16%, and osteoarthritis about 8%.
  • Ranking of major causes of death and disability (% DALYs)
  • All neoplasms 16.9%
  • Cardiovascular and circulatory diseases 16.1%
  • Musculoskeletal disorders 11.5%
  • Mental and behavioural disorders 11.5%
  • Chronic respiratory diseases 7.1%
  • Diabetes 1.2%
  • Disability due to musculoskeletal disorders is increasing due to ageing of the population, increased obesity and lack of physical activity.
  • Disability due to musculoskeletal conditions can be effectively prevented by currently available interventions, such as accident prevention, modern treatment of arthritis and injuries, and by rehabilitation.
  • The growing burden can be controlled if priority and resources are given to ensure access to these interventions.

ARMA Calendar

Medicine and Me - Birmingham                  11th March

CEO Meeting                                                    17th April

Board Meeting                                                 19th April

Rheumatology 2013                                       23-25 April

Clinical Networks Meeting                            30th April

Medicine and Me - Aberdeen                        10th May

Medicine and Me - Cardiff                              19 June

Check our website calendar for meetings and events.

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