CEO update: Promoting MSK health

by Garreth

The incidence of MSK conditions, particularly neck and shoulder pain, has gone up during the pandemic. This represents a significant amount of pain that would not have happened without the pandemic changing the way we live and work. Which got me wondering how much of the pre-pandemic MSK conditions would have been preventable.

MSK ill-health represents many thousands of lives impacted and restricted by pain and poor mobility. However great the services we have, prevention is the better option where possible.

If we look at the data pre-pandemic, we can see that the incidence of MSK conditions and chronic pain is not equally distributed. Black people are more likely to experience chronic pain than white people. Areas of social deprivation see more back pain. Something is happening which is not just about “natural ageing” or the inevitable consequence of being human. If that was all it was, the distribution would be even across all geographies and communities.

I hear a lot of talk about prevention, but I see very little action where it matters for MSK health. The NHS has a role to play in ensuring secondary prevention programmes, such as Escape Pain or Good Boost, are available. They should be a core part of an MSK pathway, which means they need to be commissioned. Social prescribing services could have a big role to play in enabling people with MSK conditions to manage their conditions.

Primary prevention requires the concerted effort of a much wider system, including public health, local authorities and the third sector. The NHS cannot address issues such as parks that aren’t safe to exercise in, town centres that are hard to walk about or employers who take the MSK health of their employees for granted.

Last year we celebrated the publication by Public Health England of Musculoskeletal health: 5 year prevention strategic framework. Whatever happens to the functions of Public Health England next year it is essential that the priority for MSK prevention remains at a national strategic level.

Many of the changes needed to create MSK-healthy places lie outside the NHS. But that doesn’t mean that MSK professionals cannot take action. If local public health is not making MSK a priority, the NHS should be asking why not and what they are going to do to implement the framework. We must champion not just MSK services but MSK health.

2021 begins with the UK back in lockdown, with MSK needs and waiting lists rising. Vaccines offer the hope that this will change. We have shown in 2020 that the MSK community can come together and achieve extraordinary things. Let’s apply that creativity in different ways so that by the end of 2021 we are building new collaborations to focus on promoting MSK health.

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