The State of Musculoskeletal Health 2021

Over 20 million people in the UK (around a third of the population) live with musculoskeletal (MSK) condition, such as arthritis and low back pain.

Pain is one of the leading symptoms of MSK conditions, however people living with conditions like arthritis also commonly experience high levels of fatigue, stiffness and loss of mobility and dexterity.

Together these symptoms can steal life’s fundamentals, affecting how we move, think, sleep and feel, and even our ability to work and spend time with loved ones.

The State of Musculoskeletal Health is a compendium of statistics that aims to provide the best picture available of the current prevalence UK-wide, the number of people at risk of developing these conditions and the subsequent impact of MSK conditions on people’s lives, the wider health system and society.

Download the full State of Musculoskeletal Health 2021 report (PDF, 872 KB).

Download the accessibility friendly version of the State of Musculoskeletal Health 2021 report (Word, 93.8 KB).

Musculoskeletal (MSK) conditions affect the joints, bones, muscles and spine, and include rare autoimmune conditions such as lupus. Common symptoms may include pain, joint stiffness, fatigue and a loss of mobility and dexterity. These symptoms can fluctuate over time. Millions of people develop these conditions over a lifetime, ranging from minor injuries to short or long-term conditions.

Broadly speaking there are three groups of MSK conditions: inflammatory conditions, conditions of MSK pain, and osteoporosis and fragility fractures.

20.3 million people have a musculoskeletal (MSK) condition such as arthritis or back pain in the UK. Almost one third (32%) of the population.

Number of people with a MSK condition by nation

England: 17.1 million people (32%)
Scotland: 1.7 million people (33%)
Wales: 974,000 people (29%)
Northern Ireland: 525,000 people (29%)

MSK conditions are more common among women

11.6 million women have a MSK condition (35% of women have a MSK condition).

8.7 million men have a MSK condition (38% of men have a MSK condition).

MSK conditions affect people of all ages but become more common with increasing age

2.8 million people aged under 35 years (11%) live with a MSK condition.
10.2 million people aged 35-64 years (40%) live with a MSK condition.
7.4 million people aged 65 and over (61%) live with a MSK condition.

Condition specific estimates

Inflammatory conditions

• Over 430,000 people have rheumatoid arthritis in the UK.
• Around 12,000 children have juvenile idiopathic arthritis in the UK.
• 220,000 people have axial spondyloarthritis in the UK.
• Around 100,000 people have psoriatic arthritis in the UK.

Conditions of MSK pain

• Around 8.5 million people have osteoarthritis in the UK.
• 10 million people have back pain in the UK.
• 1.7 to 2.8 million people have fibromyalgia in the UK.

Osteoporosis and fragility fractures

• 3 million people have osteoporosis in the UK.
• 500,000 fragility fractures occur each year in the UK.

To view the nation specific MSK Calculator estimates for osteoarthritis (hip/knee), rheumatoid arthritis, and back pain download the full report.

Physical inactivity

Around one in four adults (16+) in the UK do less than 30 minutes of physical activity per week (inactive).

Inactive people are at increased risk of developing certain painful MSK conditions. Those struggling with their MSK conditions are less likely to be active but have the most to gain from the right support.

People who have a long-term MSK condition are two times as likely to report being physically inactive than those without).

Regular physical activity reduces your risk of developing hip and knee osteoarthritis pain, joint and back pain, depression, hip fractures and falls. It also helps improve mobility and dexterity.

Obesity

Obesity increases an individual’s risk of developing MSK conditions, such as osteoarthritis and back pain. While the development of MSK problems can make it difficult to maintain a healthy weight.

More than six in ten adults in the UK have overweight body weight or obesity.

Around seven in ten adults (16+) who live with a long-term MSK condition have overweight body weight or obesity, compared with 6 in 10 without a long-lasting health condition.

Multiple long-term conditions

The number of people living with two or more long-term conditions (multimorbidity) is growing increasingly common.

One in four people are living with two or more long-term conditions in the UK, four in ten of which are living with a physical and mental health condition.

MSK conditions are very common in people with multiple long-term conditions. Among people aged over 45 in England who report living with a major long-term condition, more than 3 in 10 also have an MSK condition, increasing to almost five in ten people among those aged 65 plus.

One in five adults (21%) aged 46-48 in Britain with multimorbidity have recurrent back issues and one in every 13 (8%) have arthritis at midlife.

One in eight people (13.2%) in England report living with at least two long-term conditions, one of which is MSK related.

Quality of life

The pain and fatigue caused by arthritis and related MSK conditions result in a substantial reduction in quality of life.

21% of years lived with illness and disability (YLD) in the UK population are associated with MSK conditions.

Ten most common causes of Years Lived with Disability (YLD) in the UK

1. Low back pain
2. Diabetes
3. Depressive disorders
4. Headache disorders
5. Falls
6. Neck pain
7. Age-related hearing loss
8. Osteoarthritis
9. Other musculoskeletal conditions
10. Gynaecological

Impact on daily activities

Over 7 in 10 people (74%) of people we surveyed with MSK conditions say the pain they experience impact their daily activities (29% reporting a significant impact), followed by 68% of people saying the fatigue they experience impacts their daily activities (28% reporting a significant impact).

Work

One in ten working age people in the UK have a long-term MSK condition.

People with MSK conditions are less likely to be in work than people with no long-term health condition and are more likely to retire early.

Around 62% of working age adults with an MSK condition are in work compared to 81% of people with no long-term health condition. Likewise, around 34% of working age adults with an MSK condition are economically inactive compared to 15% of people with no long-term health condition.

28.4 million working days were lost due to MSK conditions in 2019.

Health and care services

MSK conditions account for one in seven GP consultations.

Each year one in five adults will consult their GP for a MSK condition.

Four in ten people we surveyed with MSK conditions see their GP as the main person they are supported by.

Over 90% of hip and knee replacements are due to osteoarthritis.

In 2019, around 118,316 hip replacements and 123,690 knee replacements were carried out.

Economy

Musculoskeletal ill health results in significant costs for individuals, employers, the health service, and the wider economy.

MSK conditions accounted for the third largest area of NHS programme spending at £5 billion in 2013-14 alone.

Treating the two most common forms of arthritis (osteoarthritis and rheumatoid arthritis) is estimated to have cost the economy £10.2 billion in direct costs* to the NHS and wider healthcare system in 2017. Cumulatively the healthcare cost will reach £118.6 billion over the next decade.

The cost of working days lost due to osteoarthritis and rheumatoid arthritis was estimated at £2.58 billion in 2017 rising to £3.43 billion by 2030.