According to a 2011 publication of the U.S. Bone and Joint Initiative, more than 30% of the U.S. population suffers from musculoskeletal disorders (MSDs) significant enough to warrant medical care.
In the U.S. in 2006, average orthopedic expenditures for MSDs were estimated at $1,790 per patient, with aggregate orthopedic expenditures of $160.5 billion. Orthopedic costs accounted for an estimated 2.9% of the U.S. GDP. Since a 1% drop in GDP over two consecutive quarters represents a recession, orthopedic expenditures create perpetual recessionary pressures on the economy—and significant financial challenges for employers and others who pay for healthcare.
Indirect costs of MSDs—primarily reflecting lost wages for MSD sufferers of 18 to 64 (with a work history)—were estimated at $127 billion.
Individuals with MSDs account for a large and growing share of healthcare utilization, with growth attributable to an increase in the number of MSD sufferers, rather than an increase in healthcare visits per person.
According to USBJI, in 2006, musculoskeletal injuries accounted for more than 61 million healthcare visits. Back pain alone accounted for more than 45 million visits in 2007. It caused 385 million lost work days in 2008. MSDs associated with work-related injuries account for half of total days away from work.
According to the CDC’s national Ambulatory Medical Care Survey, in 2009 in the U.S., MSD sufferers made about 49 million visits to nonfederally employed, office-based physicians specializing in orthopedic surgery versus 63 million in 2010. In both years, more than half of the visits were made by individuals aged 25–64 years.
Between 2009 and 2010, private insurance accounted for 69% and 54% of primary payment sources; Medicare, 26% (for both years); Workers’ compensation, 6% and 9%; and Medicaid, 6% (for both years, including CHIP in 2010).
Primary reasons for orthopedic visits were identified as new MSDs 35% and 37% of the time (between the two years); as pre- or post-surgery/injury follow-up, 28% and 25% of the time; as routine visits for chronic problems, 20% and 22% of the time; and as flare-up related visits for chronic problems, 15% of the time (over both years).
The top 5 reasons for visiting orthopedic surgeons were (1) knee symptoms, (2) postoperative reviews, (3) shoulder symptoms, (4) hip symptoms, and (5) back symptoms.
“Spinal disorders” and “sprains and strains” were ranked 3rd and 4th among the top five (5) orthopedic diagnoses.
Medications were provided or prescribed in 54% of MSD-related office visits.
Note: These statistics are attributable to (1) USBJI, 2011; (2) 2009 CDC Factsheet – Orthopedic Surgery; and (3) 2010 CDC Factsheet – Orthopedic Surgery.