May is an important commemorative month for us at JOF – actually there are three in one: simultaneously, it’s National Arthritis Awareness Month, National Osteoporosis Month and Mobility Awareness Month. That’s a lot all in one month, but it points out the importance of keeping the spotlight on a series of common and serious bone, muscle and joint disorders that combine to form a large percentage of patients we professionals meet and treat every day.
For example, arthritis impacts more than 50 million Americans, making it the number one cause of disability in the country, according to the Arthritis Foundation. That means 1 in every 5 adults, 300,000 children and countless families are affected by arthritis. Meanwhile, the National Osteoporosis Foundation says one in two women and up to one in four men over age 50 will break a bone due to osteoporosis.
Mobility issues also affect a large number of people: over 18 million people in North America are living with restrictive mobility issues – and more than 65 million Americans provide care for people with disabilities or a senior family member, according to the National Mobility Equipment Dealers Association, organizers of National Mobility Month.
As clinicians, it’s important to know how we can best address these conditions, especially in primary care settings. Our own research has shown that many clinician lack the confidence or the skills to be able to adequately assess, diagnose or treat nonsurgical musculoskeletal disorders. It’s also why we created our Orthopedic Primary Care course, which teaches professionals non-surgical, patient-centered approaches to maximizing function, managing pain, preventing injury, and slowing disease progression – while increasing their confidence in dealing with these increasingly common conditions.
For front-line health professionals and patients alike, these conditions can present a bewildering array of must-know information and treatment options – it can be hard to sort through and know which to prioritize. Thankfully, some of our sister organizations have published helpful clinical guides and patient brochures to help bring everyone up to speed on what they need to know:
- The Arthritis Foundation publishes numerous online guides for both clinicians and patients, including exercise, local resources, drugs and an online patient community. Additionally, the Foundation publishes a series of free e-newsletters as well as Arthritis Today magazine, with a modest subscription price of $12.95/year.
- Osteoarthritis Research Society International (OARSI), an OA-focused medical research society, publishes treatment and clinical trial guidelines and on its site and corresponding journal, including recent updates on knee treatment options. Visit www.oarsi.org.
- The National Osteoporosis Foundation has assembled a range of patient-friendly guides, including fast facts on the disease, diet guides and tips on fall prevention. Check out their downloadable PDF Healthy Bones for Life patient guide.
- For professionals, NOF has an online library of osteoporosis resources on its website, including clinical guidelines, recent news and more materials for patients.
From a daily practice perspective, we can recommend some easy-to-implement tips for clinicians to help their patients prevent or cope with musculoskeletal disease. Try these for yourself – and let us know if you have any tips you’d like to share:
- Sorting out osteoarthritis (OA) from rheumatoid Arthritis (RA): This is a common question in primary care settings – how can I tell if a patient is suffering from OA or RA? A general rule of thumb is that if symptoms are experienced bilaterally and in multiple parts of the body it’s more likely RA. By contrast, OA tends to be isolated to particular areas, affects weight-bearing joints and does not affect the whole body like RA.
- Movement Rx: Having trouble getting your patients to listen to your advice about moving more? Try writing it up as an order on a prescription pad. It’s amazing how much more seriously some patients take your advice when it looks prescriptive.
- Motivational interviewing: Try asking open-ended questions of your patients, rather than “yes” or “no” questions. For example, instead of asking them, “Have you been getting some exercise?” or “Have you been eating a balanced diet?” try eliciting more: “How are you feeling about quitting smoking?” and “What would it take for you to get more walking in?” In addition to helping them modify their behaviors, you’re also building up trust with the patient through better engagement. Repetition of questions on each office visit also helps reinforce key health messages.
- Bone density & height checks: We recommend offering adult patients bone density tests. Or, minimally, you can check your patient's’ height every 6-12 months. The earlier the better, but the sooner you establish baselines you can more readily track changes like bone loss or disc degeneration.
- Get up: While seeming simple, encourage your patients to try this mobility test of getting up from a seated position on the floor, without the aid of hands or knees. While one study hinted it could actually be a predictor of mortality, the main benefit is to quickly assess a patient’s strength and balance so you can prescribe better-aging behaviors. See the test in this video from the BBC.
With an aging population, the prevalence of musculoskeletal conditions in your practice is only likely to increase. For that reason alone, we’re glad these commemorative months help keep bone, joint and muscle-related health information front and center, where it belongs.