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The public neglect of rheumatic diseases: insights from analyses of attendees in a musculoskeletal disease awareness activity
  1. Klaus P Machold1,
  2. Marcus D Köller1,
  3. Stephan Pflugbeil2,
  4. Christof Zimmermann2,
  5. Ernst Wagner3,
  6. Ulrike Stuby4,
  7. Daniel Aletaha1,
  8. Tanja A Stamm1,
  9. Franz Mayrhofer5,
  10. Attila Dunky6,
  11. Josef Hermann7,
  12. Wilfried Ilias8,
  13. Josef S Smolen1,
  14. the Rheuma-Bus group of physicians
  1. 1Medical University of Vienna, Vienna, Austria
  2. 2Hietzing Hospital, Vienna, Austria
  3. 3Rehabilitation Centre for Rheumatic Diseases of the Lower Austrian Public Health Insurance, Ludwig Boltzmann Research Institute for Epidemiology of Rheumatic Diseases and Institute for Rheumatology, Baden, Austria
  4. 4General Hospital, Linz, Austria
  5. 5Special Hospital of the PVA, Bad Schallerbach, Austria
  6. 6Wilhelminen Hospital, Vienna, Austria
  7. 7Medical University of Graz, Graz, Austria
  8. 8Barmherzige Brüder Hospital, Vienna, Austria
  1. Correspondence to:
    Dr K Machold
    Department of Rheumatology, Internal Medicine III, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria; klaus.machold{at}


Objectives: To obtain data on the care received by individuals counselled during a public health awareness campaign on painful musculoskeletal conditions (MSC).

Methods: Easy non-formal access to rheumatologists/pain specialists was offered using a mobile unit (Rheuma-Bus) at widely accessible sites. Clients were asked to assess their severity of pain using a 100 mm visual analogue scale (VAS). Age, gender, disease duration, diagnosis if known, current and previous treatment as well as tentative diagnoses assigned and recommendations given to each individual by the counselling physicians were recorded.

Results: Average (SD) VAS pain rating was 59 (20.6) mm. Approximately 40% of clients had never consulted a physician for their condition before, but had lower pain scores than those who had seen a physician. Patients with inflammatory MSC had higher pain scores than those with non-inflammatory conditions. More than 2% of the clients had a newly detected inflammatory rheumatic disease.

Conclusions: Many individuals having painful MSC seek medical help only when a very high threshold of pain is reached. Even while under treatment, the high mean pain scores suggest neglect of MSC that are not adequately recognised as important contributors to disability and decreased quality of life.

  • MSC, musculoskeletal conditions
  • RA, rheumatoid arthritis
  • VAS, visual analogue scale

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