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The world-wide burden of musculoskeletal diseases: a systematic analysis of the World Health Organization Burden of Diseases Database
  1. Eden Sebbag1,
  2. Renaud Felten1,
  3. Flora Sagez1,
  4. Jean Sibilia1,
  5. Hervé Devilliers2,
  6. Laurent Arnaud1
  1. 1 Department of Rheumatology - Centre National de Référence des Maladies Systémiques Rares Est Sud-Ouest (RESO), Hôpitaux Universitaires de Strasbourg, Strasbourg, France
  2. 2 Internal Medicine and Systemic Diseases, Hôpital François Mitterrand, CHU de Dijon, Dijon, France
  1. Correspondence to Professor Laurent Arnaud, Department of Rheumatology - Centre National de Référence des Maladies Systémiques Rares Est Sud-Ouest (RESO), Hôpitaux Universitaires de Strasbourg, Strasbourg 67085, France; laurent.arnaud{at}


Background Musculoskeletal (MSK) diseases are expected to have a growing impact worldwide.

Objective To analyse the worldwide burden of MSK diseases from 2000 to 2015.

Methods Disability-adjusted life years (DALYs), which combines the years of life lost (YLLs) and the years lived with disability (YLDs), were extracted for 183 countries from the WHO Global Health Estimates Database. We analysed the median proportion of DALYS, YLLs and YLDs for MSK diseases (ICD-10: M00–M99) among the 23 WHO categories of diseases. Mixed models were built to assess temporal changes.

Results Worldwide, the total number of MSK DALYs increased significantly from 80,225,634.6 in 2000 to 107,885,832.6 in 2015 (p < 0.001), with the total number of MSK YLDs increasing from 77,377,709.4 to 103,817,908.4 (p = 0.0008) and MSK diseases being the second cause of YLDs worldwide. YLLs due to MSK diseases increased from 2,847,925.2 to 4,067,924.2 (p = 0.03). In 2015, the median proportion of DALYs attributed to MSK diseases was 6.66% (IQR: 5.30 – 7.88) in Europe versus 4.66% (3.98 – 5.59) in the Americas (p < 0.0001 vs Europe), 4.17% (3.14 – 6.25) in Asia (p < 0.0001), 4.14% (2.65 – 5.57) in Oceania (p = 0.0008) and 1.33% (1.03 – 1.92) in Africa (p < 0.0001). We observed a significant correlation (r = 0.85, p < 0.0001) between the proportion of MSK DALYs and the gross domestic product per capita for the year 2015.

Conclusions The burden of MSK diseases increased significantly between 2000 and 2015 and is high in Europe. These results are crucial to health professionals and policy makers to implement future health plan adjustments for MSK diseases.

  • rheumatology
  • global burden of disease
  • daly
  • YLL
  • YLD

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  • Handling editor Josef S Smolen

  • Contributors LA and ES designed the study. ES, RF, FS, JS, HD, LA analyzed the data. LA, ES and HD performed the statistical analyses. LA and ES drafted the initial manuscript. All authors reviewed the drafted manuscript for critical content. All authors approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The data used for the analyses are publicly available.

  • Author note This study is based on publicly available data and solely reflects the opinion of its authors and not that of the World Health Organization.