[jenny c.]

Good evening everybody and sorry for the late response and synthesis of our previous discussion.

I would like to thank everyone for making this discussion possible and successful and with all the responses given regarding the how and why musculoskeletal disorders affect women and what should be done to address this are as follows.

Looking into the graph given by the CDC, Osteoarthritis is the most common musculoskeletal disorder for both men and women, but is greatly seen to affect women than men in both developed and industrialized countries. Although OA affects people of all ages, it is a condition whose incidence rises greatly with age. It can affect both genders, but it is twice as a common in women over 65 years of age than it is in their male counterparts. (R. C. Lawrence, C. G. Helmick, F. C. Arnett, et al. 1998). There is also a dramatic increase of these cases in developed countries than in those industrialized countries. Changes in lifestyle factors, such as increased obesity and lack of physical activity with the urbanization and motorization of the developing world further increase the burden.
Moreover, musculoskeletal conditions greatly affect women, physiologically and psychologically. Hormonal variations and changes related to women's reproductive functions is one of the reasons pointed out to result in this case. Depletion of Estrogen and progesterone is known to have an effect in calcium absorption and utilization. The musculoskeletal problems, aches, and pains that tend to plague women after menopause could be also related to a drop in levels of collagen in ligaments and other soft tissues, according to indications in the study conducted by Rich (2006).
Poverty, another identified cause on the increased incidence, made housewives to spend more time during household chores, domestic and provision of needs.

Work-related factors including jobs involve physical labor especially lifting, pushing, or pulling heavy objects, or twisting during lifting also jobs requiring prolonged sitting and standing are considered in the formation of chronic musculoskeletal conditions most especially back pain.
As these factors are being identified by most literatures cited in our discussion, these have posted women in general to a lot of physical and psychological consequences.

Experience of these symptoms can result in poor levels of physical activity and increase in the risk of other diseases including heart disease, diabetes and obesity. In the psychological aspect, assumption of sick role may cause stress, depression, anger and anxiety. Women may experience difficulty in coping with pain and disability, which in turn can lead to feelings of helplessness, lack of self-control and changes in self-esteem and body image. They often experience social isolation which can later on affect their activities, employment and personal relationships. This may be compounded by lack of understanding and empathy among co-workers, employers and others. Economically, women may shoulder the burden for the costs of care, support and the purchase of aids and equipment. And since those who are affected by this condition may have a problem with the employment opportunities, financial independence may also be restricted. As these debilitating conditions are painful for the individual, this also lead to the inability to work and to enjoy life fully, and are a cost to societies and countries (WHO, 2003).

In the remarkable increase of chronic musculoskeletal conditions among women, Multidisciplinary treatment approach would be beneficial for women as well as Cognitive-behavioral approaches. Recent research indicates that behavioral interventions are generally superior to medical treatment controls in improving the overall condition of the woman. Exercise, a known intervention in most chronic musculoskeletal conditions, is the key to the management of certain arthritis and musculoskeletal conditions. Evidence and current research suggests that exercise and muscle-strengthening can have an impact on function by reducing pain and stiffness, improving muscle strength and endurance, maintaining cardiac fitness, supporting weight reduction, and contributing to an improved sense of well-being. Moreover, accessible employment or appropriate social security support, training and education, self management training, information and advice on positive lifestyle options and self management strategies should be strengthened; aids and adaptations and fully accessible buildings, transport, housing, leisure facilities and pursuits are also recommended.

Though women are regarded as the “primary care giver of the family”, I agree that women also need to be loved not only by their family but of the society as well.

Thank you again for sharing with us your ideas. God bless everyone!

[mfnierra]

Jenny, aren't you going to give a synthesis on this discussion?

[megsenga_crown princess o]

A mailed self-report survey gathered data from 737 Australian Public Service employees (73% women). The majority of respondents were clerical workers (73%). Eighty one per cent reported some upper body symptoms; of these, 20% reported severe and continuous upper body pain. Upper body musculoskeletal symptoms were more prevalent and more severe among women. The gender difference in symptom severity was explained by risk factors at work (repetitive work, poor ergonomic equipment), and at home (having less opportunity to relax and exercise outside of work). Parenthood exacerbated this gender difference, with mothers reporting the least time to relax or exercise. There was no suggestion that women were more vulnerable than men to pain, nor was there evidence of systematic confounding between perceptions of work conditions and reported health status.

Changes in the nature of work mean that more and more employees, especially women, use computers for significant parts of their workday. The sex-segregation of women into sedentary, repetitive and routine work, and the persisting gender imbalance in domestic work are interlinking factors that explain gender differences in musculoskeletal disorders.


Osteoarthritis of the knee is a major cause of impaired mobility, particularly among women. As the incidence and prevalence of osteoarthritis rise with increasing age, extended life expectancy will result in greater numbers of people with the condition. The burden will be the greatest in developing countries, where life expectancy is increasing and access to arthroplasty and joint replacement is not readily available.

Complex interactions exist between the female sex hormones and rheumatoid arthritis.

Back pain has a marked effect on the patient and on society because of its frequency and economic consequences.

Pain often is persistent during the episode, and many patients do not have complete resolution of their symptoms but have "flares" against a background of chronic pain. Pain is often worse with prolonged walking, standing, and sitting, which restricts mobility, as well as when travelling any distance in a vehicle. Pain may affect sleep. Episodes and fear of recurrence may affect strenuous activities and leisure pursuits. Most patients return to work within one week and 90% return within two months, but the longer a person is on sick leave the less likely he or she is to return to work. After six months off work, less than 50% of people will return to work, and after two years absence, there is little chance of the person returning, which greatly impacts on society.

Lyndall Strazdins and Gabriele Bammer Women, work and musculoskeletal health available at: http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VBF-49BS7HD-S&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=940800824&_rerunOrigin=scholar.google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=57b08d5e16b2af81ce6353ed982ee8a3


Burden of major musculoskeletal conditions available at: http://www.scielosp.org/scielo.php?pid=S0042-96862003000900007&script=sci_arttext

[megsenga_crown princess o]

Musculoskeletal conditions have a major impact on women and the society due to their frequency, chronicity, and resultant disability.

Work disability

Musculoskeletal complaints are a major cause of absence because of sickness in developed countries (60, 61); they are second only to respiratory disorders as a cause of short-term sickness absence (less than two weeks) (62). Musculoskeletal complaints are the most common medical causes of long-term absence, accounting for more than half of all sickness absences lasting longer than two weeks in Norway (63). Statistics on sickness absence in Norway show that of people who took sick leave for longer than four days because of musculoskeletal and connective tissue disorders, 33% had low back pain and 20% neck and shoulder disorders, but only 3% had rheumatoid arthritis.

Musculoskeletal complaints also are common reasons for people claiming disability pensions, along with mental disorders and cardiovascular disorders. In Sweden, up to 60% of people on early retirement or long-term sick leave claimed musculoskeletal problem as the reason (64). In Norway, low back disorders were the most common reason for people claiming disability pensions (65).

Utilization of health care services

Musculoskeletal complaints are the second most common reason for consulting a doctor and constitute, in most countries, up to 10–20% of primary care consultations (66). In the Ontario Health Survey, musculoskeletal complaints were the reason for almost 20% of all health care utilization (7). They were the most expensive disease category in the Swedish cost of illness study, representing 22.6% of the total cost of illness; the greatest costs were indirect costs related to morbidity and disability (67). The total direct cost for use of health services that results from musculoskeletal conditions was 0.7% of the gross national product in the Netherlands, 1.0% in Canada, and 1.2% in the USA (68, 69). The indirect costs of musculoskeletal conditions (loss of productivity and wages) were much greater than the direct costs, corresponding to 2.4% and 1.3% of the gross national products of Canada and the USA, respectively.



Future trends

The impact of musculoskeletal disorders on individuals and society is expected to increase dramatically. Many of these conditions are more prevalent or have a greater impact in older patients, and the predicted ageing of the worlds population, predominantly in less-developed countries, will markedly increase the number of people affected by these conditions. In addition, changes in lifestyle factors, such as increased obesity and lack of physical activity with the urbanization and motorization of the developing world, will further increase the burden.

This is an excerpt from an article I read which you can access from this site:
http://www.scielosp.org/scielo.php?pid=S0042-96862003000900007&script=sci_arttext

[megsenga_crown princess o]

I can see that Osteoarthritis afflicts more women than men and it ranks the highest in the disability causing musculoskeletal conditions among women and men as well.

While in the article posted by mrs. nierras linking muscoloskeletal conditions among elderly women with hormonal change, I have also read an article that links lifestyle of women with the incidence of osteoarthritis. Researchers of the study say that wearing stilletos and platforms may increses the risk of developing knee osteoarthrtis.

This is an exerpt from the article I have read:


PM&R physician D. Casey Kerrigan, MD, wanted to see if high heels played any part in the higher incidence of knee osteoarthritis in women. Kerrigan is an associate professor at Harvard Medical School, and director, Center for Rehabilitation Science, Spaulding Rehabilitation Hospital. She found that women who wear 2 ½ inch heels strain the joints, muscles, and tendons in their knees. That increased pressure on the knees is believed to lead to osteoarthritis, a painful joint disease that destroys the cartilage surrounding the knee. PM&R physicians treat osteoarthritis and say that by the time some patients feel its effects, a lot of damage has already been done.

Think you're saving yourself future pain by wearing "chunky" high heels instead of stilettos? Think again. Kerrigan and her research team recently went back into the lab to see if the width of the heel makes any difference. They found that wide-heeled women's dress shoes caused the same, if not greater, pressures on the knees as narrow-heeled shoes.

And because these shoes are more comfortable than stilettos, women tend to wear them longer, exposing their knees to even more strain.


Reference:
http://www.aapmr.org/condtreat/pain/highheels.htm