Musculoskeletal disorders in Norway: Prevalence of chronicity and use of primary and specialist health care services

Abstract

Background: Uncertainty exists with regards to the extent of prevalence and health care use for musculoskeletal disorders in Norway. The aim of this study was to estimate the prevalence of chronic musculoskeletal disorders and to estimate the prevalence of persons receiving primary and specialist health services for these disorders. Methods: We used three data-sources. First, four discrete years of the nationally representative cross-sectional Survey of Health and Living Conditions (SHLC) conducted in 2002, 2005, 2008 and 2012 by Statistics Norway. Second, we used the Norwegian Patient Registry (NPR) to estimate the proportion of the population who used specialist health services in 2012. Third, we used the national register dataset for reimbursement of primary care physicians, chiropractors and physiotherapists (KUHR) to estimate the proportion of the population attending primary care physicians, chiropractors or physiotherapists in 2012. Age- and sex-specific prevalence/utilization estimates for musculoskeletal disorders were calculated. Results: In 2012, 18% of men and 27% of women reported musculoskeletal disorders lasting for six months or more in the SHLC. Primary health care services reimbursed for musculoskeletal disorders were used by 37% of women and 30% of men. Of these 32% (women) and 26% (men) were physician contacts and between 5 and 9% physiotherapist or chiropractor or combined contact types. Corresponding numbers for specialist services were 5% in men and 7% in women, where the majority was out-patient consultations. Low back and neck pain were the most common diagnoses both in the general population and as reason for health care utilization. We found that musculoskeletal disorders increased with age, however our results showed no variation in prevalence of chronic disorders between 2002 and 2012. Conclusion: Chronic musculoskeletal disorders were common in the general population, with higher prevalence among women compared to men, and increasing prevalence with age. Musculoskeletal disorders had considerable impact on the use of primary and specialist health services in Norway. The use of register data on health service utilization may be a useful source for monitoring population trends, and for estimating the burden in terms of health and health service use.