Australian Institute of Health and Welfare (2022) Chronic musculoskeletal conditions, AIHW, Australian Government, accessed 08 October 2022.
Australian Institute of Health and Welfare. (2022). Chronic musculoskeletal conditions. Retrieved from https://pp.aihw.gov.au/reports/australias-health/bone-and-joint-health
Chronic musculoskeletal conditions. Australian Institute of Health and Welfare, 07 July 2022, https://pp.aihw.gov.au/reports/australias-health/bone-and-joint-health
Australian Institute of Health and Welfare. Chronic musculoskeletal conditions [Internet]. Canberra: Australian Institute of Health and Welfare, 2022 [cited 2022 Oct. 8]. Available from: https://pp.aihw.gov.au/reports/australias-health/bone-and-joint-health
Australian Institute of Health and Welfare (AIHW) 2022, Chronic musculoskeletal conditions, viewed 8 October 2022, https://pp.aihw.gov.au/reports/australias-health/bone-and-joint-health
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Conditions that affect the bones, muscles and joints are known as musculoskeletal conditions. These conditions include long-term (chronic) conditions such as osteoarthritis, rheumatoid arthritis, juvenile arthritis, back problems, gout, and osteoporosis or osteopenia (low bone density) (see Glossary).
Data for 2020–21 are based on information self-reported by the participants of the Australian Bureau of Statistics (ABS) 2020–21 National Health Survey (NHS).
Previous versions of the NHS have primarily been administered by trained ABS interviewers and were conducted face-to-face. The 2020–21 NHS was conducted during the COVID-19 pandemic. To maintain the safety of survey respondents and ABS Interviewers, the survey was collected via online, self-completed forms.
Non-response is usually reduced through Interviewer follow up of households who have not responded. As this was not possible during lockdown periods, there were lower response rates than previous NHS cycles, which impacted sample representativeness for some sub-populations. Additionally, the impact of COVID-19 and lockdowns might also have had direct or indirect impacts on people’s usual behaviour over the 2020–21 period.
Due to these changes, comparisons with previous chronic musculoskeletal conditions data over time are not recommended.
On this page, comparisons over time (trends) only contain data from the NHS 2017–18 and prior collections.
Chronic musculoskeletal conditions affect about 3 in 10 Australians. Self-reported data from the Australian Bureau of Statistics 2020–21 NHS provide estimates of the number of Australians affected by musculoskeletal conditions. These data indicate that, of the nearly 6.9 (27% of all Australians) million people with chronic musculoskeletal conditions, 3.9 million (16%) had back problems (the most common musculoskeletal condition), 3.1 million (12%) had arthritis and 889,000 (3.6%) had osteoporosis (ABS 2022a).
Note: The information below is from the 2017–18 and earlier NHS.
Rates of chronic musculoskeletal conditions were relatively consistent from 2007–08 to 2017–18 (Figure 1).
This time-series shows that the proportion of persons with arthritis has remained similar between 2007–08 and 2017–18 for both males (around 12%) and females (around 18%).
Females and older people were more likely to have chronic musculoskeletal conditions. The 2017–18 NHS shows that:
This chart shows that 3% of females and 2% of males aged 0–44 had arthritis, while 61% of females and 40% of males aged 75 and over had arthritis. A similar pattern of increasing prevalence in females and older persons was observed in the prevalence of musculoskeletal conditions; 13% of females and 14% of males aged 0–44 had a musculoskeletal condition, while 76% of females and 59% of males aged 75 and over had a musculoskeletal condition.
People with musculoskeletal conditions often have other long-term conditions. This is called ‘comorbidity’, which describes any additional disease that is experienced by a person with a disease of interest (the index disease).
In the 2017–18 NHS, for people aged 15 and over with:
Osteoporosis, 85% had at least one other chronic condition
Arthritis, 74% had at least one other chronic condition
Back pain and problems, 64% had at least one other chronic condition
The number of comorbidities varies by age and sex. For example, the proportion of people with back problems who had at least one other chronic condition increased with age, from 47% (aged 15–44) to 85% (aged 65 and over). Among those with back problems, the proportion of people with comorbidities was higher in females than males across all age groups (Figure 3).
Among persons with arthritis aged 15–44, 76% of females and 63% of males had at least one other chronic condition. For those aged 65 and over, 76% of females and males with arthritis had at least one other chronic condition.
Musculoskeletal conditions often co-occur. In comparison to those without the condition, people aged 45 and over with:
Mental and behavioural conditions commonly co-occur with musculoskeletal conditions. Compared with people without these musculoskeletal conditions, for people aged 45 and over with mental and behavioural conditions were:
Adjusting for differences in the age structure of the groups did not affect the pattern of these results.
Among persons aged 45 and over with arthritis, 36% had back problems, compared with 20% in persons without arthritis. Additionally, 30% of persons aged 45 and over with arthritis had mental and behavioural conditions, compared with 18% of persons without arthritis.
The prevalence of musculoskeletal conditions generally increases with increasing socioeconomic disadvantage, but is similar across remoteness areas, after adjusting for differences in age structures (Figure 5 shows a comparison for people aged 45 and over).
Among persons aged 45 and over, the prevalence of arthritis was higher in the lowest socioeconomic area (most disadvantaged, 41%) compared with persons in the highest socioeconomic area (least disadvantaged, 25%). The prevalence of arthritis was similar in Major cities (31%) compared with Remote areas (34%).
Chronic musculoskeletal conditions are large contributors to illness, pain and disability in Australia. People with these conditions report higher rates of poor health, psychological distress and pain, after adjusting for age (Figure 6). This may affect their ability to participate in social, community and occupational activities (Briggs et al. 2016). The 2018 Survey of Disability, Ageing and Carers found that, of the people with disability in Australia, an estimated 13% had back problems and another 13% had arthritis as the main long-term health condition causing the disability (ABS 2019b).
This graph shows that 11% of persons with arthritis rated their self-assessed health status as ‘poor’, compared with 4.0% of persons without arthritis. Similarly, persons with arthritis were more likely to self-report very high psychological distress (8.6% compared with 3.1%) and very severe bodily pain (4.4% compared with 1.4%).
Burden of disease refers to the quantified impact of living with and dying prematurely from a disease or injury.
Ill health caused by musculoskeletal conditions can have both a human and a financial cost. According to the Australian Burden of Disease Study 2018, musculoskeletal conditions contributed to:
Some of the total burden due to musculoskeletal conditions can be attributed to modifiable risk factors. In 2018:
Overweight and obesity contributed to:
Occupational exposures and hazards contributed to:
See Burden of disease for information on definitions and the burden of disease associated with these conditions.
The Australian Disease Expenditure Study found that musculoskeletal conditions was the disease group with the highest estimated expenditure in 2018–19, costing the Australian health system $13.9 billion (10% of total disease expenditure) (AIHW 2021c). See Disease expenditure in Australia 2018–19.
Of the $13.9 billion health system expenditure attributed to musculoskeletal conditions in 2018–19, an estimated:
In 2018–19, private hospital services and public hospital admissions were the areas of expenditure with the highest spending for all musculoskeletal conditions, at 36% and 18% respectively ($5.0 billion, and $2.5 billion).
In 2018–19, musculoskeletal conditions was the disease group with the highest spending for the following areas:
The relative expenditure on musculoskeletal conditions by age and sex reflects the relative prevalence of musculoskeletal conditions by age and sex. Both expenditure and prevalence are higher for females and higher for older people. In 2018–19:
Musculoskeletal conditions are usually managed by general practitioners and allied health professionals. Treatment can include physical therapy, medicines (for pain and inflammation), self-management (such as diet and exercise), education on self-management and living with the condition, and referral to specialist care where necessary (WHO 2019). Based on survey data, an estimated 1 in 6 (18%) general practice visits in 2015–16 were for management of musculoskeletal conditions (Britt et al. 2016). See General practice, allied health and other primary care services.
People with musculoskeletal conditions that are very severe, or who require specialised treatment or surgery, can also be managed in hospitals. In 2019–20, there were around 744,000 hospitalisations for musculoskeletal conditions – 6.7% of all hospitalisations in that year (AIHW 2022b). These hospitalisations included:
Osteoarthritis is the most common condition leading to hip and knee replacement surgery in Australia (AOANJRR 2021).
The COVID-19 pandemic had substantial impacts on hospital activity. The range of social, economic, business and travel restrictions, including restrictions on, or suspension of, some hospital services, and associated measures in other healthcare services to support physical distancing in Australia resulted in an overall decrease in hospital activity between 2019–20 and 2020–21 (AIHW 2022a).
In 2019–20 there were 7.8% fewer hospitalisations for musculoskeletal conditions than in 2018–19. This decrease was driven by the April–June 2020 quarter, which saw 33% fewer hospitalisations than April-June 2019.
At the beginning of the COVID-19 pandemic in Australia, non-urgent elective surgery was suspended for one month, from late March to late April 2020. For more information on how the pandemic has affected the population’s health in the context of longer-term trends, see 'Chapter 2 Changes in the health of Australians during the COVID-19 period’ in Australia’s health 2022: data insights.
This time-series shows the trends of hospitalisations for total hip and knee replacement surgeries, where osteoarthritis was the principal diagnosis from 2009–10 and 2019–20. Between 2009–17, age standardised rates for total knee and hip replacement surgeries increased, peaking at 184 per 100,000 population for total knee replacement surgery, and plateauing at 113 per 100,000 for total hip replacement surgery, between 2016–17 and 2018–19. In 2019–20 age standardised rates of total knee replacement declined to 159 per 100,000 population, and to 103 per 100,000 population for total hip replacement surgery. The crude rate of total knee replacements was highest in 2016–17 and 2017–18 (218 per 100,000 population). Whilst the crude rate of total hip replacements was highest in 2018–19 (135 per 100,000 population).
This figure shows the year-on-year change (%) in total hip and knee replacement surgeries, where osteoarthritis was the principal diagnosis, in 2019–20, by month. Most notably, this vertical bar chart shows 91% and 87% decreases in the number of knee and hip replacement surgeries in April 2019–20, compared with the same month in 2018–19. It also shows lesser but substantial year on year decreases for May 2019–20.
Restrictions continued in some jurisdictions during 2020–21, and the associated impacts are still relatively unknown. As of March 2022, elective surgery waiting times are a source of treatment data available for the 2020–21 period. Waiting times for elective surgeries increased notably for 2020–21 admissions.
The prevention, management and treatment of musculoskeletal conditions beyond hospital settings cannot currently be examined in detail due to limitations in available data on:
For more information on the musculoskeletal conditions covered in this report, see:
Visit Chronic musculoskeletal conditions for more on this topic.
ABS (Australian Bureau of Statistics) (2010) Microdata: National Health Survey, 2007–08, AIHW analysis of detailed microdata, accessed 17 February 2022.
ABS (2013) Microdata: National Health Survey, 2011–12, AIHW analysis of detailed microdata, accessed 17 February 2022.
ABS (2016) Microdata: National Health Survey, 2014–15, AIHW analysis of detailed microdata, accessed 17 February 2022.
ABS (2018a) National Health Survey: first results, 2017–18, ABS website, accessed 18 February 2022.
ABS (2018b) National Health Survey: users’ guide, 2017–18, ABS website, accessed 18 February 2022.
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AOANJRR (Australian Orthopaedic Association National Joint Replacement Registry) (2021) Annual report 2021: hip, knee and shoulder arthroplasty, AOANJRR, accessed 28 February 2022.
Briggs AM, Cross MJ, Hoy DG, Sànchez-Riera L, Blyth FM, Woolf AD et al. (2016) ‘Musculoskeletal health conditions represent a global threat to healthy aging: a report for the 2015 World Health Organization World report on ageing and health’, Gerontologist, 56(2):243–255, doi:10.1093/geront/gnw002.
Britt H, Miller GC, Bayram C, Henderson J, Valenti L, Harrison C et al. (2016) 'A decade of Australian general practice activity 2006–07 to 2015–16', General Practice Series, 43(1):1–155.
RACGP (The Royal Australian College of General Practitioners) (2018) Guideline for the management of knee and hip osteoarthritis, 2nd edn, RACGP, Melbourne.
WHO (World Health Organization) (2019) Musculoskeletal conditions, WHO website, accessed 18 February 2022.
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