Musculoskeletal JSNA

Evidence base

This section provides links and a brief summary of a robust evidence base. For example, peer-reviewd studies, systematic revies, evaluations of interventions and best practice guidelines from national sources.

Issue number 1 = highest priority
1	Source	Georgiev, T & Krasimirov Angelov, A (2019) ‘Modifiable risk factors in knee osteoarthritis: treatment implications’, Rheumatology International, 39, 1145-1157.
	Title incl. web link	Modifiable risk factors in knee osteoarthritis: treatment implications Modifiable risk factors in knee osteoarthritis: treatment implications \| Rheumatology International
	Summary	Identifies 6 key modifiable risk factors for knee osteoarthritis with a holistic approach to interventions. Interventions include muscle strengthening, weight loss and dietary changes, management or comorbidities (e.g. diabetes, depression) and services including vocational rehabilitation and orthotics.
	Source	NICE Guidelines
	Title incl. web link	1.2 Managing chronic primary pain Recommendations \| Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain \| Guidance \| NICE
	Summary	In those 16 and over NICE Guidelines suggest non-pharmacological management of chronic pain. Suggestions include offering supervised group exercise programmes tailored to need, preference and ability and encouraging people to remain physically active for longer-term general health benefits.
2	Source	Feng et al. (2023) ‘Global burden of hip fracture: The Global Burden of Disease study’, Osteoporosis International, 35, 41-52.
	Title incl. web link	Global burden of hip fracture: The Global Burden of Disease Study Global burden of hip fracture: The Global Burden of Disease Study \| Osteoporosis International
	Summary	Hip fracture incidence is rising globally among adults aged 65+ particularly in women, falls are the leading cause. There is a need for fall prevention, osteoporosis screening and public health intervention specifically targeting older adults.
	Source	Dent et al. (2023) ‘Exercise to Prevent and Manage Frailty and Fragility Fractures’, Current Osteoporosis Reports, 21, 205-215.
	Title incl. web link	Exercise to Prevent and Manage Frailty and Fragility Fractures. Exercise to Prevent and Manage Frailty and Fragility Fractures \| Current Osteoporosis Reports
	Summary	Exercise is a cornerstone of fracture prevention, especially when integrated into community or primary care settings. Exercise interventions that prevent frailty and fragility include resistance and balance training, Tai Chi and functional movement exercises and structured fall prevention programs.
3	Source	Sundstrup et al. (2020) ‘A Systematic Review of Workplace Interventions to Rehabilitate Musculoskeletal Disorders Among Employees with Physical Demanding Work’, Journal of Occupational Rehabilitation, 30, 588-612.
	Title incl. web link	A Systematic Review of Workplace Interventions to Rehabilitate Musculoskeletal Disorders Among Employees with Physical Demanding Work. A Systematic Review of Workplace Interventions to Rehabilitate Musculoskeletal Disorders Among Employees with Physical Demanding Work \| Journal of Occupational Rehabilitation
	Summary	There is strong evidence showing strength training at the workplace reduces MSK disorders. Ergonomic interventions had limited evidence of effectiveness. Participatory ergonomics and multifaceted interventions showed no consistent benefit. In deprived areas with high rates of manual labour, targeted workplace exercise programs may be more effective than complex or costly ergonomic redesigns.
	Source	Al-Worafi, Y.M. (2024). Musculoskeletal Diseases: Causes and Risk Factors in Developing Countries. In: Al-Worafi, Y.M. (eds) Handbook of Medical and Health Sciences in Developing Countries . Springer, Cham. https://doi.org/10.1007/978-3-030-74786-2_324-1
	Title incl. web link	Musculoskeletal Diseases: Causes and Risk Factors in Developing Countries Musculoskeletal Diseases: Causes and Risk Factors in Developing Countries \| SpringerLink
	Summary	Considers low socioeconomic status, malnutrition, occupational hazards and limited healthcare access in the context of musculoskeletal disease. Prevention strategies include community-based awareness campaigns, occupational health and safety measures, improved access to rehabilitation services and policy and infrastructure development.