Skip to main content
Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 2001 Nov;60(11):1040–1045. doi: 10.1136/ard.60.11.1040

The burden of musculoskeletal diseases in the general population of Spain: results from a national survey

L Carmona 1, J Ballina 1, R Gabriel 1, A Laffon 1
PMCID: PMC1753418  PMID: 11602475

Abstract

OBJECTIVE—The objective of the EPISER study was to estimate the prevalence of rheumatoid arthritis (RA), low back pain, hand and knee osteoarthritis (OA), and fibromyalgia in the adult Spanish population, and to assess the impact of these diseases on function and quality of life, and use of health and social resources.
METHODS—2998 subjects aged 20 years or above were randomly selected by stratified multistage cluster sampling from the censuses of 20 municipalities. Trained rheumatologists carried out structured visits at which subjects were asked about rheumatic symptoms and sociodemographic characteristics, completed validated instruments for measuring function (HAQ) and quality of life (SF-12), and underwent a standardised physical examination. Cases were defined by previously validated criteria.
RESULTS—The estimated prevalences with 95% confidence intervals were as follows: RA lifetime cumulative: 0.5% (0.3 to 0.9); low back pain: 14.8% (12.2 to 17.4); symptomatic knee OA: 10.2% (8.5 to 11.9); hand OA: 6.2% (5.9 to 6.5); fibromyalgia: 2.4% (1.5 to 3.2). Most conditions significantly impaired function and quality of life.
CONCLUSIONS—The EPISER study has internal and external validity for application of the results to the adult Spanish population. The diseases studied affect a significant proportion of the population, with various degrees of impact on disability and quality of life resulting in a significant number of physician visits, work disability, and medication use.



Full Text

The Full Text of this article is available as a PDF (151.6 KB).

Figure 1  .

Figure 1  

Map of Spain showing the 20 municipalities selected for the EPISER study. Each area in the same shade represents one stratum. Under the name of the city or village selected, the number of the eligible population (>20 years) is shown.    

Figure 2  .

Figure 2  

EPISER study: flow chart of response to the survey.    

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alonso J., Pérez P., Sáez M., Murillo C. Validez de la ocupación como indicador de la clase social, según la clasificación del British Registrar General. Gac Sanit. 1997 Sep-Oct;11(5):205–213. doi: 10.1016/s0213-9111(97)71299-8. [DOI] [PubMed] [Google Scholar]
  2. Altman R., Alarcón G., Appelrouth D., Bloch D., Borenstein D., Brandt K., Brown C., Cooke T. D., Daniel W., Gray R. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand. Arthritis Rheum. 1990 Nov;33(11):1601–1610. doi: 10.1002/art.1780331101. [DOI] [PubMed] [Google Scholar]
  3. Altman R., Asch E., Bloch D., Bole G., Borenstein D., Brandt K., Christy W., Cooke T. D., Greenwald R., Hochberg M. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum. 1986 Aug;29(8):1039–1049. doi: 10.1002/art.1780290816. [DOI] [PubMed] [Google Scholar]
  4. Badley E. M., Tennant A. Impact of disablement due to rheumatic disorders in a British population: estimates of severity and prevalence from the Calderdale Rheumatic Disablement Survey. Ann Rheum Dis. 1993 Jan;52(1):6–13. doi: 10.1136/ard.52.1.6. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Ballina Garcia F. J., Hernandez Mejía R., Martín Lascuevas P., Fernandez Santana J., Cueto Espinar A. Epidemiology of musculoskeletal complaints and use of health services in Asturias, Spain. Scand J Rheumatol. 1994;23(3):137–141. doi: 10.3109/03009749409103046. [DOI] [PubMed] [Google Scholar]
  6. Chaiamnuay P., Darmawan J., Muirden K. D., Assawatanabodee P. Epidemiology of rheumatic disease in rural Thailand: a WHO-ILAR COPCORD study. Community Oriented Programme for the Control of Rheumatic Disease. J Rheumatol. 1998 Jul;25(7):1382–1387. [PubMed] [Google Scholar]
  7. Dunlop D. D., Manheim L. M., Song J., Chang R. W. Arthritis prevalence and activity limitations in older adults. Arthritis Rheum. 2001 Jan;44(1):212–221. doi: 10.1002/1529-0131(200101)44:1<212::AID-ANR28>3.0.CO;2-Q. [DOI] [PubMed] [Google Scholar]
  8. Espallargues M., Alonso J., Ruigómez A., Antó J. M. Los trastornos osteoarticulares en los ancianos: una aproximación a su impacto poblacional. Med Clin (Barc) 1996 Apr 27;106(16):601–606. [PubMed] [Google Scholar]
  9. Esteve-Vives J., Batlle-Gualda E., Reig A. Spanish version of the Health Assessment Questionnaire: reliability, validity and transcultural equivalency. Grupo para la Adaptación del HAQ a la Población Española. J Rheumatol. 1993 Dec;20(12):2116–2122. [PubMed] [Google Scholar]
  10. Farooqi A., Gibson T. Prevalence of the major rheumatic disorders in the adult population of north Pakistan. Br J Rheumatol. 1998 May;37(5):491–495. doi: 10.1093/rheumatology/37.5.491. [DOI] [PubMed] [Google Scholar]
  11. Felson D. T., Naimark A., Anderson J., Kazis L., Castelli W., Meenan R. F. The prevalence of knee osteoarthritis in the elderly. The Framingham Osteoarthritis Study. Arthritis Rheum. 1987 Aug;30(8):914–918. doi: 10.1002/art.1780300811. [DOI] [PubMed] [Google Scholar]
  12. Gandek B., Ware J. E., Aaronson N. K., Apolone G., Bjorner J. B., Brazier J. E., Bullinger M., Kaasa S., Leplege A., Prieto L. Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project. International Quality of Life Assessment. J Clin Epidemiol. 1998 Nov;51(11):1171–1178. doi: 10.1016/s0895-4356(98)00109-7. [DOI] [PubMed] [Google Scholar]
  13. Guillemin F., Briançon S., Klein J. M., Sauleau E., Pourel J. Low incidence of rheumatoid arthritis in France. Scand J Rheumatol. 1994;23(5):264–268. doi: 10.3109/03009749409103727. [DOI] [PubMed] [Google Scholar]
  14. Hill C. L., Parsons J., Taylor A., Leach G. Health related quality of life in a population sample with arthritis. J Rheumatol. 1999 Sep;26(9):2029–2035. [PubMed] [Google Scholar]
  15. MacGregor A. J., Riste L. K., Hazes J. M., Silman A. J. Low prevalence of rheumatoid arthritis in black-Caribbeans compared with whites in inner city Manchester. Ann Rheum Dis. 1994 May;53(5):293–297. doi: 10.1136/ard.53.5.293. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Reyes Llerena G. A., Guibert Toledano M., Hernández Martínez A. A., González Otero Z. A., Alcocer Varela J., Cardiel M. H., Community Oriented Programme for the Control of Rheumatic Diseases Prevalence of musculoskeletal complaints and disability in Cuba. A community-based study using the COPCORD core questionnaire. Clin Exp Rheumatol. 2000 Nov-Dec;18(6):739–742. [PubMed] [Google Scholar]
  17. Reynolds D. L., Chambers L. W., Badley E. M., Bennett K. J., Goldsmith C. H., Jamieson E., Torrance G. W., Tugwell P. Physical disability among Canadians reporting musculoskeletal diseases. J Rheumatol. 1992 Jul;19(7):1020–1030. [PubMed] [Google Scholar]
  18. Wang P. P., Elsbett-Koeppen R., Geng G., Badley E. M. Arthritis prevalence and place of birth: findings from the 1994 Canadian National Population Health Survey. Am J Epidemiol. 2000 Sep 1;152(5):442–445. doi: 10.1093/aje/152.5.442. [DOI] [PubMed] [Google Scholar]
  19. Wolfe F., Smythe H. A., Yunus M. B., Bennett R. M., Bombardier C., Goldenberg D. L., Tugwell P., Campbell S. M., Abeles M., Clark P. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum. 1990 Feb;33(2):160–172. doi: 10.1002/art.1780330203. [DOI] [PubMed] [Google Scholar]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Publishing Group

RESOURCES