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Feb. 18, 2000
Volume 37, No. 11


Oooooh! My aching back!
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Oooooh! My aching back!

Increasing awareness of bones and joints

Everybody, at some point, had to memorize the names and locations of bones and learn about joints for science class. And everybody probably can recall mom’s advice about drinking milk for healthy bones. But how often do you really think about the structures that help to give the human body form and enable it to perform any task? Unless you’ve had a debilitating injury or suffer from a chronic musculoskeletal condition, the answer is probably not too often. A worldwide initiative hopes to change that.

  Stuart L. Weinstein - Photo by Helen Spielbauer.

Professional medical associations, patient advocacy groups, governments, and even the Secretary General of the United Nations and the Pope believe that musculoskeletal health is so important that they have declared 2000-2010, "The Bone and Joint Decade."

Even The University of Iowa is jumping aboard the bone-promoting bandwagon. Stuart L. Weinstein, professor of orthopaedic surgery, serves as chair of the American Academy of Orthopaedic Surgeons Task Force on the Bone and Joint Decade. Weinstein hopes the global campaign leads to improvements in the quality of life for people with musculoskeletal conditions and helps to advance understanding and treatment of these conditions through research, prevention, and education.

"The movement is just starting now, but we hope that over the next decade we can help to increase the awareness of musculoskeletal health everywhere," Weinstein says.

Watch your back

Back pain sends about six million people a year to the doctor’s office, more than any other medical problem except for colds and upper respiratory complaints. The cost of treatment, lost wages, and rehabilitation for all individuals with back pain is unknown; however, just the direct costs of insurance-compensated medical bills and payment for lost wages related to low back pain added up to more than $11.5 billion a year, according to the American Academy of Orthopaedic Surgeons (AAOS). The number one back pain-causing culprit? Improper lifting and moving.

AAOS guidelines for lifting and moving a heavy object

  • Plan ahead what you want to do and don’t be in a hurry.
  • Spread your feet shoulder-width apart to give yourself a solid base of support.
  • Bend your knees.
  • Tighten your stomach muscles.
  • Position the person or object close to your body before lifting.
  • Lift with your leg muscles.
  • Avoid twisting your body; instead, point your toes in the direction you want to move and pivot in that direction.
  • Maintain the natural curve of your spine; don’t bend at your waist.
  • When appropriate, use an assistive device such as a transfer belt, sliding board, or draw sheet to move a person.
  • Do not try to lift by yourself an object that is too heavy or an awkward shape. Get help.

How to prevent back pain

  • Use the correct lifting and moving techniques.
  • Exercise regularly to keep the muscles that support your back strong and flexible.
  • Don’t slouch; poor posture puts a strain on your lower back.
  • Maintain your proper body weight. Being overweight puts a strain on your back muscles.
  • Keep a positive attitude about your job and home life; studies show that people who are unhappy at work or home tend to have more back problems and take longer to recover than people who have a positive attitude.


Musculoskeletal conditions are a silent epidemic. Chronic conditions such as osteoporosis and arthritis and less severe problems such as sprains, strains, and back pains affect millions of people annually. In the United States alone, musculoskeletal conditions rank first among diseases according to measures of disability and on the basis of visits to physicians’ offices. They are the number one category of reported impairments, according the 1995 National Health Interview Survey, conducted by the National Center for Health Statistics.

Nobody really hears about musculoskeletal conditions or their impact on individuals, families and society, Weinstein says.

"Musculoskeletal problems don’t get their due because they don’t kill you," he explains.

Although the conditions usually are not life threatening, they do have quite an impact.

  • One in every seven Americans reported a musculoskeletal impairment.

  • Musculoskeletal conditions and injuries accounted for 130.7 million visits to physicians’ offices and hospital outpatient and emergency departments in 1995.

  • During that same year, musculoskeletal conditions cost $215 billion in direct and indirect costs.

Despite these figures, only about $92 million is devoted to orthopaedic research annually, Weinstein says. Of that total, only $16 million goes for clinical research. The UI Department of Orthopaedic Surgery, which placed eighth in the 1999 U.S. News & World Report ranking of orthopaedic surgery programs around the country, focuses its research on clubfoot; hip dislocation; and hand, hip, and knee reconstruction, to name a few. Weinstein, known for his work involving scoliosis, recently received the Bristol-Myers Squibb/Zimmer Award for Distinguished Achievement in Orthopaedic Research.

Individuals involved in the Bone and Joint Decade initiative want to raise the awareness of the increasing societal impact of musculoskeletal injuries and disorders, empower patients to participate in decisions about their care, increase funding for prevention activities and research, and promote cost-effective prevention and treatment of musculoskeletal injuries and disorders.

The issue of bone and joint health will only become increasingly important as more baby boomers reach the age when musculoskeletal conditions are most prevalent, Weinstein says. Bone and joint disorders account for more than half of all chronic conditions in people over 50 in developed countries and are the most common cause of severe, long-term pain and disability.

Article by Jennifer Cronin

To learn more about the Bone and Joint Decade, visit the international web site at or the national web site at


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