Dr. Deborah Kopansky-Giles head and shoulders
Dr. Deborah Kopansky-Giles
Dr. James J. Young

Paving the Way for a Musculoskeletal Health Strategy

This global network is aiming to make Musculoskeletal (MSK) health[1] a top priority for countries across the world to address the rising economic and social burden of MSK conditions. The Global Alliance for Musculoskeletal Health (G‑MUSC) has identified eight strategic priority areas to inform and guide strategy development for the prevention and management of MSK conditions at the global- and national-level health systems. The findings were presented in a new Towards a global strategy to improve musculoskeletal health report.

“MSK conditions, especially low back pain are the largest cause of disability and cost to health care systems across the globe,” says Dr. Deborah Kopansky-Giles, professor at the Canadian Memorial Chiropractic College (CMCC); and OCA Evidence-Based Framework Advisory Council member; and co-investigator and co-author of the report. “This work reflects over 20 years of effort to place MSK at the top of the most pressing global health issues. We’re excited to begin working closely with the World Health Organization (WHO) to identify a framework for building a policy to support MSK health internationally.”

Global Alliance for Musculoskeletal Health Strategic Response

Continuing from the inception of the UN Bone and Joint Decade (2000-2010), G‑MUSC is a network of national and international patient, professional, scientific, and civil society organizations that has called for a strategic, global response to address the health, social, and economic burden of MSK conditions. In response, the researchers published a first-of-its kind report with a blueprint for countries across the globe to strengthen their response to MSK health impairments. The report was developed in collaboration with almost 700 stakeholders from 72 countries through a project led by Professor Andrew Briggs, Curtin University and University of Sydney, Australia, and a team of international researchers, with funding from the Bone and Joint Foundation.

“This is the first time that this kind of work has been done globally,” says Dr. Kopansky-Giles. “We highlighted the burden of spine conditions, barriers to access to care, lack of integration in health care systems, and lack of funding to support MSK research, among other observations that played a key role in the development of the framework. We’re pleased that two chiropractors (myself and Dr. James Young) were members of the core research team for this important work.”

Eight Pillars of the Global Musculoskeletal Health Strategy

The research was conducted in three phases, including interviews with 31 international key informants, an MSK health policy scoping review, and a global two-phased Delphi study, which involved approximately 700 participants across the full spectrum of MSK stakeholders. Findings identified current gaps, trends in national health policies, and input from people with lived experiences with MSK conditions. These were translated into a framework of eight pillars to prioritize MSK health. These pillars are:

  1. Engaging, empowering and educating citizens, communities, organizations and governments to act on MSK health
  2. Leadership, governance and shared accountability
  3. Financing approaches
  4. Service delivery
  5. Equitable access to medicines and technologies
  6. Workforce: Building workforce capacity, systems and tools
  7. Surveillance: Monitoring population health
  8. Research and innovation

“Unfortunately, a literature review of MSK strategies showed that MSK health is not a current priority for most countries, including Canada,” says Dr. Kopansky-Giles. “This work is a first step to a collaborative approach to future policy development around MSK health to address this significant gap and improve the prevention and management of MSK health across the globe.”

Expectations and Hopes

MSK conditions are the leading cause of disability worldwide[2]. It is expected that as a result of population growth and aging, the prevalence, burden, and cost of MSK health impairments will continue to rise globally, especially in low- and middle‑income countries. If not acted upon, the researchers suggest that MSK health impairments could become unsustainable.

“My hope is that with a global MSK framework, Canada will embrace such a framework and call for engagement at provincial levels,” says Dr. Kopansky-Giles. “Strategies should support the eight pillars and include increasing funding for MSK research and integrating health care professionals, such as chiropractors into our health care system. Having a framework to remove these barriers will help to not only leverage engagement in our profession, but most importantly, benefit people suffering from musculoskeletal conditions.”

Two research papers have also been published in the journal of ‘Global Health Research and Policy’ and BMJ Global Health, and a third research paper is in the submission process.

[1] In Ontario, neuromusculoskeletal (nMSK) conditions are within the College of Chiropractors of Ontario (CCO)’s scope of practice.
[2] Global Alliance for Musculoskeletal Health. Briggs, A.M., Slater, H., Jordan, J.E., Huckel Schneider C., Kopansky‑Giles, D., Sharma S., Young, J.J., Parambath, S., Mishrra, S., March, L. (2021). Towards a global strategy to improve musculoskeletal health.