By 2050, One in Three MSDs Will Be Non-Traumatic

When we talk about musculoskeletal disorders (MSDs), most people think of well-known conditions such as low back pain, neck pain, osteoarthritis, rheumatoid arthritis, and gout. In global epidemiology, these make up the “big five” MSD categories in the Global Burden of Disease (GBD) framework.

Everything else – from fibromyalgia and myofascial pain syndrome to tendinopathies, bursitis, systemic lupus erythematosus, and spondyloarthropathies – is grouped into a residual category known as “other musculoskeletal disorders” (other MSDs). Importantly, these are not captured as long-term sequelae of injuries and often include non-traumatic, systemic, and stress-related conditions.

Looking Back: Limited Data Before 2000

For most of the 20th century, there are no comprehensive global datasets that separate “other MSDs” from the rest. Diagnostic coding systems were less standardised, and many of these conditions were either under diagnosed, misclassified, or overshadowed by injury-related and degenerative MSDs. Their recorded numbers were low – not necessarily because they were rare, but because they didn’t stand out in the data or were subsumed under broader, ill-defined categories.

It is therefore reasonable to assume that their proportion in earlier decades was both under-recognised and under-reported. Chronic, non-traumatic MSDs were simply not a statistical priority in an era where infectious disease and acute injury dominated health concerns.

What the Data Shows Since 1990
From 1990 to 2019, “other MSDs” increased in disability burden (DALYs) by 129%, compared with just 47% for low back pain. In prevalence terms, they now account for around 26–27% of all MSD cases worldwide (453 million out of ~1.71 billion in 2019/2021).

This faster growth suggests that other MSDs are taking up a larger slice of the total MSD burden – and projections indicate the trend will continue. The Lancet Rheumatology 2023 study forecasts that by 2050, “other MSDs” will more than double to 1.06 billion cases, roughly one-third of all MSDs.

Why This Matters
Many “other MSDs” are non-traumatic and systemic, often linked to chronic stress and autonomic dysregulation (Hallman and Lyskov, 2012a,b). Their rise reflects changes in lifestyle, work patterns, and psychosocial demands – a shift that traditional biomechanical treatment models were never designed to address.

For manual therapists, this is both a warning and an opportunity:

• The caseload is changing.
• Recognition and early intervention in non-traumatic MSDs will be critical.
• Integrating regulation-first strategies could be the key to meeting the needs of the 21st-century patient.