Disclosures: Amos Song, MD: No financial relationships or conflicts of interest

Objective: We determined the public health burden as well as demographic, patient, and visit characteristics of adult musculoskeletal ambulatory clinic visits in the United States, with the exception of visits for back symptoms.

Design: Epidemiologic / Retrospective Setting : n/a Participants : n/a

Interventions: n/a

Main Outcome Measures: Number of patient visits, rate of visits per 100 U.S. adults

Results: During 2009-2016, the leading cause for musculoskeletal visits was knee symptoms (15.3 million annually from 2009-10, 14.0 million annually from 2011-12, 12.5 million annually from 2013-14, and 12.4 million annually from 2015-16). The next leading causes were shoulder followed by ankle, wrist, and hip. Musculoskeletal visits were most frequent in patients that were 45-64 years of age (40.4-43.6%). MRIs were ordered most commonly for patients with shoulder (47.07±0.21; 12.5%) and knee symptoms (61.85±0.15; 11.4%). Narcotic (9.2% of patients) and narcotic analgesic combinations (14.8% of patients) were most commonly prescribed in visits related to hip complaints. Conclusions: The public health burden from musculoskeletal problems is comparable to and exceeds most medical disorders. Visits for knee symptoms were the most frequent. Musculoskeletal visits were most common in patients of working age groups which likely impacts work productivity. Orthopedic surgeons were the provider specialty of choice for majority of the patients with musculoskeletal disorders. Given that the first line of treatment in most cases is non-operative, more efficient and value-based patterns of care may involve partnerships of orthopedists with non-operative musculoskeletal physicians. Narcotic medications were prescribed most commonly for patients with hip symptoms, which may highlight an area for potential intervention given the ongoing opioid crisis in the United States. Patient education for weight reduction and tobacco cessation counseling was sub-optimal.

Level of Evidence: Level IV

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/characteristics-of-musculoskeletal-ambulatory-care-visits-in-the-united-states-2009-2016/