Musculoskeletal Medicine and PainOriginal Article

Identification of Musculoskeletal Disorders in Medically Underserved Regions of South America and Vietnam

Robin J. Jacobs, PhD, MSW, MS; Belinda A. Collias, DO; Arif M. Rana, PhD, EdS, MS; Elaine M. Wallace, DO; Kane Michael N., PhD, MSW, ACSW; and David R. Boesler, DO
Notes and Affiliations
Notes and Affiliations

Received: August 14, 2014

Accepted: July 12, 2014

Published: January 1, 2015

J Osteopath Med; 115(1): 12-22

Context: Musculoskeletal disorders have been implicated as the leading cause of disability throughout the world, representing a high percentage of the disease burden in many nations. Anecdotal evidence suggests that musculoskeletal pain has become increasingly pervasive, especially among rural populations of developing countries.

Objectives: To characterize specific musculoskeletal disorders in medically under-served regions where these issues have not yet been thoroughly examined.

Methods: The sample comprised adult residents receiving care during brief medical outreach trips to South America (Peru, Ecuador, and Argentina) and Vietnam from December 2010 to March 2013. Patients completed an anonymous questionnaire on musculoskeletal pain, self-reported health status, were associated with acute and health care-seeking behavior. Demographic information was also obtained.

Results: In Vietnam, 295 patients aged 20 to 88 years (mean [SD], 59 [14.7] years) completed the survey, 204 (69%) of whom were women. In South America, 552 patients aged 18 to 86 years (mean [SD], 44 [17.24] years) completed the survey, 398 (72.1%) of whom were women. Among the Vietnamese patients, acute pain was most frequently felt in the knees (132 [44.7%]), which were also the most frequent site of chronic pain (122 [41.4%]). Among the South American patients, acute pain was felt most frequently in the lower back (225 [47%]), and the upper back (253 [46.6%]) was the most frequent site of chronic pain. Associations were found between sex and chronic pain, with women reporting more chronic pain than men in the shoulder (17 [53%] vs 15 [47%], respectively), upper back (85 [79%] vs 22 [21%]), hand/wrist (153 [85%] vs 52 [15%]), and knee (40 [80%] vs 7 [20%]). Men reported more acute knee pain than women (73 [48%] vs 148 [38%], respectively). For patients in both samples, acute pain was associated with chronic pain in the same location for all body parts (P<.01).

Conclusions: This study characterized specific musculoskeletal disorders in selected poor and underserved regions in Vietnam and South America. Owing to reported regional differences, the authors recommend that global treatment protocols be developed with a population-specific approach after conducting a needs assessment for musculoskeletal disorders. J Am Osteopath Assoc. 2015;115(1):12-22 doi:10.7556/jaoa.2015.003

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