Update on the epidemiology of the rheumatic diseases

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Abstract
Epidemiologic studies confirm the jigh prevalence and incidence of osteoarthitis,including low back pain. The medical management of low back pain is provided primarily by physicians and chiroprators. The debate continuies regarding the comparative effecacy of these types of health care.The role of surgery in degenarative back disease is controversial. In particular,lumber fusion may be associated with poor outcomes. Studies suggest that genetic facotrs mwy be more important than environmental risk factors in determining susceptiblity to degenerative disk disease. Lifestyle modification may have a significant impact on osteoporotic hip fracture rates. Radiologic progression in patients with newly diagnosed rheumatoid arthritis is greater in seropositive patients who have baseline dameage and continued joint inflammation. Approdimately 10% of the excess mortality observed in rheumatoid arthrits may be attriutable to medication use,in particular nonsteroidal anti-inflammatory drugs and corticosteroids. Work characteristics may be less important in predicting work disability in rheumatoid arthrits than severity of disease and desire to be at home.

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