More sick days were attributed to back, neck and muscle pain than any other cause in England in 2013. Business In The Community, a Prince’s Charities organisation focusing on building healthy communities with successful businesses at their heart, estimates that by 2030, seven million people in the workforce will be affected by musculoskeletal health problems.
Maintaining good musculoskeletal (MSK) health is not only important for keeping people in work, but also for helping to prevent mobility problems in older age.
Maintaining good musculoskeletal (MSK) health is not only important for keeping people in work, but also for helping to prevent mobility problems in older age.In the foreword to an MSK toolkit, developed by Business In The Community in partnership with Public Health England, Professor Kevin Fenton, director of health and wellbeing at Public Health England says: “Poor MSK health affects all ages. The ageing population, rising obesity rates and reduced physical activity will increase the prevalence of poor MSK health. For many years there has been a perception that MSK conditions are unavoidable and part of the ageing process, leading to a focus on treatments to alleviate the pain and discomfort of MSK damage. However, most issues can be prevented and the workplace offers a unique opportunity to prevent the development of MSK conditions.”
Community pharmacy has a role in helping people to manage MSK problems and to help prevent future problems occurring.
Farah Ali, general manager at Warman-Freed pharmacy believes helping people to manage or avoid mobility health issues is an important role for pharmacy. “Both age and mobility are key focus areas for pharmacy,” she says. “In the UK, we have an ageing population, which requires products to support wellness, mobility and conditions relating to age, such as aches and pains, as well as mobility aids and advice from pharmacists.”
She thinks there are key growth areas for pharmacy to consider. “I believe age-specific products for wellness, such as vitamins and supplements, could be a potential area for growth,” she says. “Other growth areas could be condition management, for example pain relief, incontinence products, medicines management and mobility aids.”
Supporting older people to maintain their mobility means understanding them and their needs. “Understanding that, as people age, their needs may change is really important for pharmacy teams,” says Ms Ali. “Older people may well look to seek alternative pain solutions. It is also possible that they may want to buy something from their pharmacy to avoid wasting their GP’s time or resources as they become more conscious of the impact on the NHS.
“Certain wellness products are not available on prescription and therefore pharmacy teams need to have sufficient knowledge and understanding of what is suitable for older people. Their requirements may be different from those of a younger adult. The language and conversation techniques used may need to be managed depending on the age of the individual and their needs.”
The UK’s topical analgesics market is worth £74.1 million in sales through community pharmacy.
Jillian Watt, director of marketing/NPD at Mentholatum, supports pharmacy’s role in keeping people updated on the latest information based on best practice.
“Advice on managing low back pain has undergone a fundamental change,” she says. “Anyone complaining of a bad back used to be told to rest and take oral painkillers, but the latest research – and the latest advice from NICE – stresses the importance of staying active.
“NICE now recommends exercise in all its forms, including stretching, strengthening, aerobics or yoga as the first step in managing low back pain and sciatica. It also encourages people to continue with normal activities as far as possible.” Ms Watt believes this is a message that pharmacists can pass on to their customers. “Your advice can help patients understand that there is no magic pill to cure their problem, but they can help themselves if they follow simple advice,” she says.
The Mentholatum Company launched its Mind Your Back multi-media campaign last year to help people take care of their backs. The campaign was a response to the increasing incidence of back pain, which, says the company, is often caused by the greater amount of time spent sitting, which weakens the back muscles.
“Our backs are designed to move, not to stay in one position for long periods,” says Ms Watt, who is also a qualified Pilates teacher. “So, we have devised fi ve simple STEPS to help people look after their backs so they can sit, stand, lie and move more comfortably. STEPS stands for stretch, therapy, exercise, posture and strengthen, five elements that can help improve back mobility, strength and stability.”
There may be barriers, however. Research undertaken by Mentholatum to gain an insight into consumer needs and behaviours has shown that when people are suffering from arthritis or back pain, for example, they are unwilling or even frightened to move because it hurts.
“Pharmacists and their staff can help give customers, especially older ones, the motivation and confi dence to be more active if they explain that keeping moving improves lubrication in the joints and this will help ease pain,” says Ms Watt.
“Any products recommended will only be an element of a pain-management programme and one of the best pieces of advice the pharmacy team can offer is to buy a good pair of trainers and a set of walking poles or, if the patient’s knees won’t carry them, to go to the local leisure centre and jump in the swimming pool.”
Musculoskeletal conditions are a costly problem, and a growing one, according to a ‘State of Musculoskeletal Health 2017’ report from Arthritis Research UK, due to rising levels of obesity and physical inactivity, and resulting in 30.8 million lost working days. These conditions account for the third largest area of NHS spending at £4.7 billion in 2013/14. An estimated 33 per cent of people have sought treatment for osteoarthritis, and back pain affects around a third of the UK adult population.
Sadik Al Hassan
“We ran a healthy living campaign in December giving advice on falls prevention, and we have a lot of consultations around medicines that increase the risk of falls, such as blood pressure medication. One of the biggest problems of age is always trouble with walking and that can impact on everything else. To maintain mobility advise on the right amount and type of exercise, footwear choices, having the right lighting at home, and also to make sure that mats and rugs are non-slip. In terms of joint health sales, we fi nd that when you have a brand such as Vitabiotics side by side with a value line it tends to boost sales of both. You’d be surprised who buys which; it’s not necessarily who you’d think.”
“The majority of people in our local area are in the older generation. A lot of people purchase multivitamins that include nutrients for healthy joints, and the big seller we have in terms of mobility is our cod liver capsules. Seven Seas is the brand that people seem to purchase the most in that generation. Another popular product is vitamin C supplements. In an MUR with an older person we will recommend that people take things slowly when standing up or sitting down, because a lot have problems with hypertension. In terms of diet and lifestyle, we recommend including cod liver oil, eating plenty of fruit and fi bre, and doing at least 10 minutes of brisk walking or activities like that every day. Walking to the shops instead of taking the car can make a huge difference.”
“There are a lot of elderly people in our area and have queries around joint health all the time. Pain is one of the topics we give the most advice on, including joint pain and musculoskeletal pain. This ties into what we do as a healthy living pharmacy, too. I do a lot of MURs, and at the end of one I always go through healthy lifestyle. That includes weight management, healthy eating, smoking and drinking. All this can affect pain, and keeping active and mobile can reduce pain and improve quality of life. We have a whole planogram of BetterLife products, and we had a wheelchair on display that has now sold. We have a catalogue, so if we don’t have a mobility product in stock we can get it delivered to the customer.”