Current concepts in rheumatology

Musculoskeletal disorders contribute significantly to the global burden of disease and rank alongside mental health disorders in their impact on society. Nevertheless, there are large gaps in our knowledge of prevalence and impact of these disorders worldwide. The majority of musculoskeletal disorders are non-inflammatory (osteoarthritis and low back pain), yet inflammatory disorders receive a disproportionate share of the attention, possibly because of their wider impact within the patient. Major advances in the understanding and treatment of inflammatory diseases have occurred in the past 20 years and these are now being echoed in other fields, such as the management of foot health conditions. New paradigms of treatment are emerging, with the emphasis on early intervention, and the evidence base for non-pharmacological treatments is improving. This chapter will reflect on these changes and the likely future delivery of care for rheumatic and musculoskeletal disorders.