Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.

Musculoskeletal Conditions Are the Most Common Causes of Work Limitation in U.S. Adults.

Theis1,  Kristina A., Helmick1,  Charles G., Hootman2,  Jennifer M.

Centers for Disease Control and Prevention, Atlanta, GA
Centers for Disease Control and Prevention, Kennesaw, GA


People with work limitations are less likely to be employed, contribute to payroll taxes, or add to national productivity than those without work limitations, and chronic diseases are among the major causes of work limitation. However, there are existing interventions that can decrease, delay, or mitigate work limitations that may be especially effective if targeted to appropriate populations. We estimated the most common causes of work limitation among U.S. adults overall and among those with 7 common chronic diseases.


The data source was the 2009 National Health Interview Survey, an annual survey designed to be nationally representative of civilian, non-institutionalized U.S. adults (age >=18 years) conducted by in-person interview (n = 27,731; response rate = 65%). Work limitation was identified by self-report of being "unable to work" or "limited in work." Respondents with limitations were shown a flashcard of 18 health conditions plus an "other" category and asked to identify all health problems causing their difficulties. All respondents were separately asked about the presence of 7 chronic conditions. Arthritis was identified by "Have you ever been told by a doctor or other health professional that you have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?" The same question wording was used for hypertension, stroke, asthma, cancer, diabetes, and heart conditions (coronary heart disease, angina, heart attack, and any other kind of heart condition or disease). Diagnoses were not mutually exclusive. Weighted proportions and 95% confidence intervals (CI) were calculated, accounting for the complex sample design (SAS 9.2).


Overall, 28.4 million (12.5%, 95% CI = 12.0–13.1) U.S. adults reported work limitation. The most commonly reported causes of work limitation were back/neck problems (25.8%, 95% CI = 24.0–27.6) and arthritis/rheumatism (19.4%, 95% CI = 17.7–21.2), followed by depression/anxiety/emotional problems (15.1%, 95% CI = 13.6–16.6), heart problems (14.6%, 95% CI = 13.2–16.0), and musculoskeletal/connective tissue problems (13.1%, 95% CI = 11.6–14.7). Among those with 7 common chronic diseases and work limitation, arthritis/rheumatism and/or back/neck problems were among the top 3 causes for each (Table).

Table. Most Common Causes of Work Limitation by Chronic Condition, weighted prevalence estimates and proportions with 95% confidence intervals (CI), NHIS, 2009

Chronic conditionCauses of work limitationPrevalence (in 1,000s)Proportion in % (95% CI)
HypertensionBack/neck problems4,07726.4 (24.0–28.7)
 Arthritis/rheumatism3,89225.2 (22.7–27.7)
 Hypertension3,29521.3 (19.0–23.6)
StrokeStroke1,14639.3 (34.6–44.0)
 Heart problems74225.4 (22.3–28.5)
 Arthritis/rheumatism69023.7 (19.9–27.4)
AsthmaLung/breath problems2,13033.5 (29.9–37.0)
 Back/neck problems1,75327.6 (24.0–31.1)
 Arthritis/rheumatism1,39822.0 (18.9–25.0)
CancerCancer1,19326.5 (23.1–29.8)
 Back/neck problems1,10824.6 (21.1–28.1)
 Arthritis/rheumatism1,09924.4 (20.7–28.0)
DiabetesDiabetes3,44651.8 (48.0–55.6)
 Arthritis/rheumatism1,74526.2 (22.6–29.9)
 Back/neck problems1,65324.9 (21.3–28.4)
Heart conditionsHeart problems18441.9 (38.8–45.1)
 Arthritis/rheumatism2,17123.5 (20.7–26.3)
 Back/neck problems2,15223.3 (20.5–26.1)
ArthritisArthritis/rheumatism5,17533.5 (30.7–36.3)
 Back/neck problems4,99732.4 (29.8–34.9)
 Musculoskeletal/connective tissue problems2,30019.4 (17.3–21.6)


In addition to being the most common causes of work limitation overall, arthritis/rheumatism and/or back/neck problems were among the top 3 causes of work limitation regardless of chronic condition, suggesting that addressing work limitation caused by musculoskeletal conditions is important no matter what other chronic conditions are present. Evidence-based public health interventions (e.g., the Chronic Disease Self-Management Program) and vocational rehabilitation may delay or reverse disability among adults with chronic conditions experiencing work limitations.

To cite this abstract, please use the following information:
Theis, Kristina A., Helmick, Charles G., Hootman, Jennifer M.; Musculoskeletal Conditions Are the Most Common Causes of Work Limitation in U.S. Adults. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :795

Abstract Supplement

Meeting Menu