Rising Tide of Osteoarthritis in Pakistan: A 30-Year Health Burden Analysis

Overview of Osteoarthritis and Its Impact

Osteoarthritis (OA) is a degenerative joint disease that causes pain, stiffness, and reduced mobility. It primarily affects the knees, hands, and hips, and is a leading cause of disability worldwide. In Pakistan, OA has become a significant public health concern, with cases rising sharply over the past three decades.

From 1990 to 2021, the number of OA cases in Pakistan increased from 2.85 million to 8.49 million. This dramatic rise reflects aging demographics, lifestyle changes, and limited access to early diagnosis and treatment.

National Trends: Prevalence and Incidence on the Rise

Pakistan has seen a steady increase in OA prevalence and incidence. The age-standardized prevalence rate rose by 17.9%, reaching 5,854 cases per 100,000 people in 2021. Incidence rates also climbed by 16.3%, with knee OA accounting for over 61% of new cases.

Women consistently showed higher OA rates than men. In 2021, the prevalence among women reached 7,179 per 100,000, compared to 4,645 in men. This gender gap highlights the need for gender-sensitive healthcare policies and targeted interventions.

Provincial Disparities: Uneven Burden Across Regions

OA burden varies widely across Pakistan’s provinces. Islamabad Capital Territory (ICT) reported the highest prevalence and DALY rates, likely due to urban lifestyle factors such as reduced physical activity and higher obesity rates. Khyber Pakhtunkhwa (KPK) had the lowest rates, which may reflect underreporting or demographic differences.

Sindh and Azad Jammu and Kashmir also showed elevated OA indicators, while Punjab and Balochistan reported moderate levels. These regional disparities emphasize the importance of localized healthcare strategies and resource allocation.

Knee Osteoarthritis: The Most Common and Disabling Form

Knee OA is the most prevalent subtype in Pakistan, accounting for more than 60% of total OA cases. It also contributes the highest share of disability-adjusted life years (DALYs) and years lived with disability (YLDs). The dominance of knee OA may be linked to occupational stress, obesity, and lack of preventive care.

Hand OA saw the steepest relative increase, while hip OA remained relatively rare. These trends suggest the need for improved diagnostic tools and awareness campaigns tailored to different OA subtypes.

DALYs and YLDs: Measuring the True Impact

From 1990 to 2021, OA-related DALYs in Pakistan rose by 19.1%, reflecting the growing toll of the disease on quality of life and productivity. Women accounted for over 61% of total DALYs in 2021, reinforcing the need for equitable healthcare access.

YLDs followed a similar pattern, with a 19.1% increase nationally. The higher burden among women points to gaps in rehabilitation services and preventive care, especially in rural and underserved areas.

Why These Trends Matter

The rising OA burden in Pakistan poses serious challenges for the healthcare system. Although OA is non-fatal, it leads to chronic pain, reduced mobility, and loss of productive years. It affects millions of lives and strains healthcare resources, particularly in low-income communities.

Understanding these trends is crucial for developing effective public health strategies. Early diagnosis, weight management, physical therapy, and community education are key components of OA prevention and management. Integrating OA care into primary healthcare services can help reduce long-term disability and improve patient outcomes.

Call to Action: Addressing OA Through Policy and Prevention

Pakistan’s growing OA burden demands urgent action. Policymakers, healthcare providers, and community leaders must work together to implement targeted interventions. By investing in prevention, rehabilitation, and equitable healthcare access, Pakistan can curb the rise of osteoarthritis and improve the well-being of its population.