April 1996 Bulletin

Dr. Buckwalter urges funding for musculoskeletal research

Although the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) continues to make remarkable advances in research, more needs to be done, said Joseph Buckwalter, MD, chairman of the Council on Research and Scientific Affairs.

In a presentation to the House labor, health and human services, and education subcommittee on March 5, 1996, Dr. Buckwalter urged the committee to provide $261 million in fiscal 1997 for NIAMS.

"Without support for musculoskeletal research, new and effective treatments will not be pursued and our society will continue to suffer from debilitating musculoskeletal diseases and will continue to spend billions of dollars on their care," Dr. Buckwalter said.

He pointed out that injury is the leading cause of death for Americans under the age of 45. It is the most expensive health care problem in the United States, he said, costing the nation about $1.5 trillion a year in damage, death, disability, and loss of productivity.

An estimated 61 million Americans sustain injuries annually and nearly 33 million of the injuries are musculoskeletal in nature. Dr. Buckwalter said there have been numerous new technologies to reduce the time people are disabled, however, much more remains to be done. Additional research funding would enable scientists to get a better understanding of the molecular signals that control repair and growth functions in cells; develop synthetic replacements for muscle, soft tissue, and bone damaged beyond repair; and more safely manipulate the body's immune system, thereby permitting physicians to increase transplants of donated bone and ligament.

In the treatment of osteoarthritis (OA), total joint replacements have been successful in restoring near normal, pain-free, mobility of the joints. But physicians have been unable to cure OA or prevent the disease from progressing to the point where surgery is necessary.

"Reports of experimental methods for facilitating the repair of cartilage have encouraged patients to expect that current treatments for OA will soon be replaced," Dr. Buckwalter said. "However, much work needs to be done before this approach to the repair or regeneration of cartilage can be accepted as effective treatment. Increased funding for OA research will allow scientists to undertake the studies to develop the full potential of this promising new approach."

Low back pain is one of the most common musculoskeletal disorders. "Increased funding for future research would allow scientists and physicians to improve on existing diagnostic techniques, nonoperative treatments, and surgical procedures, and develop new ones; and reduce the incidence of low back pain in the population by continuing efforts to educate people regarding activities, especially high-risk activities that jeopardize their backs," Dr.Buckwalter said. "Also, there is a need to further define mechanism of injury in order to formulate means of prevention."

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