India's Silent Ache: Why the Country Is Grappling with a Musculoskeletal Crisis

Time of India

08-07-2025

By Pratibha Raju and Vishal Kumar Singh
New Delhi: India is quietly battling a surge in musculoskeletal disorders—joint pain, spinal issues, and bone degeneration are no longer limited to the elderly. Sedentary lifestyles, nutritional gaps, and screen-heavy routines are impacting people across age groups, including children.
With nearly 20 per cent of India's population expected to be over 60 by 2050, addressing
MSK
health is becoming an urgent public health priority.
Recognizing the scale and complexity of this surge, leading orthopaedic experts convened at the inaugural edition of Future MedX: The Smart Patient Care Summit. Moderated by Pratibha Raju, Senior Assistant Editor at ET Healthworld, the panel explored how lifestyle, nutrition, and technology are reshaping the landscape of joint and bone health in India.
The expert panel members consisted of Dr. Rajesh Bawari, Principal Consultant ,Orthopaedics & Head Complex Trauma & Orthopaedics Units, Max Hospital; Dr. Jayant Arora, Senior Director and Unit Head - Orthopaedics, Fortis Healthcare; Dr. Buddhadeb Chatterjee, Sr. Consultant -Orthopaedics, Apollo Hospital; Dr. Shubh Mehrotra, Director - Joint Replacement and Robotic Surgery, Lovee Shubh Hospital; Dr. Firoz Ahmed, Director and HOD, Dept of Orthopaedics, Joint Replacement and Sports Medicine, ARHI Hospital.
The discussion opened with a stark observation: MSK health is deeply connected to overall organ health. 'Poor
musculoskeletal health
will eventually translate into poor organ health and serious illness,' warned Dr. Buddhadeb Chatterjee.
He also raised a broader concern — the diminishing nutrient value in our soil and food, adding, 'As the earth is aging, the nutrients in the soil are diminishing, and that is why, since most of our food comes from the soil, the nutriments in the food that we take is also reducing. There's no definite study on this, no definite level one evidence, but this is a thought which is there in a lot of people.'
While aging is one part of the story, modern lifestyle habits are clearly accelerating degeneration. 'The 10-minute food delivery guys are also to be blamed,' stated Dr. Jayant Arora, referring to how technology has eroded basic movement from our daily lives. 'We are getting degenerative knees in patients as young as their 40s,' said Dr. Pranay Bhushan Pandey. 'The youngest degenerative non-traumatic total knee replacement I have done is in a 47-year-old.'
And it's not just older adults anymore. Children and young adults are increasingly presenting with postural deformities, vitamin deficiencies, and even degenerative spine changes. 'The spine matures at 30, but we are seeing changes at 18,' noted Dr. Shubh Mehrotra, who attributed this to excessive screen time and poor posture.
He also warned that children today are growing up disconnected from natural movement, and as a result, 'with flat feet and faulty foundations, everything from the ankle to the spine is at risk.
Environmental factors and pollution are also playing a role, particularly in the rise of osteoporosis and early degeneration. 'Patients as young as 25, mostly females, are showing degenerative knee problems,' said Dr. Firoz Ahmed. Meanwhile, Dr. Rajesh Bawari pointed out a fundamental mismatch: 'Our body is not programmed or designed to work the way we are used to… we need to balance it out with countermeasures.'
When asked about urban children's health risks, the consensus was clear — a lack of outdoor play and physical activity is taking its toll. 'Flat feet and knock knees in overweight children — it all stems from being indoors too much,' said Dr. Jayant, echoing the concerns raised earlier. Dr Buddhadeb added.
Role of Nutraceuticals
This naturally led the conversation to prevention — specifically, the role of nutraceuticals. Calcium, Vitamin D, magnesium, collagen, mucopolysaccharides, and curcumin were all mentioned as key supplements doctors now routinely recommend. 'We cannot survive without nutraceuticals in the current scenario,' said Dr. Pranay, explaining how deficiencies are now prevalent across all age groups. 'Every third person, no matter the age group, will need one.'
Dr. Rajesh explained why this matters. He highlighted that nutraceuticals offer a safer long-term option often leading to noticeable improvements that patients themselves report back.
Dr. Firoz emphasized that these aren't magic pills but crucial for tissue repair: 'They help not only in strengthening but also in the repair process.'
Dr. Buddhadeb cautioned stating that the evidence is still catching up: 'There is really no level one evidence which establishes nutraceuticals as an absolutely mandatory component. But we have definitely observed the benefits of nutraceuticals.'
For women who have attained menopause, doses change and other nutrients get added.' Others suggested adding magnesium, mucopolysaccharides, and plant-based estrogens like isoflavonoids.
Despite a strong vote of confidence for nutraceuticals, every panelist stressed that supplements alone are not enough. 'There are no quick fix solutions,' said Dr. Rajesh. 'I can't become a bodybuilder by just taking protein shakes.'
Dr. Shubh echoed this, advocating for moderation: 'Take it for a few weeks, stop, then restart and don't end up with hypervitaminosis.'
For Dr. Jayant, exercise remains paramount. He emphasized that true healing begins with movement, noting that muscles are the body's natural pharmacy — and that exercise drives the majority of clinical outcomes.
Robotic Knee Replacements
The second half of the discussion focused on Robotic knee replacements, an innovation that has rapidly gained traction in India. 'It is one of the most fruitful surgeries in medical science,' said Dr. Pranay. 'There's no shortcut — if it's end-stage, you have to go for a replacement.' He explained that robotic assistance allows for better precision, less soft tissue damage, and more accurate gap balancing, especially in complex cases.
Dr. Buddhadeb reframed robotic surgery not as a tool but as a concept. 'Every knee is different; the eye cannot see 3 degrees of misalignment, but the robot can.' He described it as a shift from 'one-size-fits-all' to personalized alignment. Jayant shared that robotic surgeries now form 80% of knee replacements at his center: 'People come asking for it after seeing the results.'
Dr. Firoz pointed out that while robotic surgery is gaining momentum in urban centres, wider adoption remains limited by cost and access—issues that need public-level intervention.
Dr. Jayant called on insurers to step up: 'Insurance companies should cover robotic surgeries — which they are not doing.'
There are also structural barriers. 'If you have a particular robot, you are restricted to that company,' Dr. Rajesh pointed out.
Dr.Pranay added that the government should consider capping robotic costs. He said that, 'No individual doctor can own a robot. If we curtail the cost, we'll have better surgeons and better knees.'
Way forward
The panel was asked why a combined approach of exercise and nutraceuticals is superior to either alone.
The panel concluded with a shared emphasis on a comprehensive, balanced approach to musculoskeletal health.
Dr. Rajesh Bawari stressed that strong muscles and bones must work in tandem, while Dr. Firoz Ahmed urged patients to adopt holistic changes—spanning lifestyle, nutrition, and exercise—to delay or avoid surgery.
Dr. Shubh Mehrotra emphasized moderation, advising against prolonged reliance on any single supplement without regular check-ups.
For Dr. Jayant Arora, movement is medicine, crucial not only for joints but for preventing broader metabolic issues.
Dr. Buddhadeb Chatterjee highlighted the value of traditional practices like yoga and meditation, encouraging people to reconnect with India's wellness heritage.
Summing it up, Dr. Pranay Bhushan Pandey noted that sustaining joint health isn't just about effort—it's about the right effort, grounded in informed habits and adaptability.