NIHR | Manchester Biomedical Research Centre

Addressing Health Inequalities – Improving exercise engagement among non-English speaking people with musculoskeletal conditions

Many people with arthritis and other musculoskeletal (MSK) conditions experience chronic pain, which can have a significant impact on their day-to-day wellbeing.

Research shows that exercise and activities which promote joint movement can help to strengthen muscles and tendons around the joints, so that people can exercise for longer without experience pain and experience better quality of life.

Health Inequalities Case Study – Improving exercise among non-English speakers with MSK conditions

Barriers to physical exercise

However, information on these conditions – along with classes and resources relating to physical exercise – is often only available in the English language. This can make it difficult for people who do not speak or are not fluent in English, particularly those from Black, Asian and Minority Ethnic (BAME) communities, to engage in exercise to help their condition. People from these communities are also disproportionally affected by MSK conditions due to higher risks factors such as physical inactivity, vitamin D deficiency, deprivation, working manual jobs and other pre-existing health conditions.

The project:

Since 2020, researchers from our MSK Theme have been working with people from the South Asian community with MSK conditions, their family members, community leaders and local health professionals, to understand the barriers to physical activity for non-English speakers. The project aims to identify and overcome these barriers, increase engagement in physical activity and improve support, resources, and treatments to meet their needs.

So far, researchers have interviewed 12 people from the South Asian community with chronic joint and muscle pain in their spoken languages (Urdu, Punjabi and Hindi), to understand their ideas, personal and cultural needs, and how health professionals can better support them in their care and treatment.

A researcher perspective:

This research will help us to deliver better treatments, support and advice that is person-centred, and culturally and ethnically sensitive. The end results will be improved care for people with musculoskeletal conditions, whatever their ethnicity and language – and that means better quality of life. Emerging themes from members of the South Asian community point to a lack of awareness among patients, who want more support around exercise, as well as a need for clinicians to be more proactive in supporting them to increase their physical activity. We plan to replicate similar studies in other ethnic groups to better understand the needs of other communities.

Dr Nasimah Maricar
Researcher, NIHR Manchester BRC Musculoskeletal Theme

A participant perspective:

There are differences between availability and accessibility in MSK services, and many people have to overcome artificial barriers such as ‘meeting minimum threshold levels’ before being offered care and treatment. My sister is almost housebound with poor mobility. Hence, we need MSK services that are provided locally at a suitable location, with suitable ground floor access and at a convenient time of the day. If the MSK professionals could communicate in the patient's own language, this would be helpful in understanding the patient's conditions and concerns more and ensuring a better outcome for patients and their families. This research is important for all the above reasons and is a step in the right direction.

Mr M Mistry,
Carer and public contributor