Work-Related Musculoskeletal Disorders.
That name. Phrase. Term.
When you hear it, how does it make you feel?
Frustrated. Angry. Scared. Unsure.
Does it have to do with your understanding of it? Or is it a “not-again!” moment?
I get upset too when I see the end of year statistics published by Health and Safety Executive (HSE).
Not delighted that about 7 million working days were lost. Or almost half a million people developed pain and injury at work. Half a million!
That’s a lot of people getting injured at work from one kind of injury; musculoskeletal disorders.
But it doesn’t have to be.
We can all reduce our risk of musculoskeletal disorders in the workplace.
And the first steps to reducing its risks are if you;
a. know and understand what it is
b. Know how it occurs in the workplace
c. Know its different stages of development
d. Know its risk factors
e. Know the common signs and symptoms
Knowing this would help you differentiate and manage it better.
So let’s begin.
What is Work-Related Musculoskeletal Disorder?
Work-Related Musculoskeletal Disorders are injuries of the musculoskeletal system caused or aggravated by work activities and their immediate working environment.
Common examples of work-related musculoskeletal disorders are;
- back pain,
- neck pain
- shoulder impingement syndrome
- Achilles Tendinitis,
- tennis elbow (lateral epicondylitis)
- prepatellar bursitis (housemaid’s knee)
- cartilage tear,
- plantar fasciitis,
- rotator cuff tendonitis,
- frozen shoulder,
- carpal tunnel syndrome,
- headache and eyestrain
- De Quervain Tenosynovitis
Is Work-Related Musculoskeletal Disorders the same as Musculoskeletal Disorders?
I get asked this question a lot.
There’s no difference between Work-Related Musculoskeletal Disorder and Musculoskeletal Disorder. They are interchangeable. They are still the same injuries of the musculoskeletal system.
However, there are many causes of musculoskeletal disorders. These causal factors damage the musculoskeletal system somewhat differently. And their clinical presentations differ too.
In medicine, knowing the cause of injuries or diseases improves diagnosis and treatment. So, to further simplify musculoskeletal disorders, their causal factors were added as prefixes.
Classification of Musculoskeletal Disorders
The causal factors of musculoskeletal disorders classify them into;
- Age (age-related)
- Sporting activities (sport-related)
- Trauma and accidents (trauma-related)
- Occupation (work-related)
So, an age-related injury would present differently from a work-related injury.
Fracture (bone breakage) caused by age could be osteoporosis (loss of bone density).
Whereas if caused by trauma could be from a fall.
And caused by overuse at work could be stress fracture.
You see all these fractures would have different clinical diagnoses and treatments.
A fracture from a fall would need an x-ray and a splint or surgery.
Osteoporosis would need an x-ray, bone density scan, and drugs to strengthen the bones. It may also need surgery.
Stress fracture, is a small fracture that happens over a period of time. Usually caused by overuse and repetitive actions, common in sports and at work.
It’s only present in weight-bearing bones. And many times diagnosed using MRI scan. Treatment could include analysing the biomechanics of the legs. Healing is quicker. And gentle gradual movements encouraged after a few weeks.
“Although musculoskeletal disorder and
Work-Related musculoskeletal disorder are the same.
Work-related musculoskeletal disorder differentiate those caused and
aggravated (worsened) by work activities.’’
How To Differentiate Work-Related Musculoskeletal Disorders
In as much as there are many injuries that occur in the workplace. It doesn’t mean that they are all work-related musculoskeletal disorders.
Take for example, work accidents e.g. fall from a height.
A fall that causes musculoskeletal disorder (e.g. ankle sprain) is not classified as a work-related musculoskeletal disorder.
The difference is the activity that caused the injury.
Was it a work activity?
Fall is not a work activity. Although the fall might have happened whilst performing a work activity. It is not a work activity. Thus, the subsequent injury is not classified as a work-related musculoskeletal disorder.
An injury from a fall is classified as a work-related accident.
Whereas, work-related musculoskeletal disorders are injuries caused by work activities. For example, typing, lifting boxes, manual handling, and working from a computer.
The Health and Safety Executive (HSE) classifies musculoskeletal disorders as workplace ill-health. And fall is classified as workplace injury same as ‘struck by moving object’.
Difference Between ‘Caused’ And ‘Exacerbated’ By Work
Sometimes, musculoskeletal disorder is not caused by work. But work activities could worsen or aggravate that existing musculoskeletal disorder. This is known as a work-exacerbated musculoskeletal disorder.
Whether caused or exacerbated by work activities, these injuries are work-related musculoskeletal disorders. Because work activity had played a direct causal role. Either to bring on the injury or to escalate it from, say, mild to severe.
Michael played tennis over the weekend. He usually doesn’t play tennis often. And after the rounds of game, his right elbow started hurting. Mind you, just a twinge, nothing serious.
He thought with rest it would go away like it always does. In fact, later that day, it had started improving. Had even forgotten about it.
Got back to work on Monday and had to rush through his shift to finish a job. He is an electrician. He was on his knee all day, screwing, cutting, clipping and rewiring cables. He’s used to such tight deadlines. Never being a problem in the past.
But come Tuesday, his elbow throbbed so much that he couldn’t even hold a screwdriver. He could use a hand-held voltmeter. But he couldn’t grip a hand tool or even a pen.
Every time, he held the screwdriver, the pain flared up again. Shooting pain down to his fingers.
He had developed Tennis Elbow Injury exacerbated by work. Gripping a screwdriver (work activity) worsened his pain.
He would get home and feel no pain. But as soon as he comes into work and picks up his hand tools, he would get shooting pain straight to his fingers.
Although his injury wasn’t initially caused by work (tennis playing, remember). Work activities exacerbated it. So, it is still classified as a Work-Related Musculoskeletal Disorder.
Lucy moved house 4 days ago and lifted a heavy sofa up two flights of stairs. Woke up the next day and felt a dull ache in her back. Took some painkillers and sat at her workstation. She was fine at first but as the day progressed, her back got painful and stiff. And by the end of the day, she could barely get up from her office chair,
The next morning, her back pain was bearable but got worse again by the end of the day after sitting at her workstation. The same thing happened again the next day. It can be fair to say her back pain is work-exacerbated.
Characteristics of Work-Related Musculoskeletal Disorder
WMSD is different from all other work-related injuries because of its unique attributes. Be it work-related or work-exacerbated;
1. Work-Related Musculoskeletal Disorder Occurs Over Time
Accidents happen in a moment. A fall, a slip, struck by an object is an event that occurs one time that leads to musculoskeletal disorder.
However, work-related musculoskeletal disorder occurs with time. It might take weeks or even years before symptoms are noticed.
Claire, a production line worker uses wire cutters during her work shift. At first, there wasn’t any discomfort. But continuous repetition for over an hour gave her a sharp twinge. By 6 months, she had developed De Quervain Tenosynovitis.
2. Work-Related Musculoskeletal Disorder is Cumulative
It occurs from continuous exposure to the risk factors. Which then builds up and escalates to pain and injury.
Just like Claire in the scenario above, who kept using the wire cutter even when she was in pain. She didn’t report her injury. She probably didn’t think her use of the wire cutter caused her injury. So it accumulated until she developed De Quervain tenosynovitis.
3. Work-Related Musculoskeletal Disorder is Episodic
At the early stages of WMSD, symptoms will come and go. In Claire’s case, it started as a twinge. A twinge was only present when she used the wire cutter. By the end of her shift, the twinge had subsided. But then returned at the start of her next shift. It was episodic. Until it escalated to her injury.
Musculoskeletal disorders can also return time and time again, even after treatment. A classic example is back pain which can happen many times in a lifetime.
Note: Not all work-related musculoskeletal disorders are episodic.
4. Work-Related Musculoskeletal Disorder Is Transient
WMSD is one of the most common reasons for early retirement due to ill-health. For example, in the NHS it’s 49% of all cases. However, most musculoskeletal disorders are temporary.
At the early onset of WMSD, symptoms disappear. Either with adequate rest or change to work activities. Also, our bodies do an amazing job of healing themselves. And if treatment is required, most sufferers recover.
Prevalence of Work-Related Musculoskeletal Disorders
- Musculoskeletal disorder is universal. It’s reported in all industries around the world. The good news is in the UK, its rate has gradually reduced for the last 4 years. However, it makes up over a third of all work-related ill-health.
- Musculoskeletal disorder cuts across all industry. It affect both the sedentary office worker and the blue collar labour-intensive worker.
- Safe Work Australia reported the highest prevalance were in social and health care industries. But awkward posture and keyboard work were also common causes of WMSD.
- WMSD is still the biggest singular cause of sickness absence. US Department of Labour Statistics, reported it accounted for 31% of all workers off-sick from non-fatal occupational injuries and illnesses.
- WMSD affects both male and female. A report by HSE shows that it affects both male and female in the same pattern. Prevalence in male is marginally higher than in female.
- Back and the upper limb injury (shoulder, elbow, wrist and hand) recorded the highest ratio of injury. According to the European Agency for Safety and Health at Work (EU-OSHA).
- WMSD affects both young and old. The same report also noted that although it was significantly higher in older adults. All ages still reported injury.
How to tell It’s Work-Related Musculoskeletal Disorder?
If you’re still unsure if it’s a work-related musculoskeletal injury you have sustained, ask yourself these questions;
- How did it start?
- What time of the day do you have the symptoms?
- How often does it come on?
- What work activites do you struggle to do?
- What activities brings it on?
- How long does it linger for after the stop the activity that agggrvated it?
- Does it ever ease off?
- Is it better in the morning?
If the answers are linked to when you are working, then it is safe to say it’s work-related musculoskeletal disorder.
What do you think?
So, tell me, do you think you have work-related musculoskeletal disorders?