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27/10/2022

How can we support workers with chronic MSDs from a psychosocial perspective?

While early intervention is essential to prevent musculoskeletal disorders (MSDs) from becoming chronic, people who do have chronic conditions should be supported to return to work and stay at work. In addition to the physical implications, psychosocial risk factors can exacerbate MSDs, as well as being barriers to returning to the workplace. Successful management of these is fundamental to the design of safe, healthy and inclusive workplaces.   

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The impact of chronic MSDs on individuals  

Chronic musculoskeletal conditions are long-term conditions that affect the muscles, bones, joints, tendons and the tissues that connect them. They can include arthritis, gout and osteoporosis, but also may not have a precise cause (presenting as back or shoulder pain, for example).  

This is likely to limit the tasks and activities a worker can comfortably undertake. Psychosocial factors are important to consider too, as fear of experiencing pain or for the future, anxiety and stress can significantly impact decisions around whether to return to work. Stress, for example at work, can itself trigger pain. However, with the right support, workers can be motivated to return and stay in the workplace.  

  
Key principles for addressing chronic MSDs in the workplace  

The starting point is for the worker to feel valued and for the organisation to be committed to supporting individuals to stay at work. A culture of open communication and listening, with channels to do this are also fundamental. This will help to reduce the individual’s anxiety about working with their condition. Employers must be mindful that they are required to fulfil health and safety regulations, as well as equality legislation.  

An individual, holistic risk assessment should be used to identify both ergonomic and psychosocial risk factors that need addressing as part of the return-to-work plan. Measures to address both physical and psychosocial risk factors are often simple and inexpensive. Usually, a combination of measures is required. For example, ergonomic equipment, coupled with a gradual return to work, flexible working, and opportunities to take rest breaks when needed can all help to make the individual feel more in control of the process.  

Psychosocial support is vital for a successful return-to-work, and it is important that the line manager, HR department and colleagues coordinate efforts to support the worker. Furthermore, healthcare interventions and other external support may include pain management and work-focused counselling and therapies. Time off work may be required to accommodate these. 

 

Case analysis: returning to hospital cleaning role 

In recent years, a hospital cleaning worker was complaining of ongoing lower back pain and took short periods of sick leave, receiving pain treatment and physiotherapy. Then an incomplete lumbar disc prolapse forced her to be absent from work for nearly two months. Fortunately, the hospital had an inclusive health policy that provided for return-to-work. This process began from the very first day of her sick leave, with the line manager maintaining supportive contact. Working together with a member of the reintegration team, OSH expert and company physician, the necessary adjustments were made to the worker’s tasks and equipment to support her rehabilitation

Open communication proved essential, as it uncovered that the worker had been taking additional shifts due to financial difficulties, leading to the development of the MSD. A social worker was brought in to help address her personal economic situation. Thanks to all these changes, the worker succeeded in returning to and staying in work, and the department retained an experienced employee.  


By considering the psychosocial risk factors along with the physical risk factors, employers can make the necessary reasonable adjustments to facilitate a successful return-to-work. This allows them to maintain productivity and efficiency, and for the worker, continuing to work is associated with better physical health and psychological wellbeing. This is particularly important as Europe’s population ages and the number of people living with chronic MSDs grows.  


Our website provides further information and resources. Check out the priority area Psychosocial risks as well as case studies and practical tools for managing chronic conditions and returning to work.  

Good practice advice is also available in the Working with chronic MSDs report and on the Chronic Conditions priority area webpage.   

Keep up to date by following #EUhealthyworkplaces on our social media channels: Facebook, Twitter and LinkedIn.