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Back pain is just the tip of the iceberg when it comes to MSDs, what else is there?

While many of us think of back pain when it comes to work-related musculoskeletal disorders (MSDs), in fact MSDs cover a wide variety of disorders involving joints and soft issues all around the body. In addition, while the causes are often connected to physical factors, there are a wide range of other causes – from organisational to psychosocial – to take account of when considering preventive measures.


MSDs – more than just back pain

Although back pain is the most common work-related MSD, reported by 43% of workers in the EU, 41% report muscular pain in the shoulders, neck and/or upper limbs and 29% in the lower limbs.[1]

Work-related neck and upper limb musculoskeletal disorders can affect any region of the neck, shoulders, arms, forearms, wrists and hands. Some common examples include tendonitis, carpal tunnel syndrome and osteoarthritis. The risk factors include poor working postures, repetitive work and handling heavy loads – most associated with machine and construction work. Prolonged computer work can also lead to problems due to its repetitive, static and intensive nature.

Musculoskeletal lower limb disorders affect the hips, knees and legs and usually occur due to overuse. They can lead to osteoarthritis, joint pain and stress fractures, for example. Workers standing or kneeling/squatting for long periods of time are most at risk, as in the retail, education, hotel and catering, health care and cleaning sectors.

Psychosocial and organisational risk factors

When it comes to risk factors and MSDs, the focus has traditionally been on physical factors. In fact, there are multiple risk factors – including physical, psychosocial and organisational – that could either act in isolation or in combination. While there is a general awareness of the main physical risks, much more attention needs to be given to these psychosocial and organisational factors.

Work-related organisational risk factors, such as high job demands, a fast work pace and a lack of breaks, can negatively impact the musculoskeletal health of workers. For example, a task may be carried out in a hurried way or involve carrying more weight than is optimal leading to poor working postures in order to get the work done more quickly. A lack of breaks means the body cannot recover from physical efforts, which in turn increases the risk of MSDs. Psychosocial risks can lead to stress, which will evoke physiological responses and may cause musculoskeletal symptoms.

The prevalence of organisational and psychosocial risk factors varies between occupations, but some risk factors show remarkable differences. For example, plant and machine operators and assemblers are particularly at risk of not being able to take a break (reported by 30%). And these workers are also often unable to change the order of their tasks. Sales workers, on the other hand, are most likely to report risks related to the pace of work, due to being dependent on customer demands (82% in 2015).[2]

MSDs are also associated with other health problems such as anxiety, fatigue, sleeping problems and a lack of mental well-being. In some cases, MSDs may even cause these health problems, or make them worse.

An integrated and combined MSD prevention approach

Due to the numerous factors that may contribute to the development or aggravation of an MSD, and because these factors interact with each other, the best way to tackle MSDs is through a combined ‘holistic’ approach.

The starting point should always be to identify the MSD risk factors. This means undertaking workplace risk assessments to identify which tasks carry risks, which workers may be affected and how they might be impacted. This will also enable early interventions to either eliminate risk factors or reduce workers’ exposure and impact on their health.

Furthermore, it is important to combine preventive measures to control risks at all levels, including actions targeting the workplace (ergonomics); improving work organisation and psychosocial factors – by allowing more breaks and giving workers control over work pace for example; and targeting workers directly, providing training on good postures, for instance.  

If you want more advice and guidance on preventing MSDs, be sure to visit the campaign’s database of practical tools, guidance and good practice examples and the prevention priority area. You can keep up with the latest news and events by following the campaign on Facebook, LinkedIn and Twitter.

[2] Source: EU-OSHA – European Agency for Safety and Health at Work, Work-related musculoskeletal disorders: prevalence, costs and demographics in the EU p.121, 2019.