Musculoskeletal disorders

Musculoskeletal disorders. Woman being treated for musculoskeletal disorders

©EU-OSHA/Adam Skrzypczak

Musculoskeletal disorders (MSDs) are one of the most common work-related ailments. Throughout Europe they affect millions of workers and cost employers billions of euros. Tackling MSDs helps improve the lives of workers, but it also makes good business sense.

Work-related MSDs affect the back, neck, shoulders and upper limbs as well as the lower limbs. They cover any damage or disorder of the joints or other tissues. Health problems range from minor aches and pains to more serious medical conditions requiring time off or medical treatment. In more chronic cases, they can even lead to disability and the need to give up work.

Causes of MSDs

Most work-related MSDs develop over time. There is usually no single cause of MSDs; various risk factors often work in combination, including physical and biomechanical factors, organisational and psychosocial factors, and individual factors.

Physical and biomechanical risk factors may include:

  • Handling loads, especially when bending and twisting
  • Repetitive or forceful movements
  • Awkward and static postures
  • Vibration, poor lighting or cold working environments
  • Fast-paced work
  • Prolonged sitting or standing in the same position

Organisational and psychosocial risk factors may include:

  • High work demands and low autonomy
  • Lack of breaks or opportunities to change working postures
  • Working at high speed, including as a consequence of introducing new technologies
  • Working long hours or on shifts
  • Bullying, harassment and discrimination in the workplace
  • Low job satisfaction

In general, all psychosocial and organisational factors (especially when combined with physical risks) that may lead to stress, fatigue, anxiety or other reactions, which in turn raise the risk of MSDs.

Individual risk factors may include:

  • Prior medical history
  • Physical capacity
  • Lifestyle and habits (e.g. smoking, lack of exercise)

Risk assessment

There is no single solution, and expert advice may occasionally be needed for unusual or serious problems. However, many solutions are straightforward and inexpensive, for example providing a trolley to assist with handling goods or changing the position of items on a desk.

To tackle MSDs, employers should use a combination of:

  • Risk assessment: taking a holistic approach, assessing and addressing the full range of causes (see above). It is also important to consider those workers who may be at greater risk of suffering from MSDs. The priority is to eliminate risks but also to adapt work to workers.
  • Employee participation: include workers and their representatives in discussions on possible problems and solutions.

Read more about preventing work-related MSDs.

Prevention action plan

After completing the risk assessment, a list of measures should be made in order of priority, and workers and their representatives involved in implementing them. Actions should focus on primary prevention, but also on measures to minimise the seriousness of any injury. It is important to ensure that all workers receive appropriate information, education and training on health and safety in the workplace, and know how to avoid specific hazards and risks.

Measures may cover the following areas:

  • Workplace layout: adapt the layout to improve working postures
  • Equipment: make sure it is ergonomically designed and suitable for tasks
  • Tasks: change working methods or tools
  • Management: plan work to avoid repetitive or prolonged work in poor postures. Plan rest breaks, rotate jobs or reallocate work
  • Organisational factors: develop an MSD policy to improve work organisation and psychosocial environment in the workplace and promote musculoskeletal health

Prevention actions should also take into account technological changes in equipment and digitalisation of working processes and related changes of ways to organise work.

Health monitoring, health promotion and rehabilitation and reintegration of workers already suffering from MSDs also need to be considered in the management approach to MSDs.

Research on work-related MSDs

EU-OSHA carried out a multi-annual OSH overview project on work-related MSDs. The aim was to investigate the issues associated with work-related MSDs, improve our understanding of this topic and identify effective ways of dealing with work-related MSDs. The project also looked into policies and workplace measures to help prevent work-related MSDs and manage chronic MSDs, including supporting workers’ return to work and rehabilitation. The OSH overview project addresses the needs of policy-makers and researchers and complements the Healthy Workplaces Campaign 2020-2022.

European legislation

European directives, EU occupational safety and health strategies, regulations of Member States and good practice guidelines already recognise the importance of preventing MSDs.

Work-related MSD risks fall within the scope of the OSH Framework Directive, which aims to protect workers from work-related risks in general and establishes the employer’s responsibility for ensuring workplace safety and health. Some MSD-related risks are tackled by specific directives, notably the Manual Handling Directive, the Display Screen Equipment Directive and the Vibration Directive. The Use of Work Equipment Directive addresses the positions adopted by workers when using work equipment and makes clear that employers must consider ergonomic principles to comply with minimum OSH requirements.

EU-OSHA monitors the incidence, causes and prevention of MSDs. EU-OSHA also supports the sharing of good practices.

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