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 the risk of musculoskeletal disorder in the workplace. Every employer. Big and small.
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.
WMSD FACTS: Improve Your Management
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What is Work-Related Musculoskeletal Disorder?
Work-Related Musculoskeletal Disorders are injuries of the musculoskeletal system caused or aggravated by work activities and its 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 disorder. 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 disorder, 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 diagnosis and treatment.
A fracture from a fall would need an x-ray and a splint or surgery.
Osteoporosis would need x-ray, bone density scan and drugs to strengthen the bones. It may also need surgery.
Stress fracture which is a small fracture that happens over a period of time. Usually caused by overuse and repetitive actions are 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 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 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.
Injury from a fall, is classified as a work-related accident.
Whereas, work-related musculoskeletal disorder are injuries caused by work activities. For example, typing, lifting boxes, manual handling and using hand-held tools.
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 work-exacerbated musculoskeletal disorder.
Whether caused or exacerbated by work activities, these injuries are work-related musculoskeletal disorder. 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 forgot 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. A 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.
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 continous exposure to the risk factors. Which then builds up and escalate to pain and injury.
Just like Claire in the senario 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 that 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 disorder 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 disorder 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 does an amazing job of healing itself. And if treatment is required, most sufferers recover.
How To Tell When It’s Work-Related Musculoskeletal Disorder
I know what you might be thinking.
Workers never come up to you and say,
“Hey guess what! I have work-related musculoskeletal disorder”.
No! that would never happen.
Instead, they would use other terms. For example, back pain, neck pain, sciatica, rotator cuff Injury and tennis elbow.
“How would you then tell if they are musculoskeletal disorder?”
Do what I do.
When I see a patient for the first time. I need to know if I can help them and treat them. I need to know if physiotherapy is ideal for their injury. So I ask the first question.
“How did it start?”
You should do the same. Your worker know your injury more than you. It’s not about ransacking your brain wondering if they expect you to give them a solution. At this point, all you need to do is listen.
They might use words like,
”it hurts when I sit for too long”,
“when I’m bending it sends a sharp pain into my back”,
“ typing makes the tingling worse”.
“I find it difficult to reach the top shelf without shoulder pain”.
If you notice they’ve linked their pain to a work activity, there you have it. It’s most likely work-related musculoskeletal disorder.
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.
Is there More to Know About Work-Related Musculoskeletal Disorder?
For sure. I have written a mini-guide to help you understand it more. Downlaod the free guide below.
WMSD FACTS: Improve Your Management
Yipee! Welcome to Ergohealth VIP community. On our way to your email.
But this would get you started. And I’m a believer of starting from the basics and building upon it.
In summary, always assume that work-related musculoskeletal disorder is present in your workplace. And every worker but old and young, male or female, deskbound or otherwise, is susceptible to it.
When your employees report their injury, and they say it’;
– “caused or exacerbated by work”
– “comes and goes”
– “happened before and it’s happening again”
Know it’s work-related musculoskeletal disorder.
To help you further, why don’t you check out how WMSD develops in the workplace.
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