You may have heard the term “musculoskeletal disorder” used to refer to or describe work-related injuries and wondered what that term meant. Or, you may have wondered what MSD stands for. Let’s see what the experts have to say…
According to the Centers for Disease Control (CDC), musculoskeletal disorders are “injuries or disorders of the muscles, nerves, tendons, joints, cartilage, and spinal discs.” (1)
The National Institute of Health (NIH) describes them in a similar way as comprising “diverse conditions affecting bones, joints, muscles, and connective tissues.” (2)
The World Health Organization (WHO) states that they “comprise more than 150 different diseases/conditions that affect the [musculoskeletal] system and are characterized by impairments in the muscles, bones, joints and adjacent connective tissues.” (3)
Suffice it to say, there’s pretty much universal agreement that MSDs involve more than one condition and that they involve muscles, bones, joints, and connective tissue. The CDC also includes disorders of the nerves, cartilage, and spinal discs—all could be considered “adjacent connective tissue.”
And all agree that these conditions lead to musculoskeletal pain and dysfunction.
Work-related MSDs, or WMSDs, are also referred to by a variety of other names. Here is a list of musculoskeletal disorders that may occur in the workplace: (5)
According to the National Institute for Occupational Safety and Health (NIOSH) (5), these disorders can come on gradually or can be the result of acute trauma.
Although the exact magnitude of the problem and the data cited varies according to the source, all sources agree that MSDs are an enormous problem:
The idea that work tasks cause or contribute to MSDs is not a new concept. The CDC and the National Institute for Occupational Safety and Health (NIOSH) published a review of the research regarding work-related MSDs as far back as 1997. They found studies that showed that the following were related to the development of MSDs of the neck, shoulder, elbow, hand and wrist, and back. (4)
Other work-related environmental conditions contribute to the development of MSD, such as
These factors create emotional stress, which in turn can increase muscle tension and the total load on the musculoskeletal system. These changes all have an impact on the development of MSDs. (7,8,9)
In general, a lack of workplace policies to promote healthy/non-aggravating work conditions contributes to the development of these conditions. (6) In environments without adequate ergonomic controls, workers are more likely to complain of discomfort and musculoskeletal pain that eventually lead to work absences.
In addition to work characteristics, personal characteristics significantly affect the development of MSDs. Personal health issues such as obesity, smoking, deconditioning, eating unhealthy foods, drinking alcohol, and age influence the likelihood of developing MSD (8).
If workers do not know how to incorporate good body mechanics and lifting techniques into their work, their poor ergonomic habits are more likely to lead to MSDs. If their physical abilities are not adequate for performing the physical demands of the job, MSDs are more likely to occur.
If minor aches and discomfort are ignored, then a full-blown lost time MSD is more likely to develop. If, after injury or illness, employees return to work too quickly, they may not be able to perform their jobs safely, and thus, another musculoskeletal injury is more likely to occur.
When MSDs occur, it’s tempting to blame the work or the worker in isolation, depending on one’s perspective. We often hear comments like:
“Well, it’s no surprise that he was injured. That job is just too hard.”
OR
“Well, given her weight, what did she expect?”
In most cases, MSDs and musculoskeletal pain are caused by a complex combination of factors, not just the job or the worker.
Just as the cause of MSDs is not simple, neither is the prevention.
It all starts with the work culture. A strong safety culture at work goes a long way toward preventing MSDs. A work environment where safety is considered at least as important as productivity sends a message to the employees that injury prevention is truly important. And regarding safety culture, actions speak louder than words.
Most sources agree that there is not one magic bullet that will decrease MSDs; rather, a multifactorial approach is required. However, our experience working with organizations in the US shows that most of them focus exclusively on training employees in proper lifting techniques and body mechanics. Most organizations use generic online or classroom training, and employees are on their own to implement the new information.
And sadly, most of the time, this limited approach is not very successful in preventing MSDs.
Organizations that take a more comprehensive approach are the ones that experience fewer MSDs.
MSD prevention begins by hiring employees who are physically capable of performing their jobs. If job requirements exceed employees’ abilities, MSDs are far more likely to occur. To be legally defensible under the Equal Employment Opportunity Commission (EEOC) and the Americans for Disabilities Act (ADA), these tests need to be job-specific. A thorough job analysis that defines the physical job requirements of the job helps the test developer meet these legal requirements.
In today’s sedentary society, many employees take jobs they are not physically conditioned to do. Even if they can handle the lifting, bending, reaching, squatting, and climbing during a pre-hire test, it’s optimal to let them gradually work up to sustaining the full workday and the environmental conditions that go with the job.
While they are getting acclimated to the physical requirements of the job, new employees can be trained in the most ergonomically correct way to do that job. The combined approach of job acclimation and training greatly reduces the likelihood of that new employee sustaining a work-related musculoskeletal injury.
The first two actions help you build a more qualified new workforce. But what about your existing employees? What can you do for them? That’s where ergonomic assessments and controls come in.
With ergonomic assessments, employers can identify and quantify the hazards of their jobs. Most employers can’t address every hazardous aspect of the work, but having ergonomic hazard scores allows them to prioritize and address the most hazardous job tasks and address those first. If the ergonomics program is ongoing, gradually, over time, most of the risk factors can be addressed.
In addition to implementing ergonomic controls, it is essential to teach employees how to do their jobs using the most ergonomic work practices. How they lift, how they position their bodies, how they breathe, how they use their muscles, and when and how often they implement stretch breaks all influence their level of fatigue and the strain on their bodies.
Our experience shows that training needs to be job-specific to be effective. Classroom or online training needs to be followed by reinforcement at the job site—out in the field, on the production floor, in the warehouse, etc. Body mechanics and lifting techniques don’t change overnight but need to be reinforced over a period of 30-90 days and periodically refreshed.
Despite prevention actions 1-5 above, MSDs will occur if the work is heavy and repetitious, and the required positions are awkward. So, when symptoms rear their ugly heads, it’s best to nip them in the bud with an OSHA-compliant Early Intervention Program (EIP).
With this program, employees self-identify as having discomfort. An onsite EIP practitioner (typically an athletic trainer or physical or occupational therapist) provides first-aid treatments relevant to the musculoskeletal system and that are approved by OSHA: heat or cold, massage, and non-rigid supports (often—sports taping).
The EIP practitioner can also review work practices with the employee to make sure the best ergonomic practices are being utilized. For companies that don’t have space at the worksite for these interventions, the employee can go to a nearby clinic. Most employees attend for 3-5 sessions, experience significant improvement, and never have to receive additional medical intervention.
Even if all the above programs are in place, some MSDs will result in lost or restricted duty workdays. In these cases, the question eventually becomes: When can the employee return to work? Unfortunately, in many of these cases, the return-to-work decision is made without any information about the worker's physical ability to do their job.
Physicians typically release employees to return to work based on the resolution of their medical diagnoses—i.e., when they’ve reached maximum medical improvement. For many individuals, the resolution of a medical diagnosis does not mean a return to full physical function.
If, instead, a return-to-work physical abilities test is used to determine the worker’s ability to perform the physical requirements of the job, the physician can make the return-to-work decision based on objective information that is relevant to the job. If the worker does not pass the return-to-work test, then a few weeks of work conditioning typically resolves the issue and makes reinjury much less likely.
ErgoScience's "Hire-to-Retire" program offers a proactive and holistic approach to preventing Musculoskeletal Disorders (MSDs) in your workforce. Investing in employee health and safety from day one can create a more productive and profitable work environment. It can also reduce the human cost of work-related musculoskeletal injuries.
If you're looking to safeguard your employees' well-being and your company's bottom line, ErgoScience's "Hire-to-Retire" MSD prevention program is a powerful solution to consider.
Contact ErgoScience today to discuss how our "Hire-to-Retire" MSD prevention program can benefit your workplace!
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