Introduction and understanding Musculoskeletal Disorders

Musculoskeletal disorders (MSDs) are among the most common health problems, yet they are still widely misunderstood and often underestimated. They affect millions of people, from office workers, drivers, construction workers and retail staff. What are MSDs, what are some common misconceptions and why can they cause a serious impact to your business? 

What are MSDs?

MSDs are injuries or conditions that affect the body’s movement and musculoskeletal system and include damage to muscles, joints, tendons, ligaments, nerves, bones and supporting blood vessels. They typically develop when these structures are exposed to strain, overload or repetitive stress over time. 

MSDs can be:

• acute, e.g.  appearing suddenly, such as after lifting something heavy incorrectly
• chronic, e.g.  developing gradually over weeks, months or years due to repeated or sustained strain. 

They can also be referred to as:

• work-related MSDs
• work-related upper limb disorders 
• repetitive strain injuries 
• cumulative trauma disorders
• overuse injuries 

Although many MSDs are linked to work, they can also arise from everyday activities, sports, ageing and underlying health conditions. 

Typical symptoms include pain or aching, stiffness or reduced range of movement, swelling, redness or warmth in a joint or area, numbness or tingling, e.g. in hands or fingers, weakness or loss of grip strength and fatigue or heaviness in affected limbs. Symptoms may start mildly and be easy to ignore, but early warning signs often precede more serious and chronic problems. 

For employers, MSDs typically show up as staff reporting back, neck, shoulder, hip, knee, hand or wrist problems, reduced ability to perform core tasks, such as lifting, packing, driving, using tools, working at a screen, rising short‑term absences for “back pain” or “aches and pains”, which can become long‑term sickness, etc. 

Types of MSD 

MSDs cover a wide range of conditions. Some of the most common include: 

Back and neck disorders. General lower back pain is one of the most prevalent MSDs globally. Sciatica causes pain from irritation or compression of the sciatic nerve, whilst general neck pain and cervical strain are often linked to prolonged screen use, poor posture or sustained awkward positions. These conditions are frequently associated with manual handling, prolonged sitting, driving and poorly designed workstations. 

Upper limb disorders. These affect the shoulders, arms, elbows, wrists and hands. Common examples include: (1) shoulder tendonitis/rotator cuff disorders resulting from repetitive overhead work, heavy lifting or awkward reaching; (2) tennis elbow (lateral epicondylitis) and golfer’s elbow (medial epicondylitis) caused by repetitive gripping, twisting or forceful movements; (3) carpal tunnel syndrome, which is compression of the median nerve at the wrist, often associated with repetitive hand and wrist movements, forceful gripping or vibrating tools; and (4) tenosynovitis, which is tendon inflammation at the thumb side of the wrist, linked to repetitive thumb or wrist movements. 

Lower limb disorders. This type of injury or illness affects the hips, knees, ankles and feet. Examples include knee osteoarthritis, which can be worsened by frequent kneeling, squatting, heavy lifting or impact, hip and knee strain caused by manual handling, prolonged standing or walking on hard surfaces, and the lesser talked about plantar fasciitis, which is heel pain often linked to prolonged standing or walking, sometimes in poor footwear. 

Spinal and joint degeneration. Wear and tear of joints, which can be aggravated by repetitive loading or past injuries can lead to osteoarthritis or degenerative disc disease. These are usually age- or load-related changes to spinal discs, sometimes worsened by heavy or repetitive manual work. 

Systemic and inflammatory conditions. Not all MSDs are caused by work or mechanical strain. Some are due to personal factors, such as lifestyle choices and family history and personal susceptibility due to autoimmune or inflammatory processes, e.g. rheumatoid arthritis, ankylosing spondylitis, lupus-related joint disease. etc. 

These conditions can still be significantly affected by work demands, ergonomics and access to appropriate support. Although there is nothing that you can do to prevent these, you still have a duty of care to look after staff members who may be suffering with non-work-related MSDs. 

Why MSDs matter 

MSDs are not just “aches and pains” to be ignored. They have real consequences for individuals that suffer from them including pain and disability affecting mobility, sleep, mood and quality of life, reduced work ability, such as difficulty lifting, standing, typing, driving or performing fine tasks and even absence from work, leading to lost income for workers and lost productivity for employers. 

Work-related MSDs are a significant health challenge in the UK workplace. In 2024/25, an estimated 511.000 workers were suffering from a work-related MSD, including both new and long-term conditions. Over the same period, 7.1 million working days were lost as a direct result of MSDs, which each worker losing an average of 145 working days. Back-related conditions accounted for 41% of all reported MSD-related working days lost. 

Common myths and misconceptions about MSDs 

Misunderstandings about MSDs can delay treatment, worsen outcomes and discourage prevention. Here are some of the most frequent myths. 

“It’s just part of getting older - nothing can be done” 

While age is a risk factor for many MSDs, pain and disability are not an inevitable or untreatable part of ageing. Many older adults remain active and pain-free with well-designed ergonomics, regular movement and strengthening exercise and perhaps most importantly early intervention when symptoms begin. Believing there is “nothing to be done” often leads to unnecessary suffering and avoidable loss of independence. 

“If you have back pain, you should stay in bed” 

Extended bed rest is no longer recommended for most back pain. Prolonged inactivity can weaken muscles, stiffen joints, slow down recovery and increase the risk of chronic pain. Modern guidance usually encourages gentle movement, gradual return to activity, and staying at or returning to work where possible with appropriate adjustments. 

“Only heavy manual workers get MSDs” 

Manual handling, construction and similar jobs are high‑risk, but MSDs are also very common most sectors, including :

• office and home‑based workers due to prolonged sitting, poor posture, keyboard and mouse use
• drivers due to whole‑body vibration, static posture
• healthcare workers due to patient handling, awkward postures
• retail and hospitality due to standing, repetitive tasks, awkward lifting 

Any job that involves repetition, force, awkward posture, vibration, sustained static positions or time pressure can contribute to MSDs. 

“If there’s no obvious injury, it can’t be serious” 

Most work-related MSDs develop gradually. Micro-traumas from repetitive or awkward movements accumulate over time. Pain that comes and goes, or only appears at the end of the day, can still indicate a serious developing problem. 

“Pain always means serious damage” 

Pain is complex. It is influenced by numerous factors including: (1) Physical factors, such as tissue strain, inflammation; (2) psychological factors, e.g. stress, anxiety, fear of movement; and (3) social factors including work pressures, support at home or work. In many MSDs, especially lower back pain, pain does not necessarily equal severe damage, and imaging can often look “worse” than a person’s actual function. Understanding this helps reduce fear and supports active recovery. 

“There’s no point in reporting MSD symptoms - nothing will change” 

This is far from the truth. Early reporting of symptoms can enable you to trigger workplace assessments and adjustments and lead to ergonomics improvements that help others. It also allows to source appropriate resources, e.g. support access to physiotherapy or occupational health. These can in turn prevent a minor problem becoming a long‑term disability. A culture that encourages early reporting and open discussion is central to effective MSD prevention and management. 

“If you’re fit and strong, you’re protected” 

Physical fitness helps, but it does not eliminate risk. Poor technique, excessive loads, and badly designed workstations can injure even very fit people. Prevention requires both good physical condition and safe systems of work. 

MSDs as a workplace issue 

We have mentioned that work can contribute to MSDs through:

• manual handling - lifting, carrying, pushing, pulling heavy or awkward loads 
• repetitive tasks - frequent, similar movements. Such as typing, packing, assembly work 
• awkward or static postures - bending, twisting, reaching, kneeling, prolonged standing or sitting 
• vibration - from power tools or driving 
• time pressure and high workload - leading to fewer breaks, rushed movements and increased muscle tension 
• poor workplace design - non‑adjustable chairs or desks, inadequate tools, poorly arranged workstations. 

These risk factors often interact, e.g. a worker may be lifting heavy loads in a twisted posture, under time pressure, with limited rest. 

For employers, MSDs can have a detrimental effect on the business as it can lead to organisational issues such as increased sickness absence and lost working days, presenteeism, e.g. employees at work but not fully productive due to pain, higher staff turnover and recruitment costs, e.g. covering shifts, re‑allocating work, training temporary staff, and reduced morale and engagement if staff feel unsafe or unsupported. Untreated MSDs can lead to early retirement and premature job loss, leading to “corporate memory loss” due to loss of skills, knowledge and experience. 

In some of the worst cases, you may also receive compensation claims and insurance costs where work‑related MSDs are recognised. Therefore, investing in prevention, from ergonomic design to training and early support, is often far cheaper than dealing with long‑term consequences. 

For SMEs with limited margins, these costs quickly add up, and the loss of key skills can be particularly damaging. These are all controllable through risk assessment, design and management, which is where your legal duties and business interests align.  

Stress and MSDs  

This is where many employers join the dots for the first time. Stress and musculoskeletal pain feed off each other. When people are stressed, muscles tend to stay tense, especially in the neck, shoulders and lower back, the nervous system is on high alert, so pain signals feel stronger and sleep is often worse, so the body has less chance to recover. That means the same physical job can feel much harder - and minor niggles can turn into long‑term problems.  

The HSE’s Management Standards for stress talk about things like demands, control, support, role and change. All of these can show up in MSDs:

• high demands / relentless pace – people rush, skip aids, take fewer breaks
• low control – they can’t vary tasks or posture, even when they’re hurting
• poor support or culture – they don’t feel safe reporting problems
• unclear roles or constant change – they improvise, often unsafely 

So, your stress management work is also part of your MSD strategy and vice versa.  

Prevention and prompt action 

It is important to emphasise that MSD management is a shared responsibility between you and your workers, but you must provide safe systems of work, appropriate equipment, and a culture where reporting is safe and expected. Workers should follow safe systems and report issues early, but they can only do this if they trust that reporting leads to support, not blame.  

While this blog focuses on understanding the problem, it is important to recognise that many MSDs are preventable or can be better managed. This will be discussed in more detail during week three. 

MSDs are extremely common and affect muscles, joints, tendons, ligaments, nerves and bones. They include low back or neck pain, shoulder and elbow disorders, hand and wrist problems like carpal tunnel syndrome, and many others. MSDs are not just minor aches - they are a leading cause of disability, work absence and reduced quality of life. Work can play a significant role, but understanding MSDs can significantly reduce risks via prevention, early reporting and supportive management to make a real difference for individuals and employers.