Musculoskeletal disorders (MSDs) - bad backs, sore shoulders, aching knees, stiff wrists - are some of the biggest reasons people are off work in the UK. They are also one of the areas where simple, practical changes at work can make a huge difference. Why should you build the hazard into your policy, risk assessment, training and occupational health support so that problems are reported and managed early?
Work-related musculoskeletal disorders
As an employer, you’re not expected to turn into a physio. But you are expected to design work sensibly, involve your people, and encourage habits that protect their long‑term health. And the bonus is: what’s good for MSDs is usually good for productivity, morale and retention too. Under the Health and Safety at Work etc. Act 1974, you must make a “suitable and sufficient” assessment of risks to the health and safety of employees and others affected by their work, recording any significant findings. This includes risks of MSDs arising from manual handling, repetitive tasks, awkward postures and similar.
Looking after muscles, joints and back is a shared responsibility and whilst you may, so far as reasonably practicable, avoid risky manual handling, assess any lifting that cannot be avoided, put safer systems and lifting aids in place, and train and consult workers on how to use them, they must follow that training, use the equipment provided and report any concerns or pain early so controls can be reviewed and improved.
Where to start?
Beginning the management of work-related MSDs with a suitable and sufficient risk assessment is crucial because it identifies hazards, evaluates risk levels and informs effective preventative and control measures, allowing you to comply with relevant legislation. It helps you systematically identify potential sources of MSDs, such as repetitive movements, awkward postures, excessive force and prolonged static positions. Recognition of these allows you to target the most significant contributors to musculoskeletal problems before they result in injuries and potentially lost time.
By understanding the nature and severity of risks, you can then design interventions that are evidence-based and proportionate, such as ergonomic redesign, job rotation or use of mechanical aides. Without a proper assessment, these interventions may be ineffective or misdirected, wasting resources while failing to protect your workers effectively.
Tip. Use our Ergonomic Risk assessment to deep-dive into which tasks could potentially lead to the risk of an MSD developing.
Tip. Don’t forget to take individual risk factors and vulnerable workers into account in your risk assessments. Under Regulation 16 of the Management of Health and Safety at Work Regulations 1999, pregnant workers and new mothers must have the physical demands of their work assessed and reviewed. You also have extra duties towards disabled and neurodivergent workers and young and inexperienced workers. And with the UK’s aging workforce, older workers should also have extra consideration paid to their physicality to protect them and keep them in the workplace.
Getting your policy right
Your suitable and sufficient risk assessment outcomes will also help you define your manual handling policy, making it relevant to your business and allowing you to state specific, measurable, achievable, realistic and timely objectives on what you will put in place to prevent the onset of MSDs. Your health and safety policy and any manual handling policy should:
- recognise MSDs as a key occupational health risk
- commit to assessing and reducing MSD risks “as low as is reasonably practicable”
- emphasise that early reporting of discomfort is expected and supported.
Your policy should specify who is responsible for MSD risk assessment and reviews, how supervisor must monitor handling techniques and respond to reported issued, and how HR and/or Occupational Health will be involved in adjustments and case management.
Tip. Make sure your policy is well-documented and trained out to all members of staff. Review it whenever there are changes, such as process change, new equipment, etc. to ensure it stays relevant and impactful.
Tip. Regularly review absence data and incident reports to identify trends in MSD-related complaints, e.g. short absences for back pain in a particular team. Being proactive and joining the dots together before a certain task negatively impacts your workers can save you a lot of time and money in the long term, as you can re-assess and put control measures in before illness or injury develops into long-term absenteeism.
Practical risk assessment measures
Firstly, look at the individual tasks and the workplace design of where those tasks are undertaken, e.g. microscope works where a person is static with a bent head and neck in a poorly lit laboratory, or packing work in a production facility which involves repeated movements of medium-weight boxes in a cramped area.
In line with the hierarchy of control used for hazardous substances, which prioritises elimination and substitution, you should:
- eliminate or reduce manual handling by using mechanical aids, such as pallet trucks, conveyors, hoists. In the case of microscope use, consider projecting the slide contents onto a screen to eliminate the need to peer into the eyepiece.
- redesign workstations and vehicle cabins to promote good posture and reduce reaching/twisting. For the examples given, ensure walkways are clear and that good lighting is provided.
- enclose or reconfigure processes to minimise awkward positions and excessive force.
If the task cannot be eliminated or substituted, you should next look at reducing the exposure. Consider job rotation and work organisation, such as regular breaks, to reduce repetitive movements and static loading, particularly in high-demand seasons.
Next, you should review your engineering controls and ensure that equipment integrity is maintained by regularly inspecting and maintaining lifting equipment, in accordance with regulations. Not only will this keep you compliant, but reducing the force needed to drive a pallet truck with a wonky wheel will reduce the physicality required from the user, reducing the risk of harm to them. Equipment in good working order will also prevent sudden failures that can cause MSD injuries.
Tip. Use worker consultation as a screening tool and include pertinent comments in your risk assessment. Consult employees regularly about how tasks feel physically, whether they experience pain or fatigue, and what aspects of the job they find physically difficult. This can be done via toolbox talks, team meetings or safety committees.
Prioritisation and resource allocation
Once you have assessed your tasks and workplace design, it can be difficult to know where to start in implementing suitable controls which do not break the budget. Your risk assessment will point you in the right direction and focus your attention on areas with the greatest impact of reducing incidences. This systematic approach helps prevent overlooking less obvious but high-risk tasks. You should have consulted your workers when undertaking your assessment, and this will help enhance the quality and accuracy of the risk evaluation. You will find that most workers who undertake the tasks will have an opinion on how to do it better, and in many cases, they may have a straightforward solution that will be quick and cheap for you to implement, e.g. rearranging racking so that the most frequently handled objects are at waist height, rather than arranged in numerical or alphabetical order for instance.
Tip. Use risk assessments as live tools, not dusty files. Manual handling and DSE risk assessments are legal must‑haves, but they’re also great coaching tools if you use them well.
- Walk the job with staff: “Show me where it feels heavy / awkward / rushed.”
- Involve them in solutions - they usually know the work‑arounds already.
- Review assessments when you change layout, kit or processes, you see a cluster of similar complaints or someone has an MSD‑related absence.
This is exactly the kind of “suitable and sufficient” approach HSE expects.
Lifting and carrying - smarter, not tougher
Under UK law you must avoid hazardous manual handling where you reasonably can and reduce the risk where you can’t. But day-to-day, this translates into some very human questions:
- Can we avoid this lift altogether?
- Use pallet trucks, trolleys, hoists or roller systems instead of sheer muscle where possible
- If we can't avoid it, can we make it easier?
- Split heavy loads
- Add handles or grips
- Store heavy items between knee and mid‑chest height
- Keeping walkways, floors and lighting in a safe condition so staff are not straining or over-reaching to get the job done
- Are we asking the right person to do it?
- Match tasks to people’s capabilities, especially with an older workforce or anyone with existing conditions.
For workers, the message is:
- keep the load close to the body
- bend your hips and knees, not just your back
- turn with your feet, don’t twist at the waist
- if it feels too heavy or awkward - stop and ask for help.
You can reinforce this with short, regular manual handling refreshers and toolbox talks, not just a one‑off course at induction.
Simple changes such as splitting heavy loads, adding handholds, adjusting shelf heights, using suitable trolleys, rotating between tasks, and taking short movement breaks can sharply cut the risk of back and joint problems, and manual handling risk assessments and safe systems of work should be reviewed and updated whenever jobs, equipment or incidents show that current controls are not enough.
Stress and poor mental health can make pain feel worse and slower to recover, and high work pressure, tight deadlines or workers feeling they cannot speak up can push people into unsafe lifting shortcuts, so it is your responsibility to manage workload and work pace, involve workers in risk assessments and improvements, and take concerns about stress or mood seriously as part of your general duty of care.
Workstations, benches and desks
Whether it’s a packing bench or a computer desk, poor set‑up is a classic route to neck, shoulder and back pain. Tips you can build into your local guidance:
- Height matters. Packing benches should be roughly at waist height for most tasks. Keyboard and mouse so forearms are roughly horizontal, shoulders relaxed.
- Bring the work to the person. Frequently used items within easy reach – no constant stretching or leaning.
- Chairs and standing. Adjustable chairs with proper back support when sitting, and footrests or mats where people stand for long periods.
- Screens. The top of the screen should be roughly at eye level, about an arm’s length away.
For hybrid or home workers, give simple self‑assessment checklists and pictures so they can get the basics right at home too.
Repetition and pace - Why micro‑breaks are not “skiving”
Repetitive tasks, such as scanning, taping boxes, typing, sorting items, bricklaying, etc. are a big contributor to hand, wrist and shoulder issues. You can help by:
- rotating tasks where possible to change posture and muscle use
- building in micro‑breaks, e.g. 30-60 seconds to shake out the hands, roll the shoulders, walk a few steps
- being realistic about targets so people don’t feel forced to rush or skip safe techniques.
A good message to workers is “little and often” movement keeps joints and muscles happier than long periods of being stuck in one position.
Training, supervision and self-assessment tools
Your risk assessment will have determined the likelihood of MSD injuries in your workplace, so you should tailor your training programme to account for this. For example, if you have a high proportion of MSD injuries, then refresher training should be at least annually for every employee who is exposed to the risk. If the problem is being well-managed, you could reduce this to every three years.
There are three key types of MSD-focused training content:
Induction training. At induction you should cover the physical risks of the job, procedures for reporting pain, near misses or concerns, and the key findings of your relevant risk assessments and safe systems of working.
Task-specific training. This should included safe lifting techniques of the objects being handled and the correct way of using mechanical aids provided. Here you should discuss how to recognise early signs of strain and when to stop and ask for help. Also use this opportunity to empower them to adjust their workstations, seating positions, etc. without fear of retribution.
Refresher training and behavioural reinforcement. Monitor whether staff follow safe techniques; if not, investigate why, e.g. time pressure, poor layout, and provide refresher training or adjust work organisation so staff are not incentivised to cut corners.
Tip. Use our Safe and Unsafe Acts programme to assist you with behavioural reinforcement, be it positive or negative. Praising a person for sticking to the proven safe practices is a strong cultural driver for overall safety.
Once trained, it is the part of the supervisory responsibilities to observe workers on the job. Not only should they observe manual tasks and correct unsafe techniques but should regularly ask about discomfort during regular check-ins and encourage workers to report symptoms early and reassure them that this will not be held against them.
Managing MSDs when they do happen
Even with the best set‑up, some people will develop MSDs . How you respond can make the difference between a short blip and a long‑term absence. Once a report is received, log it in your ill‑health/incident system. Look at the job and see what you can change quickly, e.g. height, load, rotation, extra help and so on. For recurring or more serious issues get occupational health (OH), or the GP if you don’t have OH, to advise on what the person can do, not just what they can’t. Ask for suggestions on adjustments and phased return if they’ve been off. Then tie that into your duties to make reasonable adjustments for disabled workers where MSDs are long‑term or substantial.
Reporting and investigation procedures
It is important that workers know who to report issues to and what the process entails. Make sure that you inform workers, either through the induction process or refresher training, how spot potential issues and what they should do about it. Encouraging a culture of speaking up early means that you will have the opportunity to address the problem before it escalates.
Tip. Periodically run a campaign on MSD awareness, using posters, self-assessments, and on-the job discussions to keep the hazard firmly in workers’ minds so they don’t just wait until an annual health check before problems are raised, as the damage may be done long before then.
Tip. Where an MSD is diagnosed as an occupational disease within the scope of the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR) , ensure it is reported and that risk assessments and systems of work are reviewed for similar workers.
Occupational health support and case management
If you do have access to an OH provider, it is important to know when and how to involve them. Triggers for referral include:
- symptoms persist beyond a few weeks or recur frequently
- MSD symptoms are clearly linked to work tasks
- there is any doubt about fitness for particular duties.
OH professionals will assess the likely work-relatedness of MSDs and recommend specific adjustments. e.g. reduced lifting, changed hours, equipment changes. They can also advise on phased returns to work and long-term management plans.
Where a worker’s MSD amounts to a disability, you must consider and, where reasonable, implement adjustments such as: (1) redesign of tasks to reduce manual handling; (2) provision of ergonomic equipment or mechanical aids; (3) changes to working hours, shift patterns or rest breaks; and (4) redeployment to a less physically demanding role if necessary.
Tip. Ensure managers and supervisors understand that refusing reasonable adjustments, ignoring occupational health advice, or penalising staff for disability-related absence can amount to disability discrimination and lead to significant awards.
Confidentiality and data protection. You must also ensure that you handle health data appropriately. Health surveillance and occupational health records are sensitive personal data; employers must comply with data protection requirements and limit access to those who need to know for health and safety management.
Tip. Consult workers before introducing health surveillance or monitoring, explain what data will be collected and how it will be used, and include this in inductions.
Bringing it all together
You don’t need a glossy wellbeing brochure. What really counts is what people see day to day, that is a culture that cares about backs and minds. Aim for a culture where:
- managers model good habits using aids, taking short breaks, talking about ergonomics and stress
- staff feel safe saying “This set‑up isn’t working for me” without fear of being seen as weak
- risk assessments, safe systems of work and training are living documents, not tick‑box exercises
- MSDs and stress are seen as shared problems to solve, not individual failings.
Starting MSD management with a suitable and sufficient risk assessment ensure hazards are identified, risks are understood, and control measures are targeted and effective. It supports regulatory compliance, priorities prevention efforts, promotes worker engagement and establishes a foundation for ongoing improvement in workplace safety. Get these basics right, and you’ll not only meet your legal duties, you’ll keep more of your people fit, engaged and in work for longer.
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