Creating a musculoskeletal disorder strategy

A risk-based strategy is key to preventing and managing musculoskeletal issues.

A staggering 131 million working days were lost through employee sickness or injury in 2011, with musculoskeletal disorders the biggest cause of days lost (35 million), according to the Office for National Statistics’ Sickness absence in the labour market report, published in April 2012.

That is why a proactive, integrated approach to managing musculoskeletal disorders must be core to any sickness absence policy.

There is no one-size-fits-all method of managing musculoskeletal disorders. An employer must consider its size and business sector to determine the most appropriate strategy, but there are some fundamental features that all strategies should include.

Central to any comprehensive health and safety policy is risk assessment, in this case to identify potential causes of musculoskeletal disorders. Examples include repetitive activities with heavy lifting, and inactivity through prolonged sitting in meetings and computer use.

Take a long-term view

Employers should talk to staff to understand the issues behind musculoskeletal conditions in the workplace. They should also take a long-term view, because average musculoskeletal sickness periods tend to exceed two weeks.

Occupational health and health and safety should be involved in developing musculoskeletal policies and procedures, and HR and employee representatives may also be consulted.

Employers should consider road testing ideas with first- and second-line managers, who may be responsible for most absence management.

But, ultimately, the treatment of musculoskeletal disorders is mainly the responsibility of doctors and National Health Service (NHS) primary care providers. Timely access to treatment can reduce the pain and disability resulting from musculoskeletal problems. When such issues are recognised in the workplace, employers should urge the employees concerned to seek early advice.

It may be more cost-effective for employers to provide occupational health services to employees than to risk long-term sickness absence. Workplace physiotherapy or, at the very least, links with local health providers, can speed access times and recovery rates.

Doctors can recommend support

Doctors can also recommend a range of support for employees with musculoskeletal issues through a fit note, the Department of Health’s statement of fitness for work. For example, a phased return to work can promote an earlier return. Employers can adapt an employee’s workload to match their reduced ability, preventing them taking more time off work. This could be combined with altered hours or more rest periods to control symptoms better.

Workplace adaptations, such as reviewing working patterns or investing in new work equipment, can also help speed an employee’s return to work. But the biggest challenge with musculoskeletal issues is often communication.

Short-term absence management tends to involve an employee and a line manager, while long-term absences can involve an employee, two line managers, HR, occupational health, NHS professionals and staff representatives. In these situations, it can be hard to ensure the timely communication of facts, so employers should hold conferences involving all concerned parties.

One of the most important pitfalls for employers to avoid is putting pressure on employees to return to work. Equally, HR should not be preoccupied with absence management targets at the expense of staff wellbeing.

Key points

  • A risk assessment should be central to any musculoskeletal disorder strategy.
  • Repetitive activities with heavy lifting are classic causes of musculoskeletal disorders.
  • Employers should consider occupational health services to combat staff absence.

Iain Loughran is senior physiotherapist at South Tyneside NHS Foundation Trust