Mark Sharpe: How to manage musculoskeletal disorders

Musculoskeletal disorders are one of the largest contributors to workplace costs, so employers need to have a robust strategy in place to treat them.

A reduction in healthcare spend, coupled with an improvement in employee health, is always beneficial to a business. But what is the best approach, particularly for musculoskeletal disorders, which are one of the largest contributors to those costs?

Employers should first identify the cause of the disorders and the cost of dealing with them. This should include a breakdown of the spend on management time, replacement staff, morale and
productivity. When employers understand the financial impact of musculoskeletal problems on their business, they are perfectly placed to optimise that spend.

Preventative measures

Employers should focus on investing in preventative measures to ensure the workplace is safely set up for each employee’s role. They should also provide education and support to encourage staff to make healthy choices around a balanced work and home lifestyle.

The clinical benefits of early intervention are well documented, as are the commercial benefits. It is a simple equation: a prompt intervention can be beneficial to a diagnosis of a problem before it gets worse, which, in turn, could lead to higher treatment costs and a longer period of rehabilitation.

In short, an individual may require less treatment for a successful outcome and usually returns to work sooner. These two factors provide a strong business case for establishing easy access to prompt, expert assessment and support.


However, another contributor to escalating treatment costs for musculoskeletal disorders is over-medicalisation: a patient having too much treatment, often resulting from seeing a specialist directly without considering more appropriate, less expensive alternatives.

The good news is that rapid access to clinician-led triage is being accepted as a more effective, safe way of signposting treatment as well as developing return-to work plans. It is also highly cost-effective.

Employers can avoid over-medicalisation by building a relationship with a healthcare provider that has the clinical expertise to recognise this risk.

For example, the employees for whom physiotherapy was recommended via our Back-Up service have needed fewer sessions, and the percentage of employees who needed to be referred to a specialist or for further investigations was reduced from 35% to between 10% and 15%, reducing employers’ costs by between 10% and 23%.

Typically, employers invest in a number of reactive services to tackle musculoskeletal problems, but our experience shows that this is not the way to achieve the best possible outcomes. In reality, the efforts and aims of reactive initiatives will often overlap.

Early intervention

Employers that adopt early intervention as their broad underlying strategy, by working with a provider that offers early intervention services, are far more likely to reduce long-term absence and income protection claims.

But it is important for employers to set expectations about their healthcare provider’s service standards from the outset. They should establish what they need in terms of employee experience, reporting and ongoing management, as part of their cost discussion.

To embrace early intervention entirely, an organisation may need to revisit how it looks at healthcare funding and accept that there is greater return on investment, usually through reduced long-term absence, if other areas of a relatively smaller spend can increase slightly in the short term.


  • Employers must identify the cause of disorders and treatment costs.
  • Prompt intervention can be beneficial to a diagnosis.
  • Employers should clearly outline their expectations of their healthcare providers.

Mark Sharpe is the rehabilitation clinical lead at Aviva UK Health