More than half a million workers in Great Britain suffered from a musculoskeletal disorder (MSDs) last year. Becky Spencer investigates why they remain such a huge problem.

During the last decade there have been many changes in the way people work and in the type of work people are doing. However, one thing that hasn’t seen much change is the number of workers suffering from musculoskeletal disorders (MSDs) caused or made worse by their job.

In 2023/24, MSDs, which can affect the muscles, joints, tendons and nerves in all parts of the body, accounted for around a third of all cases of work-related ill health self-reported by workers in Great Britain – that’s approximately 543,000 cases, which is around the same number of MSD cases as was reported back in 2013.

In the years before the Coronavirus pandemic, work-related MSD cases did start to reduce but since the pandemic ended the number of cases has increased again. In 2023/24, just under a third of the cases reported (160,000) were new MSD problems caused or made worse by work in the previous 12 months.

Suffering from an MSD can have a massive impact on a person’s quality of life, particularly if it turns into a long-term condition. The financial and organisational impact for employers as a result of lost productivity and sickness absence can also be significant. In 2023/24, workers in GB took over 7.7 million days off work sick due to musculoskeletal disorders - that’s an average of 14 days absence per case. In comparison, 4.1 million working days were lost in the same 12-month period because of non-fatal workplace injuries.

As with many issues in the workplace, there isn’t a simple answer as to why work-related MSDs are still so prevalent – there are likely to be many factors at play, including:

Risk assessment

Conducting suitable and adequate risk assessment is the cornerstone of MSD prevention in the workplace. Under health and safety legislation all employers have a legal duty to assess the risks to their employees’ health from their job or work environment. Whether they all do, and how thorough they are, is anyone’s guess. With Health and Safety Executive (HSE) inspections at an all-time low, failings will often only come to light if an accident occurs.

A risk assessment should identify any work practices that could potentially cause musculoskeletal disorders, enabling employers to implement control measures to mitigate these risks. Shortcomings in the risk assessment process can result in workers developing MSDs. On the other hand, a comprehensive risk assessment, carried out by a competent assessor, can go a long way to preventing MSDs in all workplaces.

Over the last decade, the idea of what constitutes a comprehensive risk assessment for work-related MSDs has evolved from one that solely focuses on physical hazards, such as excessive repetition, awkward postures and heavy lifting, to one that considers both physical and non-physical MSD risk factors.

Non-physical risk factors include poor work organisation as well as stress and other psychosocial factors.

HSE defines psychosocial risk factors as “things that may affect workers' psychological response to their work and workplace conditions”. Examples include high workloads, tight deadlines, a lack of control of the work/working methods and a lack of management support. All of these factors can cause work-related stress if not managed correctly, and, as HSE highlights, “stress is known to induce changes in the body (such as increased muscle tension) that can make people more susceptible to musculoskeletal problems”.

In addition, stressed workers may change their behaviour to try and cope with work demands. For instance, going without breaks to cope with high workloads and in doing so putting their body under more strain.

How many employers consider these non-physical MSD risk factors during the risk assessment process is an unknown, many may not realise there is a link between these risk factors and MSDs. But with reported cases of work-related stress increasing according to the Labour Force Survey (LFS), these psychosocial risk factors are not going to go away any time soon, so ensuring they are part of an MSD risk assessment is vital.

Changing world of work

According to the LFS, workers in physically demanding jobs such as tradespeople and process, plant and machine operatives report around double the number of MSDs than the ‘all occupation average’. These are people working in roles that are traditionally associated with risk factors for MSDs such as lifting and carrying heavy objects, prolonged awkward posture, repetitive movement, and intensive physical exertion or pressure.

However, over the last decade there have been two major changes in the world of work which have potentially increased the number of workers suffering from MSDs – more people are working in warehousing roles as a result of the rise in online shopping and the digitalisation of the workplace has resulted in many more people working from home. 

While a lot of warehousing work is automated, there are still a high number of workers who are picking, packing, loading and unloading goods, often at speed, all of which are known risk factors for developing MSDs.

Millions more people now work from home for some or all of the week compared to ten years ago. We know that homeworking has many benefits for staff and employers but it also has the potential to increase the number of workers developing MSDs, mainly as a result of poorly set up workstations and people working longer hours and not taking adequate rest breaks. Most risk assessments for homeworkers are done by the workers themselves, and most have had minimal, if any, training in ergonomic risk assessment.

Workforce

The UK population is ageing, meaning a growing portion of the workforce is over 50. An older workforce has an increased likelihood of musculoskeletal problems, whether caused by work or not. The LFS data shows workers aged over 45 report a much higher number of work-related MSDs than the ‘all age average’, and those aged over 55 report an even higher number still (around 2,300 MSD cases per 100,000 workers).

The higher rate of cases in older workers coincides with longer NHS waiting lists and lower access to occupational health support for many workers. According to a recent report from the Royal Society for Public Health, over ten million UK workers lack access to workplace health support. To try and tackle this, in January the UK Government announced the ‘Keep Britain Working review’ to identify measures to help employers help more people with health conditions to stay in work.

Apart from ageing, unhealthy lifestyle choices, physical inactivity and rising obesity rates may result in increased musculoskeletal problems in all ages. Workplace health promotion initiatives could play a role in MSD prevention by encouraging healthier lifestyle changes.

Not all musculoskeletal disorders can be prevented. NHS data shows over 20 million people in the UK have a musculoskeletal condition such as arthritis or back pain. Most of these cases are not caused by work but some are and many more will be made worse by it, which is why employers have to take steps to ensure their approach to tackling MSDs in the workplace is working as well as it should be.