Need to know:
- Employers should be focused on prevention and early intervention to minimise long-term sick leave due to musculoskeletal disorders.
- Having a clear plan, with the goal of returning at its core, alongside a foundation of strong communication, is integral.
- Organisations should consider whether their internal processes, such as those around sick leave, are conducive to a phased return and rehabilitation.
Whether due to the increasing age of the working population, or the ever-growing prominence of sedentary and screen-based jobs, musculoskeletal disorders (MSDs) are a pervasive issue.
However, they are also among the most successfully rehabilitated conditions, notes Liz Walker, director of HR at Unum. “We’re more likely to get people with MSDs back to work than most of our other conditions, so it’s really important to know that you can be successful.”
Prevention and early intervention
The key to any successful return-to-work programme starts before any sick leave has been taken, and might include ergonomic and display equipment assessments or encouraging employees to take regular breaks.
Prevention is not always successful, however, and employers should be willing to pick up on early signals. “It might be as simple as somebody complaining or saying their chair isn’t comfortable," says Walker. "[Organisations should] understand what those red flags are and make sure that managers are using the right resources when they see [them].”
Early notification of external providers is also integral, agrees Vanessa Sallows, benefits and governance director, group protection, at Legal and General. “Once the individual has received their sick note at day eight we want them to get treatment as soon as possible, that’s where we can be really effective.”
Have a plan from the start
Returning should be the goal as soon as the employee leaves work, says Sallows. “[It] sets those clear expectations, and the individual also knows that’s the goal they’ve got to aim for. It actually helps with recovery.”
Employers should outline a clear recovery and return plan, and ensure that employees know that this will be adapted according to their progress and needs.
This should then be underpinned by strong communication which covers not only the individual’s progress, but also keeps them connected to developments in the workplace. This will help them feel connected, secure and welcome to return.
Understand their fears
Employers should work to dispel common myths, such as the idea that insurance will not cover the employee, or that they cannot return if they have a sick note, says Dr Lindsey Wright, clinical director and owner of Wrightway Health.
However, some fears are more justified. “A lot of organisations have sick leave policies that are triggered by episodes,” continues Wright. “If they go back and attempt to go off sick again, they get penalised. We can’t persuade people to trial [going back to work] because they’re fearful they’ll get the next trigger and they’ll be on performance management. But a bit of trial and error is often how you get people back to work, by being a bit flexible.”
Organisations should, therefore, consider whether their sick leave policies are truly supportive or whether they may be hindering eager employees from returning earlier.
“If you get people through the door, they often find things they can do,” Wright explains. “It’s when you can’t get them through the door that’s the difficult thing.”
Relapse prevention
“Just getting somebody back to work doesn’t mean that it’s all going to go smoothly from there,” warns Walker. “[Employers should be] repeatedly checking in, making sure the team is supportive, checking the effectiveness of the plan and modifying it.”
Ensuring that the employee has returned to an environment that helps them rehabilitate is, in part, tied in with normal health and wellbeing initiatives, such as encouraging healthy eating and promoting breaks and exercise.
For a returner with musculoskeletal issues, however, employers also need to consider methods such as task rotating, DSE set-ups, part-time or adjusted hours, or even redeployment to a new role.
Embracing modern methods, such as providing learning modules around physiotherapy, can be integral to a holistic approach to relapse prevention. "It's giving them control and saying it's okay to push yourself a little more as long as you do it in that safe way," says Sallows. "There is a lot of information that [employees] can go and access. Digitalisation is the way forward."
Share responsibility
Employees are regularly convinced that work has caused their MSD, but it is often only a minor factor, says Wright. While the employer certainly has a role to play, this should all be in support of the individual’s own efforts.
“Really empower employees to be proactive in taking care of themselves physically,” says Walker. “Often [employees] will blame work for getting them into the situation, but work is also an important part of the recovery process and getting healthy again. It just needs to be done in the right way.”
One method, notes Walker, might be a ‘dress for your day’ initiative, with the employer allowing for more casual attire when possible. Employees are then more able to take ownership of their health by going for walks on days when they can wear trainers, for example.
The psychological backdrop
MSDs and mental health might be seen as separate issues, but both are major causes of sickness absence, and they can often exacerbate one another.
Employers should consider what other elements of their benefits provision might be opened up to those struggling with MSDs, such as support and counselling services.
“You can imagine it could be very difficult to be in chronic pain and have to be off work without that impacting your mental wellbeing,” says Walker. “If you want to bring that person back and have them contributing fully again, you need to get behind them emotionally and physically.”
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