Need to know:
- Employers’ strategies should promote good musculoskeletal health in the workplace.
- Creating an open culture allows for continued conversations around musculoskeletal disorders (MSDs) and employee health.
- Employees should be encouraged to be active in the workplace and take advantage of initiatives such as on-site gyms and exercise classes.
With the UK’s ageing population staying in work for longer, it makes sense for employers to look after the health of their workforce. The Chartered Institute of Personnel and Development (CIPD) and Simplyhealth's Absence management survey, published in November 2016, found that 44% of employer respondents include musculoskeletal injuries, excluding back pain, in the top five most common causes of short-term absence, and 44% include it among their top five causes of long-term absence. More than a third of respondents, meanwhile, list back pain in the top five causes of short-term absence (34%) and long-term absence (35%).
Taking a proactive approach to musculoskeletal disorders (MSDs) can, therefore, help reduce sickness absence, as well as combat presenteeism, because employees with constant pain often struggle to concentrate, in turn, impacting productivity.
Martin Docherty, rehabilitation clinical governance manager at Aviva, says: “There is a recognition that we can’t simply treat [MSDs] as they arrive and we’ve got to get employees to be focusing on what they can do with their musculoskeletal health to reduce the risk of [MSDs] ever occurring in the first place.”
Louise Ward, policy and standards director at the British Safety Council, adds: “It’s all about getting in before something goes wrong. After somebody’s been hurt, then it’s too late."
Tackling the causes
Taking a proactive approach to managing MSDs in the workplace means tackling the root cause of problems. Dr Cathy Garner, director of partnership at The Work Foundation, says: “There needs to be an encouragement of attention to individuals’ wellbeing. They need to take breaks, they need to do the necessary stretches and things that can help to ensure that people are not straining their muscles, getting repetitive strain injury [or] back pain.”
Encouraging employees to be active within the workplace is vital, and warming up before completing manual work and doing stretches during the day ensures muscles are not overworked and that the body is not put under too much pressure.
Initiatives such as an on-site gym, masseuse or physiotherapist, and exercise programmes such as pilates, allow employees to engage with their health. Employers could also implement walking or standing meetings, regular health assessments, and encourage staff to take regular breaks.
Exercises can be done on the spot with very little space. For example, employees can use the time waiting for the kettle to boil when making tea to try exercises such as bouncing on the balls of their feet or squeezing their shoulder blades together. Employers can also download online fact sheets available from GPs or physiotherapists that feature exercises to help combat MSDs, which can be added to an organisation’s intranet site. Posters, leaflets and computer screensavers also act as useful methods of communication to demonstrate exercises or reminders about the benefits of exercise.
Vicki Leslie, client relationship manager at Electrical Contractors Insurance Services (ECIS), says: “These are things that are helping the musculoskeletal system stay strong rather than waiting until there is a problem.”
Employers can also provide access to occupational health, ergonomic specialists or physiotherapists, who can offer more personalised advice.
Organisations should also look to reinforce their mental health initiatives or consider implementing a mental health strategy. Mental ill health is a common co-condition to MSDs, because employees who are in constant pain could suffer from anxiety or depression, especially if they need to take time off because of the complaint. This can make returning to work feel like an uphill battle. Dr Zofia Bajorek, researcher at The Work Foundation, says: “If these conditions are long term, [the employee has] a greater likelihood to develop anxiety or depression alongside their back pain, so it’s not just looking at the physical nature of adjustments in the workplace, it’s looking at how we can adapt to improve their wellbeing: physical and mental.”
Staff training and awareness
Staff training and education about MSDs are included in an organisation’s delivery of compulsory health and safety requirements. This includes risk assessments and task evaluations that focus on an organisation’s specific working environment to form a training programme that tackles individual challenges found in that particular workplace.
Claire Herne, head of client services at FirstCare, says: “Depending on the job risk, [organisations] will have manual handling training, guidance and practices, and for office workers, they’ll have the [display screen equipment] and workstation assessments to make sure the workstation is set up appropriately.” Support aids suitable for desk stations includes ergonomic chairs, raised mouse mats and keyboards, and standing or moving desks.
Continually communicating initiatives and exercises aimed at proactively tackling MSDs will help employees know what to look for in terms of unsafe working conditions or movements, and an understanding of MSD symptoms to watch for.
When paired with an open working culture where employee health can be comfortably discussed, this enables staff to actively look after their own health at work, as well as support their colleagues' health.
It is important that senior management fully interacts and actively promotes musculoskeletal health measures, says Leslie. Employees will then feel that it is acceptable and recommended to fully engage in exercises and the available services that can protect their musculoskeletal health in the long term.
Proactive employers should also consider staff working outside the usual working environment. For example, if flexible-working policies are available, then it is important that employers also make staff aware of how they can protect themselves from MSD risks when working away from the office, says Aviva’s Docherty.
Employers that take a proactive approach to preventing MSDs within their workforce are not only safeguarding the health and wellbeing of employees but also supporting the business by reducing sickness absence and presenteeism.
Keyline adopts proactive approach to physical health to reduce employee back pain cases
Construction organisation Keyline takes a preventative approach to employee health and wellbeing to minimise the risks of musculoskeletal back pain, which can be exacerbated by physical and manual labour, as well as sedentary, desk-bound working.
The organisation, which has 1,200 employees across 65 sites in the UK, runs regular wellness sessions, which aim to encourage staff to get up from their desks at timely intervals and move around the office to lessen potential musculoskeletal disorder (MSD) risks. The organisation has also completed branch manager training, empowering senior leaders in the business to look after their teams’ wellbeing by informing them about healthy eating and hydration, and how they can support individuals in these areas. These measures act to help increase employee fitness and wellbeing, counteracting potential instances of back pain which was anecdotally found to be a persistant problem within the business.
Keyline also has measures in place to help prevent manual handling injuries and MSD-related back complaints that could arise among manual workers, who make up 75% of the working population. This includes instructing employees to complete a warm-up before heading outside to work in the yard in cold conditions, which helps to prevent pulled muscles. This would typically include static stretching.
The organisation has also introduced new mechanical working practices to lessen the physical lifting load on employees, using systems such as hydraulic grabs for forklifts and shrink-wrap machines to reduce the weight lifted by each employee, as well as decrease the amount of bending and twisting performed by staff.
Kieran Griffin, managing director at Keyline, says: “We can do all the manual handling training we like, but unless we start doing things differently, we’re just going to continue creating this legacy of back complaints in the business.”
Viewpoint: Consider psychosocial factors when addressing musculoskeletal disorder risks
Musculoskeletal disorders (MSDs), for example, back pain and arthritis, are very common and, alongside mental health conditions, cause most of the UK’s burden of sickness absence and long-term work disability.
Work factors can increase the risk of MSDs. Interestingly, it is not only physical workplace exposures such as heavy lifting, pushing and pulling, kneeling and squatting that are responsible, but also psychosocial factors. High levels of demands, such as tight deadlines, high pressure; low levels of control over work; and poor levels of support from managers and colleagues also need to be addressed if MSDs are to be prevented.
Investment in training managers about MSDs, what to look for and how to support employees will more than pay for itself. Flexibility of job demands and giving workers autonomy over their workload are key to MSD reduction.
Among desk-based workers, MSD risk relates to psychosocial factors or long periods of sedentary work in abnormally static postures. Employees need to be mobile regularly, engaging in varied activities to facilitate movement or taking ‘micro-breaks’. Regular stretching before and after work is helpful. Employees should feel comfortable standing in meetings and walking meetings can be popular.
Attention should be paid to workstation set-up to minimise prolonged periods with the neck flexed or rotated. Appropriate use of adjustable chairs, footrests, ergonomic mice and keyboards can be helpful too.
Employers should encourage and incentivise employees to maintain physical fitness and resilience by participating in regular physical activity, maintaining a healthy body weight, and avoiding excess alcohol and smoking.
Professor Karen Walker-Bone is director at Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work
