Tackling Work-related Musculo-Skeletal Disorders (WMSDs)

Work-related musculoskeletal disorders (WMSDs) are a group of painful disorders of muscles, tendons, and nerves such as tendonitis and tension neck syndrome (Canadian Centre for Occupational Health and Safety) associated to work posture and movements.

A range of workplace interventions and policies in place across Europe and abroad are aimed at facilitating disease management and reintegration into the workplace. What works best?

Workplace interventions:

  • It is important for patients to stay active and return to ordinary activities as quickly as possible
  • Low back disability: the risk of experiencing back pain maybe greater among blue-collar workers (while construction workers showed a longer duration of disability)
  • Work-related factors include not only physical aspects but also relationship with co-workers and supervisors, psychosocial stress, and employer’s response to injury
  • A combination of multiple intervention approaches (involving work modifications, exercise therapy, behavioural treatment, psychosocial interventions) prove more effective than single elements alone, but more challenging in terms of assessing cost-effectiveness
  • Evidence for the effectiveness of interventions is derived mainly from the evaluation of medical treatment. A wider range of criteria should be evaluated by policy-makers and employers.

Policy initiatives:

Most policies in place focus on integrating into the workforce people with disabilities who are not employed, rather than on retaining and rehabilitating workers who have developed the disease at work.

Legislation on return-to-work still varies widely from one European country to another. An overview of main advantages and disadvantages include:



Emphasis on early recognition of problems  and on returning employees to work as quickly as possible

More effort needed to provide help not only to severe cases but also to people who could return to work with little help or minor adjustments to their jobs

Focus on comprehensive care including medical, occupation and social rehabilitation, multidisciplinary approach and collaboration among treating physician, occupational physician and insurance fund’s medical advisor

The dual social health insurance system that exists in many states (strictly separating work and  social insurance) may hamper stronger collaboration

Introduction of financial incentives for employers (ie funding for work adaptations and improving workplace conditions)

Adversarial legal systems impact on employers and employees efforts to address and reintegrate at work