Work-related Musculoskeletal Disorders – A brief overview

Musculoskeletal disorders refers to health problems of the locomotor apparatus. This refers to the muscles, skeletons, and tendons [1]. The severity of MSDs can vary and in some cases, they cause pain and discomfort that interfere with everyday activities [2]. Early diagnosis and treatment may help ease symptoms and improve long-term outlook [2]. Some of the symptoms of MSDs can include recurrent pain, stiff joints, swelling or dull aches [2].

Musculoskeletal conditions comprise more than 150 conditions that affect the locomotor system [2]. These “range from those that arise suddenly and are short-lived, such as fractures, sprains, and strains, to lifelong conditions associated with ongoing functioning limitations and disability” [2]. These conditions are typically characterized by pain (often persistent) and limitations in mobility, dexterity, and overall level of functioning, reducing people’s ability to work [3].

The World Health Organization (WHO) has characterized work-related musculoskeletal disorder is multifactorial [4]. This indicates that a number of risk factors contribute to and exacerbate these conditions. Despite the efforts to control WMSD, these sets of disorders account for a huge amount of human suffering due to worker impairment, often leading to either permanent, partial or total disability [4].

Furthermore, the strong correlation between the incidence of WMSD and the working conditions are well known, particularly the physical risk factors associated with jobs and other psychosocial factors that increasingly contribute to the onset of those disorders [4]. As stated by WHO, this condition is attributed by a multifactorial etiology, meaning it is a consequence of the worker's exposure to a number of work-related risk factors [4].

Three sets of risk factors can be considered:

• Physical factors - e.g., high-intensity forces, long exposure durations, strong and prolonged muscular strains, sustained or awkward postures, high repetition of the same movements, forceful exertions, hand-arm vibration, all-body vibration, mechanical compression, and cold [4]

• Psychosocial risk factors- these are related to work content (the workload, work control, and work clarity), interpersonal relationships at work (supervisor-worker relations) and financial/economic aspects (salary, benefits, and equity), and social (prestige and status in society). Psychosocial factors cannot be seen as risk factors that, by themselves, led to the development of WMSDs [4].

• Individual factors - e.g., age, gender, professional activities, sports activities, domestic activities, recreational activities, alcohol/tobacco consumption and, previous WMSD [4].

Some major identified work-related Musculoskeletal disorders include [4][5]:

1. Tension Neck Syndrome

2. Back Injuries

3. Carpal Tunnel Syndrome

4. Tendonitis

5. Tenosynovitis

6. Intersection Syndrome and deQuervain’s Syndrome

7. Trigger Finger

8. Ischemia

9. Vibration Syndrome

10. Thoracic Outlet Syndrome

11. Ganglion Cysts

Factors to be considered in prevention include [1]:

• Follow the principle of ergonomics- create an appropriate balance between the requirements of work and the capacity of the working person.

• Work performance strategies- motivating and educating workers methods of performing work that does not result in strain.

• Avoid accidents and injuries

• Promote healthy workplace

In summary, disorders of the musculoskeletal system are a major cause of absence from work, which therefore lead to a considerable cost for the public health system. WMSD arises when the mechanical workload is higher than the load-bearing capacity of the individual's musculoskeletal system (bone, tendons, muscles, skeletons, etc.). Hence, a reduction in the mechanical loading on the musculoskeletal system during the performance of occupational work is an important measure in the prevention of WMSD. Prevention of WMSDs can be achieved by engineering controls and appropriate organization arrangements. Therefore, the World Health Organization launched the Rehabilitation 2030 initiative in 2017 to draw attention to the profound unmet need for rehabilitation worldwide, and highlight the importance of strengthening health systems to provide rehabilitation [3]

1. Protecting Health Workers. Health Series No 5. Alwin Luttman et al. Preventing musculoskeletal disorders in the workplace. 4-36. 2003

2. Healthline. Kristeen Cherney. Musculoskeletal Disorders. 2018. Available at: https://www.healthline.com/health/musculoskeletal-disorders

3. World Health Organization. Musculoskeletal conditions. 2021. Available at: https://www.who.int/news-room/fact-sheets/detail/musculoskeletal-conditions

4. Isabel L. Nunes and Pamela McCauley Bush. Work-Related Musculoskeletal Disorders Assessment and Prevention. 1-17. 2012

5. McCauley Bush, P. Ergonomics: Foundational Principles, Applications and Technologies, an Ergonomics Textbook; CRC Press, Taylor & Francis, Boca Raton, FL. 2011.