Musculoskeletal (MSK) Overview

Musculoskeletal (MSK) is a term used to refer to a range of conditions which affect bones, muscles and joints, often as a result of repetitive overuse of the parts of the body in question. Musculoskeletal conditions mostly affect the upper body (elbows, wrists, hands, neck, shoulders and lower back) as well as the lower body (knees, ankles, legs and feet). A commonly known example of an MSK condition is arthritis. About 25% of the UK adult population have a musculoskeletal condition and more years are lived with an MSK condition than any other in the UK.

What are the signs and symptoms of musculoskeletal conditions?

Musculoskeletal conditions are characterised by pain in the body, of various natures. These conditions develop over time and are linked to certain types of use. In the case of upper limb MSK disorders, repetitive strain injury from using computer screens and also vibrating tools is common. Back and lower limb MSK conditions are associated with squatting, heavy lifting and kneeling for extended periods.

 The types of (pain) sensation associated with musculoskeletal conditions include:

  • Aching and tenderness
  • Stiffness
  • Throbbing
  • Cramping
  • Tingling and numbness

Without treatment, musculoskeletal conditions may cause swelling in the part of the body suffering from overuse and the pain may become constant.

Common MSK conditions include:

How are musculoskeletal conditions diagnosed and treated?

The first stage in treating musculoskeletal conditions is to alter the tasks and activities which are causing the symptoms. This includes avoiding situations which may exacerbate the condition, such as using vibrating equipment, working in cold temperatures and stress.

A GP may suggest taking painkillers such as paracetamol or ibuprofen, or using heat packs or supports for wrists, hands, etc.

Physiotherapy can also help someone with an MSK condition manage it, advising them how to improve posture, strengthen and relax muscles affected by symptoms.

Prevention is generally preferable to treating musculoskeletal conditions once they develop. This can be achieved by sitting at a desk with good posture and taking breaks from lengthy, repetitive tasks. A Display Screen Equipment (DSE) Assessment can help to reduce the likelihood of musculoskeletal issues occurring. 

In the case of bunions, a prevention method would be to wear comfortable shoes which can mould to your feet. 

For gout, a doctor might recommend lifestyle changes such as losing weight and reducing consumption of alcohol and red meat, which contribute to the excess of uric acid in the blood which, in turn, causes gout.

Scoliosis is an example of a more complex MSK condition, which cannot be treated or prevented as easily. It can be caused by a decrease in bone density in the spine – which calcium and vitamin D consumption can aid with – but it is often difficult to identify a cause. Treatment can involve a back brace or, in more severe cases, surgery to correct the curvature of the spine.

There are a few ways to confirm what sort of reasonable adjustments should be made for an employee with a musculoskeletal condition:

An employer can ask questions regarding the nature of an employee’s musculoskeletal conditions and what extra support they may need can be broached sensitively. For example:

  • Have they required adjustments in the past? For example, avoiding certain types of manual tasks which might exacerbate their symptoms.
  • Encouraging the employee to express their strengths and interests and which tasks they might enjoy doing is a positive way of adapting to their needs.
  • Employers should be aware of the risk factors for musculoskeletal conditions in their workplace and encourage all employees to inform them of symptoms as soon as they start to develop.
  • Completing a DSE assessment and ensuring all equipment, desk and seating facilities are appropriate for their particular needs. 

What reasonable adjustments are possible for employees with musculoskeletal conditions?

Employers have a legal duty to make reasonable adjustments for employees with musculoskeletal conditions if they know, are aware of, or could ‘reasonably be expected to know’ that the employee has a musculoskeletal condition. Most employees will tell their employer what reasonable adjustments they need. They often involve simple changes in the way an employer might usually do things.

If the employee does not disclose a health issue or disability which may affect their performance upfront, an employer should broach the subject sensitively if they suspect that there may be a disability behind the employee’s reduced performance. Reasonable adjustments can then be made in accordance with the employee’s needs, including, in the case of musculoskeletal conditions:

  • Flexible return-to-work policy to accommodate an employee who may need to take time off as a result of their musculoskeletal conditions.
  • Allowance for regular breaks to reduce the impact on parts of the body susceptible to musculoskeletal conditions, including time to break if the employee is taking pain medication for their condition which may affect their concentration, etc.
  • Adjustments to duties depending on the severity of their symptoms, which may be variable and improve or deteriorate from one week to the next. This may also be dependent on when they take their medication if they are required to operate machinery, for example.
  • Raising awareness so that colleagues understand the employee’s musculoskeletal conditions and are aware of what they can do to avoid developing musculoskeletal conditions themselves.
  • Ergonomic equipment to reduce pressure on the back, neck, forearms, wrists and other susceptible parts of the body while sitting at a desk. Guidance should also be made available on posture tips so that workstations are as optimised for preventing musculoskeletal conditions as possible.

Musculoskeletal conditions Signposting  

Arthritis and Musculoskeletal Alliance – an umbrella organisation uniting patient and professional groups to provide the best care for people with existing conditions, as well as to raise awareness about the conditions in the general public (0203 856 1978).

MSK Knowledge Hub – a partnership between the Arthritis and Musculoskeletal Alliance and NHS England to bring information to people about MSK conditions. It is a database of searchable articles to inform the support of people with MSK conditions, as well as the people themselves.

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