Work-Related Interventions to Reduce Work Disability Related to Musculoskeletal Disorders

  • Dwayne Van EerdEmail author
  • Peter Smith
Living reference work entry
Part of the Handbook Series in Occupational Health Sciences book series (HDBSOHS, volume 1)


Musculoskeletal disorders (MSD) cause considerable disability and lost productivity in many economic sectors worldwide. In fact, the most common MSD (low back pain and neck pain) rank as the first and fourth highest disability causes among noncommunicable diseases globally. Research has shown there is a strong link between work factors and MSD. The goal of this chapter is to provide an overview of work-related interventions designed to reduce the work disability burden resulting from MSD. The chapter also covers some emerging topics relevant to conducting research on MSD and work disability. The research findings described in this overview suggest that seven return-to-work principles created over a decade ago continue to be supported by the scientific literature. In particular there is consistent support for employers providing work accommodations and communication between healthcare providers and the workplace. However, there are more high-quality studies required as the available evidence regarding interventions to reduce the work disability caused by MSD is not strong. Emerging topics related to sex and gender, sitting and standing, and aging are important to MSD and work disability. The existing research evidence on these topics is equivocal; however, it is clear that workplaces must consider them in RTW and accommodation practices. More high-quality research, while challenging to conduct, would be beneficial contributing to positive workplace results.


Musculoskeletal disorders, Return to work Work disability Interventions Prognosis Sex and gender Aging 


  1. Aas RW, Tuntland H, Holte KA et al (2011) Workplace interventions for neck pain in workers. Cochrane Database Syst Rev (4):CD008160Google Scholar
  2. Alper BS, Haynes RB (2016) EBHC pyramid 5.0 for accessing preappraised evidence and guidance. Evid Based Med 21(4):123–125. Scholar
  3. Antle DM, Vezina N, Messing K et al (2013) Development of discomfort and vascular and muscular changes during a prolonged standing task. Occup Ergon 11(1):21–33CrossRefGoogle Scholar
  4. Armstrong P, Messing K (2014) Taking gender into account in occupational health research: continuing tensions. Policy Pract Health Saf 14:3–16CrossRefGoogle Scholar
  5. Baker RP, Coenen E, Howie J et al (2018) A detailed description of the short-term musculoskeletal and cognitive effects of prolonged standing for office computer work. Ergonomics 61:877–890CrossRefPubMedPubMedCentralGoogle Scholar
  6. Barone Gibbs B, Hergenroeder AL, Perdomo SJ et al (2018) Reducing sedentary behavior to decrease chronic low back pain: the stand back randomised trial. J Occup Environ Med 75:321–327CrossRefGoogle Scholar
  7. Barros C, Carnide F, Cunha L et al (2015) Will I be able to do my work at 60? An analysis of working conditions that hinder active ageing. Work 51(3):579–590CrossRefPubMedPubMedCentralGoogle Scholar
  8. Bos JT, Donders NCGM, Schouteten RLJ et al (2013) Age as a moderator in the relationship between work-related characteristics, job dissatisfaction and need for recovery. Ergonomics 56(6):992–1005CrossRefPubMedPubMedCentralGoogle Scholar
  9. Briggs AM, Dreinhofer KE (2017) Rehabilitation 2030: a call to action relevant to improving musculoskeletal health care globally. J Orthop Sports Phys Ther 47(5):297–300. Scholar
  10. Briggs AM, Woolf AD, Dreinhöfer K et al (2018) Reducing the global burden of musculoskeletal conditions. Bull World Health Organ 96(5):366–368. Scholar
  11. Buchbinder R, Blyth FM, March LM et al (2013) Placing the global burden of low back pain in context. Best Pract Res Clin Rheumatol 27(5):575–589. Scholar
  12. Buckley JP, Hedge A, Yates T et al (2015) The sedentary office: an expert statement on the growing case for change towards better health and productivity. Br J Sports Med 49(21):1357–1362CrossRefPubMedPubMedCentralGoogle Scholar
  13. Callaghan JP, De Carvalho D, Gallagher K et al (2015) Is standing the solution to sedentary office work. Ergon Des 23(3):20–24Google Scholar
  14. Campbell P, Wynne-Jones G, Muller S et al (2013) The influence of employment social support for risk and prognosis in nonspecific back pain: a systematic review and critical synthesis. Int Arch Occup Environ Health 86(2):119–137CrossRefPubMedPubMedCentralGoogle Scholar
  15. Cancelliere C, Donovan J, Stochkendahl MJ et al (2016) Factors affecting return to work after injury or illness: best evidence synthesis of systematic reviews. Chiropr Man Ther 24(1):32CrossRefGoogle Scholar
  16. Carroll C, Rick J, Pilgrim H et al (2010) Workplace involvement improves return to work rates among employees with back pain on long-term sick leave: a systematic review of the effectiveness and cost-effectiveness of interventions. Disabil Rehabil 32(8):607–621CrossRefPubMedPubMedCentralGoogle Scholar
  17. Clendon J, Walker L (2016) The juxtaposition of ageing and nursing: the challenges and enablers of continuing to work in the latter stages of a nursing career. J Adv Nurs 72(5):1065–1074. Scholar
  18. Coenen P, Willenberg L, Parry S et al (2017) Associations of occupational standing with musculoskeletal symptoms: a systematic review with meta-analysis. Br J Sports Med 52(3):176–183CrossRefGoogle Scholar
  19. Cote JN (2012) A critical review on physical factors and functional characteristics that may explain a sex/gender difference in work-related neck/shoulder disorders. Ergonomics 55:173–182CrossRefPubMedPubMedCentralGoogle Scholar
  20. Cote D, Coutu MF (2010) A critical review of gender issues in understanding prolonged disability related to musculoskeletal pain: how are they relevant to rehabilitation? Disabil Rehabil 32:87–102CrossRefPubMedPubMedCentralGoogle Scholar
  21. Cullen KL, Irvin E, Collie A et al (2018) Effectiveness of workplace interventions in return-to-work for musculoskeletal, pain-related and mental health conditions: an update of the evidence and messages for practitioners. J Occup Rehabil 28(1):1–15CrossRefPubMedPubMedCentralGoogle Scholar
  22. Duffield SJ, Ellis BM, Goodson N et al (2017) The contribution of musculoskeletal disorders in multimorbidity: implications for practice and policy. Best Pract Res Clin Rheumatol 31(2):129–144. Scholar
  23. Fillingham RB, Edwards RR, Powell T (1999) The relationship of sex and clinical pain to experimental pain responses. Pain 83:419–425CrossRefGoogle Scholar
  24. Franche RL, Cullen K, Clarke J et al (2005) Workplace-based return-to-work interventions: a systematic review of the quantitative literature. J Occup Rehabil 15(4):607–631CrossRefPubMedPubMedCentralGoogle Scholar
  25. Frot M, Feine JS, Buchnell MC (2004) Sex differences in pain perception and anxiety. A psychophysical study with topical capsaicin. Pain 108:230–246CrossRefPubMedPubMedCentralGoogle Scholar
  26. GBD 2017 Disease and Injury Incidence and Prevalence Collaborators (2018) Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 392:1789–1858CrossRefGoogle Scholar
  27. Gensby U, Labriola M, Irvin E et al (2014) A classification of components of workplace disability management programs: results from a systematic review. J Occup Rehabil 24(2):220–241.
  28. Gonzalez I, Morer P (2016) Ergonomics for the inclusion of older workers in the knowledge workforce and a guidance tool for designers. Appl Ergon 53(Pt A):131–142CrossRefPubMedPubMedCentralGoogle Scholar
  29. Guest M, Boggess MM, Viljoen DA et al (2014) Age-related injury and compensation claim rates in heavy industry. Occup Med 64(2):95–103CrossRefGoogle Scholar
  30. Hagberg M, Silverstein B, Wells R et al (1995) Work related musculoskeletal disorders (WMSDs): a reference book for prevention. Taylor & Francis, LondonGoogle Scholar
  31. Haldeman S, Nordin M, Chou R et al (2018) The Global Spine Care Initiative: World Spine Care executive summary on reducing spine-related disability in low- and middle-income communities. Eur Spine J 27(Suppl 6):776–785. Scholar
  32. Holtermann A, Mathiassen SE, Straker L (2018) Promoting health and physical capacity during productive work: the Goldilocks Principle. Scand J Work Environ Health 45:90. Scholar
  33. Hoy D, Geere JA, Davatchi F et al (2014) A time for action: opportunities for preventing the growing burden and disability from musculoskeletal conditions in low- and middle-income countries. Best Pract Res Clin Rheumatol 28(3):377–393. Scholar
  34. Hughes SL, Seymour RB, Campbell RT et al (2011) Comparison of two health-promotion programs for older workers. Am J Public Health 101(5):883–890. Scholar
  35. Human Resources & Skills Development Canada (2011) National occupational classification career handbook. Government of Canada, OttawaGoogle Scholar
  36. Hurwitz EL, Randhawa K, Torres P et al (2018) The Global Spine Care Initiative: a systematic review of individual and community-based burden of spinal disorders in rural populations in low- and middle-income communities. Eur Spine J 27(Suppl 6):802–815. Scholar
  37. Institute for Work & Health (2008) Seven ‘principles’ for successful return to work. Institute for Work & Health, TorontoGoogle Scholar
  38. Institute for Work & Health (2017) Seven “principles” used in return-to-work policies and practices. IWH case impact study. Available via Accessed 10 Oct 2018
  39. Irvin E, Van Eerd D, Amick BC et al (2010) Introduction to special section: systematic reviews for prevention and management of musculoskeletal disorders. J Occup Rehabil 20(2):123–126CrossRefGoogle Scholar
  40. Johnson CD, Haldeman S, Chou R et al (2018) The Global Spine Care Initiative: model of care and implementation. Eur Spine J 27(Suppl 6):925–945. Scholar
  41. Koolhaas W, Groothoff JW, de Boer MR et al (2015) Effectiveness of a problem-solving based intervention to prolong the working life of ageing workers. BMC Public Health 15:76. Scholar
  42. Korshoj M, Jorgensen MB, Hallman DM et al (2018) Prolonged sitting at work is associated with a favorable time course of low-back pain among blue-collar workers: a prospective study in the DPhacto cohort. Scand J Work Environ Health 44:530–538CrossRefPubMedPubMedCentralGoogle Scholar
  43. Kristensen TS (2005) Intervention studies in occupational epidemiology. Occup Environ Med 62:205–210CrossRefPubMedPubMedCentralGoogle Scholar
  44. Laisne F, Lecomte C, Corbiere M (2012) Biopsychosocial predictors of prognosis in musculoskeletal disorders: a systematic review of the literature. Disabil Rehabil 34:355–382CrossRefPubMedPubMedCentralGoogle Scholar
  45. Le P, Marras WS (2016) Evaluating the low back biomechanics of three different office workstations: seated, standing, and perching. Appl Ergon 56:170–178CrossRefPubMedPubMedCentralGoogle Scholar
  46. Loisel P, Gosselin L, Durand P et al (2001) Implementation of a participatory ergonomics program in the rehabilitation of workers suffering from subacute back pain. Appl Ergon 32(1):53–60CrossRefPubMedPubMedCentralGoogle Scholar
  47. MacEachen E, Clarke J, Franche RL et al (2006) Systematic review of the qualitative literature on return to work after injury. Scand J Work Environ Health 32:257–269CrossRefPubMedPubMedCentralGoogle Scholar
  48. Makkonen M, Silvennoinen M, Nousiainen T (2017) To sit or to stand, that is the question: examining the effects of work posture change on the well-being at work of software professionals. Int J Networking Virtual Organ 17:371–391CrossRefGoogle Scholar
  49. Martel L, Malenfant EC, Morency JD et al (2012) Projected trends to 2031 for the Canadian labour force. Statistics Canada, Ottawa. Available via: Accessed 22 Nov 2018
  50. McMaster University (2016) Resources for evidence-based practice: the 6S pyramid. Accessed 10 Oct 2018
  51. Monteiro MS, Alexandre NMC, Ilmarinen J et al (2009) Work ability and musculoskeletal disorders among workers from a public health institution. Int J Occup Saf Ergon 15(3):319–324CrossRefPubMedPubMedCentralGoogle Scholar
  52. Murad MH, Asi N, Alsawas M et al (2016) New evidence pyramid. Evid Based Med 21(4):125–127CrossRefPubMedPubMedCentralGoogle Scholar
  53. National Research Council (2001) Musculoskeletal disorders in the workplace: low back and upper extremities. National Academic Press, Washington, DCGoogle Scholar
  54. Neumann WP, Eklund J, Hansson B et al (2010) Effect assessment in work environment interventions: a methodological reflection. Ergonomics 53(1):130–137. Scholar
  55. Palmer KT, Harris EC, Linaker C (2012) Effectiveness of community- and workplace-based interventions to manage musculoskeletal-related sickness absence and job loss: a systematic review. Rheumatology (Oxford) 51(2):230–242CrossRefGoogle Scholar
  56. Pitt-Catsouphes M, James JB, Matz-Costa C (2015) Workplace-based health and wellness programs: the intersection of aging, work, and health. Gerontologist 55(2):262–270. Scholar
  57. Pransky GS, Benjamin KL, Savageau JA et al (2005) Outcomes in work-related injuries: a comparison of older and younger workers. Am J Ind Med 47(2):104–112CrossRefPubMedPubMedCentralGoogle Scholar
  58. Riethmeister V, Brouwer S, van der Klink J et al (2016) Work, eat and sleep: towards a healthy ageing at work program offshore. BMC Public Health 16(1):134CrossRefPubMedPubMedCentralGoogle Scholar
  59. Rivilis I, Van Eerd D, Cullen K et al (2008) Effectiveness of participatory ergonomic interventions on health outcomes: a systematic review. Appl Ergon 39(3):342–358CrossRefPubMedPubMedCentralGoogle Scholar
  60. Sackett DL, Rosenberg WM, Gray JA et al (1996) Evidence based medicine: what it is and what it isn’t. BMJ 312(7023):71CrossRefPubMedPubMedCentralGoogle Scholar
  61. Schneider E, Irastorza X (2010) OSH in figures: work-related musculoskeletal disorders in the EU – facts and figures. European Agency for Safety and Health at Work (EU-OSHA), LuxembourgGoogle Scholar
  62. Settersten RA, Mayer KU (1997) The measurement of age, age structuring, and the life course. Annu Rev Sociol 23:233–261CrossRefGoogle Scholar
  63. Silverstein B, Evanoff B (2011) Musculoskeletal disorders. In: Levy BS, Wegman DH, Baron SL et al (eds) Occupational and environmental health: recognizing and preventing disease and injury. Oxford University Press, New York, pp 335–365Google Scholar
  64. Smith PM, Berecki-Gisolf J (2014) Age, occupational demands and the risk of serious work injury. Occup Med 64(8):571–576. Scholar
  65. Smith PM, Bielecky A, Mustard CA et al (2013) The relationship between age and work injury in British Columbia: examining differences across time and nature of injury. J Occup Health 55(2):98–107CrossRefPubMedPubMedCentralGoogle Scholar
  66. Smith P, Chen C, Mustard C et al (2014a) Examining the relationship between chronic conditions, multi-morbidity and labour market participation in Canada: 2000 to 2005. Ageing Soc 34(10):1730–1748CrossRefGoogle Scholar
  67. Smith P, Bielecky A, Ibrahim S et al (2014b) Impact of pre-existing chronic conditions on age differences in sickness absence after a musculoskeletal work injury: a path analysis approach. Scand J Work Environ Health 40(2):167–175. Scholar
  68. Smith P, Bielecky A, Ibrahim S et al (2014c) How much do pre-existing chronic conditions contribute to age differences in health care expenditures following a work-related musculoskeletal injury? Med Care 52:71–77CrossRefPubMedPubMedCentralGoogle Scholar
  69. Smith P, Ma H, Gilbert-Ouimet M et al (2018) The relationship between occupational standing and sitting and incident heart disease over a 12-year period in Ontario, Canada. Am J Epidemiol 187(1):27–33CrossRefPubMedPubMedCentralGoogle Scholar
  70. Statistics Canada (2010) Estimates of population, by age group and sex for July 1, Canada, provinces and territories, annual (CANSIM Table 051-0001). Statistics Canada, OttawaGoogle Scholar
  71. Stedmon AW, Howells H, Wilson JR et al (2012) Ergonomics/human factors needs of an ageing workforce in the manufacturing sector. Health Promot Perspect 2(2):112–125Google Scholar
  72. Sterns HL, Doverspike D (1989) Aging and the retraining and learning process in organisations. In: Goldstein I, Katze R (eds) Training and development in work organizations. Jossey-Bass, San Francisco, pp 299–332Google Scholar
  73. Strazdins L, Bammer G (2004) Women, work and musculoskeletal health. Soc Sci Med 58:997–1005CrossRefPubMedPubMedCentralGoogle Scholar
  74. Tornqvist EW, Hagberg M, Hagman M et al (2009) The influence of working conditions and individual factors on the incidence of neck and upper limb symptoms among professional computer users. Int Arch Occup Environ Health 82(6):689–702CrossRefPubMedPubMedCentralGoogle Scholar
  75. UN (2012) Ageing in the twenty-first century: a celebration and a challenge. United Nations Population Fund (UNFPA)/HelpAge International, New York/LondonGoogle Scholar
  76. Van Eerd D, Cole DC, Steenstra IA (2016) Chapter 16: participatory ergonomics for return to work. In: Schultz IZ, Gatchel RJ (eds) Handbook of return to work: from research to practice. Springer, New York, pp 289–305CrossRefGoogle Scholar
  77. van Vilsteren M, van Oostrom SH, de Vet HC et al (2015) Workplace interventions to prevent work disability in workers on sick leave. Cochrane Database Syst Rev (10):CD006955Google Scholar
  78. Vargas-Prada S, Demou E, Lalloo D et al (2016) Effectiveness of very early workplace interventions to reduce sickness absence: a systematic review of the literature and meta-analysis. Scand J Work Environ Health 42(4):261–272CrossRefPubMedPubMedCentralGoogle Scholar
  79. Verkerk K, Luijsterburg PA, Miedema HS et al (2012) Prognostic factors for recovery in chronic nonspecific low back pain: asystematic review. Phys Ther 92(9):1093–1108CrossRefPubMedPubMedCentralGoogle Scholar
  80. Vogel N, Schandelmaier S, Zumbrunn T et al (2017) Return-to-work coordination programmes for improving return to work in workers on sick leave. Cochrane Database Syst Rev (3):CD011618Google Scholar
  81. Vos T, Flaxman AD, Naghavi M et al (2012) Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380(9859):2163–2196CrossRefPubMedPubMedCentralGoogle Scholar
  82. Wells R, Van Eerd D, Hagg G (2004) Mechanical exposure concepts using force as the agent. Scand J Work Environ Health 30(3):179–190CrossRefPubMedPubMedCentralGoogle Scholar
  83. Whalin C, Ekberg K, Persson J et al (2013) Evaluation of self-reported work ability and usefulness of interventions among sick-listed patients. J Occup Rehabil 23(1):32–43CrossRefGoogle Scholar
  84. Williams-Whitt K, Bültmann U, Amick B 3rd et al (2016) Workplace interventions to prevent disability from both the scientific and practice perspectives: a comparison of scientific literature, grey literature and stakeholder observations. J Occup Rehabil 26(4):417–433CrossRefPubMedPubMedCentralGoogle Scholar
  85. Workers Compensation Board of Manitoba (2014) Manitoba workplace injury and illness statistics 2000–2013. Workers Compensation Board of Manitoba, Winnipeg. Available from
  86. Workers Compensation Board of Nova Scotia (2013) Workers’ Compensation Board of Nova Scotia 2013 Annual Report. Workers’ Compensation Board of Nova Scotia, HalifaxGoogle Scholar
  87. Workplace Safety and Insurance Board (WSIB) (2013) By the numbers: 2013 WSIB statistical report (schedule 1). Workplace Safety and Insurance Board (WSIB), TorontoGoogle Scholar
  88. WorkSafeBC (2013) WorkSafeBC 2013 statistics. Vancouver: WorkSafeBCGoogle Scholar
  89. World Health Organisation (2003) Preventing musculoskeletal disorders in the workplace. In: Protecting workers’ health series. World Health Organisation, GenevaGoogle Scholar
  90. World Health Organization (2015) World report on ageing and health WHO press. World Health Organization, GenevaGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Institute for Work & HealthTorontoCanada

Personalised recommendations