When considering workplace injuries, it’s human nature to think about the “big” hazards on a worksite, such as accidents involving equipment, falls from elevated locations, or serious injuries caused by faulty or improperly used tools. Few people automatically think about a less-obvious cause of injury, even though it accounts for a large share of medical costs, as much as a third of workers’ compensation claims, and – just as concerning in a time of worker shortages – a significant amount of lost time. What’s more, this cause is largely preventable.
What are known as musculoskeletal disorders (MSDs) reportedly rack up $20 billion in annual direct costs for employers, and adding indirect costs such as lost productivity may easily drive that number to more than $50 billion. These disorders create chronic pain and suffering for workers, often resulting in long-term or permanent disability or impaired quality of life. The Bureau of Labor Statistics reports they accounted for more than 55 percent of work-related emergency room visits in 2019. Recovery from MSDs takes longer than other injuries and illnesses, too – accounting for 38 percent more lost time.
What are MSDs?
Work-related MSDs encompass a lengthy list of injuries to muscles, bones, tendons, joints, ligaments, cartilage, nerves, and even blood vessels that are triggered or aggravated by tasks performed in the workplace. They normally occur over time as stresses to those elements of the musculoskeletal system exceed the body’s ability to recover. Activities such as lifting, pushing, and repetitive motions can create excessive stresses leading to damage. While carpal tunnel syndrome is one of the best-known examples, it’s only one of many types of MSDs occurring in workplaces.
With muscles. When muscles contract as we perform tasks, they access energy from sugars and release lactic acid and other chemicals. Normally, our blood washes those potentially harmful chemicals away from the muscle tissue, but when a contraction is prolonged, it can interfere with the blood flow through the muscle. Lactic acid and other substances that aren’t cleared away then begin to accumulate in muscle tissue, leading to irritation and pain.
In tendons. Our tendons connect our muscles to our bones. Some tendons, like those in our wrists and hands, are protected by sheaths. Similar to tubes, the sheaths naturally generate fluid that keeps the tendons lubricated, allowing for easier movement. Excess or repetitive movements of a tendon can interfere with that lubrication, leading to inflammation, swelling, and pain. Other tendons, such as those in our forearms, elbows, and shoulders, are made of fibers that can be torn by too much stress or become thick and irregular. Where tendons move through constricted areas, sacs known as bursa manufacture similar lubricating fluid. If the tendon becomes too thick, it can irritate the bursa, causing the painful condition we now as bursitis.
Around nerves. Our nerves are also a common location for MSDs. We count on our body’s network of nerves to deliver the brain’s commands to muscles, and to relay important information back to the brain – for example, when we touch something that’s too hot. The thin nerves wind around our muscles and tendons, and as those systems stretch and swell from stress, being used in odd positions, or performing repetitive actions, the nerves can be squeezed. In addition to causing pain, the pressure on the nerves can begin to interfere with the function of the muscles.
From healthy to painful
As we noted earlier, if muscles and the like are given adequate opportunities for recovery after a stress, they can generally repair themselves. Unfortunately, the nature of work means people often subject their musculoskeletal systems to frequent or continuous stresses through the workday. The more we experience those stresses without sufficient recovery, the more lasting the damage becomes.
We’ve taken a brief look at the physiology behind MSDs. To better understand how that physiology is affected by workplace activities, let’s examine some of the common stress factors that are involved.
Most often, MSDs are the result of common everyday activities – the kinds of things we perform daily without ever thinking about it, like lifting objects, grabbing others, bending over to tie our shoes, or reaching for something from a high shelf. When we do those things, sometimes we know we’ve stretched too far or lifted too much, because our bodies immediately let us know by making us feel discomfort or outright pain.
So why do those everyday activities become harmful in the workplace? There are several reasons, with repetition being of the most common. Lift a 50-pound bag of dog food once, and you’ll probably feel some strain that passes fairly quickly as your body undoes the damage. Now lift that same weight 30 times an hour for an 8-hour shift, and see how you feel. Besides repetition, other aspects of the workplace contributing to the development of MSDs includes continually putting intense force on specific musculoskeletal systems, like having to turn a screwdriver the same way for hours on end, or having your body positioned in an awkward way for a long time. None of those acts is inherently dangerous, but they don’t give your body the all-important opportunity to recover.
Not just heavy work
It’s important for employers to remember MSDs aren’t limited to “industrial” or heavily physical activities such as construction or manufacturing. Even people who work behind desks can develop MSDs if their bodies are subjected to excessive or repetitive stress. An assembly line worker who performs the same manual task hour after hour can easily end up with an MSD, even if the task requires little physical effort. Those MSDs can have a significant effect on the worker’s quality of life and can be just as costly as other injuries when they rise to the level of a worker’ comp claim.
Usually, a slow progression
MSDs are particularly insidious because they sneak up on people over time. Perform an identical task all day, every day, for a month, and you may notice a little discomfort. Do it for ten years, and you may develop an MSD. By the time workers are in enough pain to take action, the damage is already done.
Most often, workers who are in the early stages of MSDs notice irritating symptoms such as minor body aches, tightness, or tingling, but those symptoms tend to subside with rest. They may have been hurting when they came home from work Friday, but by Monday morning, they assume they’re back to 100 percent.
As damage to the body accumulates, workers may notice they’re sore more of the time. Discomfort that once took hours to appear starts showing up earlier in their shift. They go to bed feeling sore and aren’t much better when they wake up. Over-the-counter pain relievers like ibuprofen and naproxen become part of their daily diet. Eventually, they find it difficult to perform their daily work because of the pain and their sleep begins to suffer. That’s when they finally end up visiting a doctor or chiropractor.
Prevention: the best medicine
A better way to address MSDs in the workplace is to keep them from happening in the first place — and the best way to do that is a comprehensive prevention process that’s a central element of your company’s commitment to health and safety.
We’ll explore specific strategies in a moment, but first, it’s important to mention the three overarching areas your process should address:
- Your process must examine the conditions under which workers perform tasks so you can eliminate, engineer, or mitigate the risks of MSDs.
- Workers and supervisors need to develop an understanding of how MSDs occur and what they can do to protect themselves and others.
- You need to establish a plan of action for when workers begin to experience symptoms of MSDs, so you can prevent further damage and facilitate recovery.
Effective prevention strategies
There are many ways employers can address MSD prevention long before workers experience serious damage or discomfort.
- Reengineering tasks. If the nature of a task contributes to MSDs, look for ways to reduce the risk through engineering, which can involve anything from automation to simply changing the why the workplace is designed. Something as simple as a different kind of chair or changing the height of the work surface often pays big dividends.
- Replace tools. Better tools or other equipment may be available to perform specific tasks, reducing the physical stresses workers experience.
- Rethink workflow. Instead of expecting a worker to perform the same task throughout a shift, look for ways to rotate tasks among multiple workers so each gets time to recover. Another approach is to divide tasks so no single worker handles all the potentially detrimental work. In addition to reducing physical fatigue, job changes like these can help with morale.
- Better practices. Sometimes, you can’t eliminate or engineer the risks out of tasks. That’s when you may consider training workers in ways they can perform the task with less exposure to physical damage – whether that involves lifting differently or changing their stance while performing the task.
- Prioritize prevention. Educate everyone about how MSDs occur and the role they can play in preventing and recognizing them, so they can help with early intervention.
The human body is an amazing machine that’s adept at repairing itself. A comprehensive program to address MSDs will help the body do what it’s designed to do, so workers aren’t forced to suffer or seek medical help. That will save employers time and money, and allow workers to enjoy a better quality of life.
SMG offers an array of safety training that ranges from injury prevention classes to OSHA 10-hour and 30-hour training. Contact us today to learn more.