ABC of Occupational and Environmental Medicine, 3rd Edition Musculoskeletal Disorders

• Musculoskeletal symptoms are very common, with lifetime prevalence rates of 75% or more for problems such as low back pain. Causes are frequently assumed, but are actually unpredictable and largely unknown. This makes outright prevention unfeasible.
• Explanations and diagnostic labels can negatively influence responses to symptoms,. Care needs to be taken to reassure and emphasise the benefits of maintaining participation, and avoiding prolonged rest and inactivity.
• Clinical management should aim at symptomatic relief with maintenance of activity and work. Most interventions exhibit only weak to moderate treatment effects, and combining or repeating them does not seem to enhance effectiveness.
• Effective occupational management depends on communication and coordination between the key players, with optimal intervention being a combination of work-focused healthcare and accommodating workplaces.
• Psychosocial issues contribute most strongly to absence from work. These obstacles can be identified in three main areas: the person, their workplace, and the everyday context in which they function. Actively tackling obstacles results in improved outcomes.