Musculoskeletal disorders (MSDs) – an umbrella term that covers over 200 different ailments including arthritis, back pain and damage to joints, muscles and tendons – affect twice as many people as “stress”, account for up to a third of all GP consultations, cause 9.5 million lost working days, and cost society £7.4bn a year.
These are the main findings of a new report from The Work Foundation into the economic and social impact of MSDs – by far the most prevalent cause of work-related illness in the UK.
The report argues that early intervention and an emphasis on keeping sufferers in work wherever possible are likely to boost national productivity and help reduce the 2.6 million people claiming incapacity benefit. “There is overwhelming evidence that worklessness is, itself, bad for health,” the report says.
The government needs to urgently rethink how health agencies co-ordinate treatment of MSDs, offer greater support to small businesses, and give a higher priority to understanding the labour market impact of MSDs as part of its work, health and wellbeing strategy, the report recommends.
The report urges GPs and employers to look beyond immediate physical symptoms in their management of MSDs. The “biopsychosocial model” of health, which emphasises the interplay between biological (eg, disease, strain, joint damage), psychological (eg, disposition, anxiety) and social (eg, work demands, family support) factors, represents a “helpful” way of assessing causes and planning treatment and rehabilitation.
The report calls for:
- Early intervention: long periods away from work are usually bad for patients. Partnerships between patient, employer and GP can achieve a balance between an individual’s need for respite and the need to work. For some MSD patients early access to physiotherapy or to drug therapies can reduce the severity, impact or progression of the condition.
- Better job design: managers can change the way work is organised – from adjusting working time, altering task allocation, to improving ergonomics.
- Enhanced measurement of direct and indirect costs of MSDs: much better mechanisms to assess and monitor the social and work impact of MSDs are needed. The National Institute for Health and Clinical Excellence (NICE) should take into account labour market impacts when examining the economic effectiveness of different therapies. For example, whether a patient can be kept in work and off incapacity benefit may drastically affect decisions about the cost effectiveness of drug therapies.
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