Identify, Treat and Prevent MSDs


By Beth Mirza August 1, 2011
Musculoskeletal disorders probably have been around since humans first started using tools to do work. Blacksmiths more than likely developed some pretty sore tennis elbows from swinging heavy hammers all day. And can you imagine the carpal tunnel symptoms a seamstress would suffer?

Employers are more aware than ever of musculoskeletal disorders, or MSDs. Employees who develop them can experience significant pain, and their days away from work lead to higher health care costs and lower productivity.

The U.S. Occupational Safety and Health Administration (OSHA) has proposed adding a column to the Form 300, the workplace illness and injury log, in which employers would place a check mark to denote MSDs. The proposed rule would define an MSD, for record-keeping purposes only, as a disorder of the muscles, nerves, tendons, ligaments, joints, cartilage or spinal discs that was not caused by a slip, trip, fall, motor vehicle accident or similar accident.

According to the U.S. Bureau of Labor Statistics, musculoskeletal injuries are the largest single category of workplace injury and account for 28 percent of occupational injuries. Employers have been tracking and recording injuries like these all along, but this would be the first time they would be required to specify that the injury is an MSD.

Employers who do not record MSDs face monetary penalties from the federal government. An administrative law judge with the Occupational Safety and Health Review Commission in Denver affirmed in late spring 2011 an OSHA citation issued to Peoria, Ill.-based Caterpillar Logistics Services for failing to record a worker’s MSD on the company’s OSHA 300 log. Caterpillar was assessed a proposed penalty of $900, according to an OSHA news release.

Administrative Law Judge Patrick Augustine noted that, in order to be recordable, “an employee’s work activities do not have to be the cause, but rather a cause of injury or illness,” and determined that evidence showed that the employee’s work activities were at least a contributing, if not the sole, cause of the employee’s epicondylitis—commonly known as tennis elbow. This decision is the first to address whether an MSD is work-related under an OSHA record-keeping standard revised in 2001, the news release stated.

Under the proposal to add the MSD column to the OSHA 300 log, an MSD consists of the disorders listed above and any reported “pain, tingling, burning, numbness or any other subjective symptom of an MSD.” The proposal states that the case is recordable (should be logged) if an employee with such reported symptoms is offered or receives “medical treatment,” according to an update from the law firm of Constangy, Brooks & Smith. “Upon implementation of OSHA’s proposed new requirement to identify MSD cases in a separate column on the OSHA 300 Log of Occupational Injuries and Illnesses, it is expected that the Agency’s scrutiny of employers’ recording of, and responding to, MSD cases will increase,” the update stated.

Employers who help employees identify and treat MSDs before they become debilitating will be ahead of the game, say workplace health experts. Even better: Prevent MSDs before they can start.

Getting Ahead of the Problem

Employers can reduce and prevent MSDs in their workplaces by hiring workers who are qualified for the jobs at hand; conditioning employees to do the job and modifying the work area if needed. In addition, they can treat signs and symptoms of MSDs before they become intolerable, said Kevin Schmidt, senior vice president at WorkWell, an occupational health services company.

“In the hiring phase, it’s important to prescreen [applicants] for physically demanding jobs,” Schmidt said. “Do a functional assessment—what weights does the employee have to push, pull or carry. Make sure the employee can do the job.”

So that hiring managers and HR know which employee skills to look for, job descriptions should include:

  • Whether the job requires pushing, pulling, lifting and/or carrying.
  • How much weight will be moved.
  • How high the weight must be lifted.
  • How often tasks need to be performed.
  • The equipment that will be used to perform the task.
  • The environment in which the work will be done.
When the employee is on the job, the employer can make modifications to reduce the forces and weight that the employee’s body is trying to bear, Schmidt said. For example, can an 80-pound load be separated into two 40-pound loads? Can the employee improve his or her posture?

“When I think of MSD injuries, I think of overexertions, awkward positions, high forces and weights” that aren’t actually necessary to do the job, he said.

An educated workforce is part of the MSD solution, Schmidt added. Employees should know how to lift heavy objects properly, how to identify symptoms of injuries and where to turn at the first sensation of pain or numbness.

Rotating employees through different jobs can give aching body parts a break and is another way to stave off MSDs, Schmidt added.

Employees complaining of aches and pains should receive prompt medical treatment, coaching to reduce discomfort while on the job, and instruction on how to perform the job better, according to a report from WorkWell.

You’re Not Alone

Third-party administrators will be your friend during this process, said Todd Hohn, vice president of strategic resources at PureSafety, a safety and health training management software provider.

“Engage your insurance company,” Hohn said. Insurers have the resources to identify, evaluate and control MSD injuries. If your insurance provider doesn’t offer this service, turn to an occupational health consultant. However, know that your insurance company normally would provide this service for free as part of your existing coverage, while a consultant will charge a fee. In general, an insurance broker is more likely to make changes to the work environment and machines and tools used, while an occupational health provider will work with the employee on postures, exercises and treatments.

Assess your OSHA logs and workers’ compensation claims to pinpoint injuries classified as MSDs, and prioritize those work areas for training and strengthening, Hohn and Schmidt said. Educate managers and workers on MSD signs, symptoms and preventions.

“Everyone is thinking about this today because more people are hanging onto their jobs. At 50, you can’t do the same job you did as when you were 20, but the job hasn’t changed. You have to examine how you change things up for people,” Schmidt said.

Hohn and Schmidt agreed that the most money can be saved by investing in prevention of MSDs, rather than waiting for MSDs to develop and then treating them.

“You almost want to force [the employee to file a workers’ comp] claim” when he or she starts complaining of aches and pains, Schmidt said. “Work on it now, when it’s small, rather than when it becomes a lost-time claim. You’d rather have lots of small [OSHA] recordable [incidents] than a big claim.”

“We’ve put in some workplace accommodations for as low as $20,” Hohn said. “Typically, the ergonomic improvements that are made impact quality and productivity positively. The person and the job are more aligned,” which can lead to productivity increases of 5 percent to 20 percent, he added.

“Because [employees] are more productive, there is less stress while they are working, so quality improves as well. Defects go down over time. [However], when an employee is out of work because of these injuries, there are production and quality losses of four to 10 times the actual cost of treating the injury,” Hohn said.

Beth Mirza is senior editor for HR News. She can be reached at

Related Articles:

MSD Column Back Again for Review, SHRM Online, Safety & Security Discipline, May 2011

OSHA to Address Confined Space, MSD Proposal, SHRM Online, Safety & Security Discipline, July 2011

OSHA’s Requirements for Recording Illnesses and Injuries, SHRM Online, Research, November 2001

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