Musculoskeletal Disorders

By Katie O'Neill, DC, BS
Director of Clinical Wellness/National Practice Leader
Katie.Oneill@McGriff.com

As you’re reading this article, take a moment to think about your posture. Are you leaning forward at your desk, or have your neck craned over a phone? Are you sitting upright with your head forward? Or, are you noticing tension in your neck, and an ache in your lower back?

Compared to the awareness around chronic conditions such as diabetes and heart disease, aches and pains are easy to dismiss as transient concerns. However, according to the American Academy of Orthopedic Surgeons, musculoskeletal disorders (MSDs) impact 1 in 2 Americans to the tune of $213 billion a year in treatment, lost wages, and decreased productivity. If these disorders progress into chronic pain, the burden in costs, disability, and lost productivity can be even greater.

The term “musculoskeletal disorder” describes injuries or impairments of the body’s movement system, including muscles, joints, tendons, spinal discs, ligaments, and nerves. Most everyone has experienced the symptoms: local or diffuse pain and achiness, pulling or burning sensations within the muscles, and general fatigue. If not properly prevented or treated, further impairments can lead to more serious and costly complications, such as opioid dependency, surgeries, and disability.

While we tend to think of MSDs with labor-intensive industries, sedentary desk work and improper ergonomics are becoming increasingly more common sources of injuries and strain. One example of this, called “cross syndrome,” develops when certain muscles become weakened by lack of use, while opposing muscles try to compensate and become shortened and tight. Often due to poor posture and prolonged sitting, this see-saw effect between front and back forms an “X” (cross) pattern. This can occur in the upper body, the lower body, or concurrently.

In the case of upper cross syndrome (UCS), the muscles of the front of the neck and middle back become weakened and lengthen, as the muscles of the chest and upper portion of the back of the neck become tight. Think of how frequently we are typing, driving, holding our phones, or looking down and forward. The muscles that support “good posture” (head lifted and in line with the shoulders, chest broad, shoulders back) have become progressively weakened and are not properly supporting the upper body, causing tightness in the compensatory muscles. The result is a forward translation of the head, rounding forward or elevation of the shoulders, and hunching of the mid-back. This can lead to pains in the neck, shoulders, and mid-back, numbness and tingling in the arms, headaches, and reduced range of motion. In addition to these outward symptoms, the head held in a forward vs. upright position creates additional wear and tear on the joints, which can lead to spinal degeneration (tech neck).

In the case of lower cross syndrome (LCS), the hip flexor and low back muscles become tight and short, the abdominal and gluteal muscles become weakened, and the pelvic bones tip forward. Commonly due to sitting for long periods, the increased stress on the low back and thigh muscles can lead to low back pain and an increased risk of injury.

These are just two very common examples of how MSDs may develop and present in the workplace. Carpal tunnel syndrome, tendonitis, and other repetitive-use injuries can occur in employees of any age and across many job functions. Even in the absence of pain, poor biomechanics and dysfunction can cause someone to be predisposed to an accident or injury.

Even when pain and dysfunction are limited to acute episodes, the impacts can be long lasting and interfere with productivity, general health, and overall well-being. For example, consider an otherwise healthy employee experiencing a bout of low back pain. Not only could this interfere with his/her ability to work, it could also prevent participation in regular physical activities at home. Pain may also cause the employee to feel anxious, depressed, and lose sleep which could potentially lead to the adoption of coping vices such as unhealthy food, alcohol, or tobacco. Any potential weight gain or unhealthy behaviors can further inhibit healing and exacerbate the problem.

While MSDs are very common, and can be unavoidable, below are suggestions on how to minimize the risks to your employees and prevent existing conditions from progressing.

Provide and promote comprehensive wellness programs as part of a culture of health and well-being

• Excess weight, tobacco use, and unmanaged chronic conditions can lead to the development of MSDs, as well as lead to complications and delayed healing.

Provide coverage for treatment, decision support and funding options (HSA, FSA) for conservative therapies (acupuncture, chiropractic care, physical therapy, massage)

• Education and decision support can help keep employees from improperly self-treating their condition and help to prevent further damage
• Conservative therapies can help to correct underlying issues, and prevent the use of potentially dangerous opioid medications

Make proper stretching and strengthening exercises a daily habit for all employees

• Provide programs and resources for correcting muscular imbalances and encouraging better posture
• Consider employees across job functions when evaluating safety

Environmental support

• Consider on-site resources to encourage engagement in injury prevention, such as physical therapy and yoga
• Provide ergonomic support before problems develop

Communications

• Make MSD awareness and education part of your internal employee communications strategy
• Make sure employees know about and take advantage of available resources, such as employee assistance programs, to help with psycho-social aspects of pain

Creating a healthier workforce is an ongoing process that requires consistent communications and support. Encouraging daily habits consistently for better health can result in global effects to improve employee health, productivity and morale.