The Impact and Prevalence of Musculoskeletal Disorders in the Workplace

Musculoskeletal disorders (MSDs) affect the muscles, bones and joints, typically developing gradually due to repetitive strain and overuse rather than from a single traumatic event. Despite being largely preventable, these injuries continue to be a common and costly occurrence in workplaces across industries.

“The most striking aspect of musculoskeletal disorders is that they are largely preventable,” said Michelle Despres, PT, CEAS II, REAS, CETS, vice president, product management, national clinical leader at One Call. “It seems contradictory that we have such a high frequency and expense associated with these disorders, yet there is so much that can be done to prevent them.”

Michelle Despres, PT, CEAS II, REAS, CETS, vice president, product management, national clinical leader, One Call

According to One Call’s data, the most common MSDs vary by age group. For workers over 45, shoulder disorders, including rotator cuff pathology, are most prevalent. For those under 45, low back disorders top the list. Overall, 54% of One Call’s physical therapy referrals and 63% of diagnostic referrals are for musculoskeletal disorders.

“Neck disorders such as cervicalgia also frequently occur,” Despres said. “Elbow disorders like epicondylitis or tennis elbow are pretty common as well. Wrist and forearm disorders, including De Quervain’s tenosynovitis and carpal tunnel syndrome, round out the list of the most frequently seen musculoskeletal problems in the workplace.”

These injuries can affect workers in any industry, not just those in physically demanding roles. Even office workers who sit at desks all day can develop MSDs due to poor posture and static positioning.

Pre-existing Conditions That Complicate MSK Injury Treatment

Darren Barr, vice president of product management, One Call

When managing musculoskeletal injury claims, understanding the role of pre-existing conditions is crucial for appropriate treatment planning and cost containment.

“While many musculoskeletal injuries are preventable, there is an entire subset of cases where pre-existing conditions are present,” said Darren Barr, vice president of product management at One Call. “These are not always attributable to the work-related incident and, in some cases, may not be related at all.”

Barr noted that statistics show more than 50% of cases seen through One Call’s diagnostic program involve chronic conditions that pre-date the specific incident. This can significantly impact treatment approaches and claim duration.

Chronic pain conditions that existed prior to a workplace injury present particular challenges. As Despres explained, “Chronic pain is challenging and may not be fully resolved under a work comp claim if it predates the workplace injury by decades. The carrier is responsible for resolving symptoms directly related to the recent injury.”

Pre-existing degenerative conditions are also common complications. For example, an individual with a pre-existing shoulder condition might experience a tear from a seemingly minor movement at work, resulting in a compensable injury despite the underlying condition.

Age-related degeneration, particularly in the spine and major joints, can complicate diagnosis and treatment planning. MRIs often reveal anomalies in the low back even in people without excruciating pain, which can create confusion about what findings are related to the workplace injury versus normal aging.

Psychosocial factors, while not physical pre-existing conditions, can significantly impact recovery. “Psychosocial factors that may be present are often not screened for or considered, despite their potential to greatly impact an injured worker’s recovery journey,” Despres said.

Early Risk Detection and Predictive Analytics

Effectively managing musculoskeletal claims requires a strategic approach that combines early intervention, appropriate diagnostics, and evidence-based treatment.

Predictive analytics are valuable tools for helping claims professionals identify potential complications early. “Our company has a predictive analytics program that uses machine learning, optical character recognition, and natural language processing to identify injured workers who might be at risk of delayed recovery,” Despres explained.

These tools can help identify cases that might not appear problematic on the surface but could develop into complex claims requiring additional intervention.

Strategic Use of Diagnostic Tools

While MRIs remain the gold standard for diagnosing MSK injuries, the timing of diagnostic testing is crucial. There are two schools of thought regarding when to order advanced imaging.

“The Official Disability Guidelines (ODG) often recommend waiting for advanced imaging on many injuries, as they may resolve with physical therapy, reducing claims exposure,” Barr said. “Conversely, some argue that diagnostics are less expensive, and having a definitive image of the injury can provide mental clarity for the patient.”

A particularly valuable diagnostic approach is the Age of Injury assessment, which helps distinguish between acute injuries and chronic conditions. “Using Age of Injury to identify chronic issues, a payer may only be responsible for returning the patient to their pre-injury baseline under the comp claim,” Barr noted.

Physical Therapy as a Primary Intervention

“Physical therapy is the best treatment for musculoskeletal disorders,” Despres emphasized. “We should avoid relying on medications that have proven ineffective for these conditions, such as opioids.”

Physical therapists offer comprehensive care that extends well beyond just treating the injury itself. They educate injured workers on safer and more effective work techniques, significantly reducing the risk of re-injury upon return to work.

Additionally, psychologically informed care directly addresses the fear and uncertainty often accompanying workplace injuries—critical components that can otherwise delay recovery.

Many physical therapists also conduct thorough ergonomic assessments that serve dual purposes as both prevention tools and treatment components, identifying workplace factors that may have contributed to the injury.

For workers requiring more structured support, physical therapists implement specialized return-to-work programs such as work conditioning, which gradually builds stamina and work-specific capabilities to ensure successful job reintegration.

Preventative Measures

Prevention remains the most cost-effective approach to MSK injuries, with several proven strategies yielding significant results. Post-offer employment testing (POET) helps employers determine whether job candidates can safely perform required physical tasks before placement, reducing injury risk from the start.

Baseline testing establishes a worker’s range of motion, strength, and movement capabilities, providing valuable comparative data if injuries occur later.

Proactive ergonomic assessments identify potential risks before injuries happen, allowing for workspace or process modifications that prevent problems. Advanced motion screening technology offers another layer of protection by identifying risky movements and providing immediate feedback, helping workers correct potentially harmful techniques before they cause injury.

“By modifying tools based on the technique of the most tenured worker who had never been injured, adding a larger knob and allowing the use of shoulder and elbow muscles instead of hand and wrist muscles, the claims that previously averaged $15,000 to $18,000 each essentially disappeared,” Despres said, describing a successful intervention at one workplace.

One Call’s Integrated Approach to MSK Claims Management

One Call differentiates itself through an integrated approach to coordinating musculoskeletal claims, utilizing high-quality diagnostics and physical therapy providers along with powerful claims insights.

“An integrated approach offers several tangible benefits for both injured workers and payers,” Barr explained. “Injured workers, dealing with a single, uniform entity for all their care needs, outside of their primary treating provider, can significantly reduce confusion and improve responsiveness when needing to coordinate physical therapy or imaging services.”

This integration enables better coordination between different aspects of care, ensuring that information flows seamlessly between providers. “Having all disciplines under one roof is helpful in sharing information, which can be challenging in work-related claims,” Despres said. “The ability to connect the dots, keep everyone in the loop, and maintain open communication channels is crucial.”

One Call’s approach includes several distinctive elements:

1. Comprehensive data analysis: With insights from millions of claims, One Call can identify trends and patterns that inform treatment approaches.
2. Predictive analytics: One Call’s program uses machine learning and predictive analytics to identify injured workers at risk of delayed recovery, allowing for early intervention.
3. Age of Injury assessment: This tool helps distinguish between acute injuries and chronic conditions, enabling more appropriate treatment planning and cost allocation.
4. Psychologically informed care: Many of One Call’s contracted physical therapists are trained to address the psychosocial challenges that injured workers face during recovery.
5. Coordinated care across services: Coordinating multiple aspects of care, One Call ensures that information is shared appropriately and treatment plans are aligned.

“Setting appropriate expectations early is one of the most significant advantages of an integrated approach,” she noted. “As an injured worker, understanding what’s happening and receiving swift answers is crucial. The integrated approach allows for better decision-making by all stakeholders, including PTs, radiologists, treating physicians, claims professionals, and case managers.”

By incorporating early intervention, appropriate diagnostics and evidence-based physical therapy into their care coordination efforts, One Call helps ensure injured workers receive the right treatment at the right time, ultimately improving outcomes and reducing costs for employers and insurers.

To learn more, visit: ​​https://onecallcm.com/.

This article was produced by the R&I Brand Studio, a unit of the advertising department of Risk & Insurance, in collaboration with One Call. The editorial staff of Risk & Insurance had no role in its preparation.