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MSD return to work

Recording sickness absence

Back pain is a major cause of work related sickness absence in the UK and can affect every type of business. But it is not the only type of musculoskeletal disorder (MSD) that can cause employees to take time off. There are many MSDs that could lead to long-term sickness absence and in many cases it can be difficult to identify the link between injury and the work done.

Proper monitoring of sickness absence can help identify the causes of MSDs, which will enable them to be tackled early on. It will also enable you to identify individuals with MSD problems early on in their absence so they may be approached to consider an appropriate and timely plan for their return to work.

It could help identify those cases where an employee is likely to take time off and need help in getting back to work, as well as those which could resolve themselves quickly.

Keeping in contact

For musculoskeletal disorders (MSDs), early contact could help identify the cause of an MSD. This would allow the employer to review their risk assessment and attempt to rectify the problem. The employer can then reduce the risk of other employees being affected by a similar injury, and limit the likelihood of the returning employee experiencing a reoccurrence of their injury.

The general messages for people who suffer back pain are they should stay active, try simple pain relief and seek medical help if necessary. This would include getting back to work, so employees with back pain and other injuries should be encouraged to come back to work where possible. It may be that there are simple temporary measures that can be agreed, such as reduced hours so they can avoid peak travel times, which would make the process easier.

Contact should not end when the employee returns to work, regular discussion and review of the return to work process should ensure that actions taken have been effective. It can also help to identify any reoccurrence and prevent further injury. In many cases the steps taken, to minimise the risk of the MSD reoccurring and prevent further injury, will need to be kept under review. This can only be done effectively by talking changes over with the individual concerned.

Planning adjustments

For musculoskeletal disorders (MSDs), altering a task, equipment or the workload an individual faces can significantly reduce the risk of MSDs reoccurring. These adjustments are often simple, cheap, and cost effective. The case studies included on the site contain details of several different adjustments that have been made to an individual's work. Often the costs of any adjustment are outweighed by the longer term benefits of getting the employee back to work early.

Some changes may be temporary, designed to help someone build up to the level of work they did before, such as reduced hours or lighter duties. It may help to make a permanent change eg introduce a lifting aid to reduce manual handling not only for the individual affected but also for others exposed to similar risks.

There may be other simple inexpensive adjustments that can be made to a workstation, this is particularly evident where upper limb disorders are concerned. Simple adjustments such as changing equipment or introducing voice recognition software can have a major impact on someone's well being and their ability to return to work.

These adjustments may require several attempts to perfect and a degree of trial and error is likely to be necessary. Introduction of the adjustments should be carried out in consultation with the employee, their representatives and others who may be affected.

In most cases those who have been absent due to MSDs make a full recovery and can return to their old jobs. It is important to learn lessons on causes of injury and how the task can be eliminated or adjusted to prevent others being injured and having to take time off with MSDs.

After a long time off work with MSDs there may be other factors which prevent an employee's return to work other than the MSD itself. A variety of psychosocial issues could also become a barrier to returning to work. Evidence suggests that overcoming these barriers is as important as overcoming the disorder or injury which took the employee away from work originally.

Using professional advice/services

There are a wide range of professional services and advice that could be used in order to assist an employee affected by MSDs. These could include occupational health professionals, NHS direct, a GP, physiotherapists, ergonomists (for workplace adjustments) and a variety of complementary therapies providers.

The treatment of MSDs can be complicated and could depend on the individual themselves as well as the nature of their injury. If you have access to occupational health providers or experts you should consult them as they will be able to help with every stage of the process. If occupational health advice is not available then you may need to speak to the individuals GP about the best course of action to take. You will need the individual concerned's permission to do this.

Some MSDs may need medical treatment of one type or another, this could range from an exercise regime to strengthen the muscles, to surgery or other types of medical intervention. Any treatment should follow evidence based good practice and be suitable for the individual concerned, this will often be recommended by an occupational health professional or a GP.

This may involve physiotherapy; either through the NHS or by an arrangement with a local private service who can often provide treatments almost immediately. Many organisations have found this cost effective as the cost of the healthcare is offset by the speedy return of the employee to work resulting in significant savings made on sick pay, retraining, employing a replacement and the other costs of sickness absence.

Some organisations have introduced a holistic approach to dealing with the MSD health problem involving education, discussion, exercise, workplace adjustments, treatment and addressing the other factors that can play a part in restricting the chances of return to work.

For details on several examples of how organisations have addressed the problem of sickness absence due to MSD go to Case Studies.

Agreeing a return to work plan

Returning to work after time off with an MSD can be difficult. It will be easier if this process is planned by all of those involved, including the employer, employee, employee representatives, occupational health professionals and others. A plan needs to be agreed for the individual, with the support of all parties involved.

With many MSDs returning to work is possible and in many cases beneficial even before all the pain has gone. Working on different tasks or shorter hours may help the recovery process. Assisting with transport may be another way to help. However, it is important that an employee does not feel rushed back to work.

Co-ordinating the return to work process

This process should be as inclusive as possible and a wide variety of people may need to be involved. This should be done in a way which supports the employee in their return to work. In some cases it may be necessary to appoint a formal co-ordinator or case manager.

Case Studies

We have published a number of examples of how organisations have addressed the problem of sickness absence due to MSDs. They have used a variety of different approaches to tackle the problem.

Each example sets out the problem and how it has been tackled. Any figures quoted have been provided by the organisation concerned and not HSE.

Updated 2011-10-20