The impact of musculoskeletal disorders on work is demanding more attention from stakeholders, including clinicians and policymakers. Musculoskeletal disorders are the most frequently cited reason for absence from work (Black, 2008). Dame Carol Black's report Working for a healthier tomorrow (Black, 2008) and the subsequent government response Improving health and work: Changing lives (DWP and DH, 2008) highlight the need for new approaches and attitudes to assess and reduce the burden. National policies directed at extending working life further increase this need. The incidence and prevalence of many musculoskeletal disorders increase with age. Extensions to working life will result in greater numbers of older adults in the workplace with musculoskeletal disorders and associated disability. Significantly, new approaches impose the view that work loss does not need to be a consequence of a musculoskeletal disorder or disability. This presents an achievable challenge to everyone and underlines the importance of a biopsychosocial and interdisciplinary approach involving interaction between those with a musculoskeletal condition, employers, clinicians and policymakers.

This chapter provides an overview of the link between musculoskeletal disorders and work. It is not exhaustive, but provides examples of the evolving approach to musculoskeletal disorders and work and outlines the challenges to, and opportunities for, improving work participation. In the first instance, it reinforces the size of the burden of musculoskeletal disorders, and summarises the current health and employer approaches to improving work participation. Importantly, the discussion moves on to outline future research questions to maintain the current momentum and interest in reducing the burden of musculoskeletal disorders on work.

The burden of musculoskeletal conditions on work

Much attention is given to stress and mental health problems because they account for the majority of time absent from work. However, musculoskeletal disorders account for a rather higher number of episodes of absence from work. In the United Kingdom in 2007, 9.5 million working days were lost, with the cost estimated at £7.4 billion (Black, 2008). The level of morbidity is perhaps not reflected in the priority given to musculoskeletal disorders for their effective prevention and treatment by clinicians and policymakers, and for research to advance understanding (Woolf, 2000).