The purpose of this article is to shed light on the concepts used in the field where we (client organisations, occupational health and other actors) work together to address the problems, losses and work incapacity that musculoskeletal disorders cause for our clients’ employees now and in the future. The terminology and phenomena discussed in this article should be understood in the same way by managers – and in fact by all those involved in work capacity management in our client organisations (including employees) – to ensure effective cooperation in occupational health and, thus, to bring about the desired changes.
How should managers understand musculoskeletal conditions?
Let’s start with health. In this article and in Pihlajalinna Occupational Health, we understand musculoskeletal health to mean the experience individuals have of their state of musculoskeletal wellbeing. The effortlessness and ease of physical activity are at the heart of musculoskeletal health. Muscles, tendons and joints make up the musculoskeletal system that supports the body and allows us to move our body or body parts. Thus, the musculoskeletal system has two quite different functions: to support and to move.
Ailments and disorders of the musculoskeletal system are not the same thing
Complaints related to our musculoskeletal system (usually pain) are often triggered by straining a part of the body and can be a real nuisance. However, these symptoms tend to heal with time and by addressing the cause. On the other hand, the problem tends to recur if the straining is repeated or persistent. Although the onset of musculoskeletal problems is linked to physical straining, there are many other dimensions and factors that are not specified in this article, but which should be taken into account in both the prevention and, in particular, the treatment of the problems.
The diagnosis code for musculoskeletal disorders starts with the letter M on medical certificates sent to the managers of our client organisations. In the diagnostic classification, M stands for musculoskeletal disorders, which is abbreviated as MSD. The sequence of events often goes as follows: an employee goes to see a doctor for a musculoskeletal complaint. The symptom is then diagnosed, and the complaint turns into an MSD.
There are also musculoskeletal disorders which are not caused by physical strain. These include, for example, rheumatic diseases. There are also a number of MSD diagnoses that indicate a specific musculoskeletal feature or structural change, such as the diagnosis of arthrosis. It is important to note that these structural diagnoses do not indicate whether a disorder is disabling, nor do they necessarily lead to a musculoskeletal condition or reduction in work capacity.
Is one or the other more relevant?
From the point of view of the promotion of work capacity and the prevention of musculoskeletal problems, musculoskeletal complaints can be considered as more noteworthy than musculoskeletal system disorders. Firstly, they have a more direct and stronger link to work capacity than musculoskeletal system disorders, because in practice musculoskeletal complaints always reduce our capacity to work. Furthermore, musculoskeletal complaints are present and therefore detectable earlier than musculoskeletal system disorders. It is, however, noteworthy that in the context of work capacity management and occupational health cooperation, such as in reporting, it has traditionally been more common, for a variety of reasons, to focus on musculoskeletal disorders rather than on complaints. Nevertheless, situational data on staff musculoskeletal complaints are available, for example in the form of health check surveys and stress surveys. This information could often be used to a greater extent, which would help shift the focus of work capacity management and responsive occupational health interventions towards early detection if that is the will of the client organisation.
Of the occupational health professionals, occupational physiotherapists are the ones whose specific area of expertise and role is to operate at the intersection of musculoskeletal health, musculoskeletal complaints and work capacity and who will be happy to discuss your organisation’s objectives on this topic, whether that means tackling existing musculoskeletal complaints and the use of temporary work arrangements (see self-referral to an occupational physiotherapist) or the prevention of musculoskeletal problems (e.g. TULETKO survey. )
Lauri Raivo
Pihlajalinna Service Manager, Occupational Physiotherapy