Return to Work after MSD-related Sick Leave in the Context of Psychosocial Risks at Work


Musculoskeletal disorders (MSDs) are one of the health problems most frequently reported by workers and are responsible for a considerable proportion of sick leave.


Produced by the European Agency for Safety and Health at Work (EU-OSHA), this discussion paper investigates the effect of psychosocial risks on returning to work with an MSD. The term work-related MSDs refers to health problems affecting the muscles, tendons, ligaments, cartilage, vascular system, nerves or other soft tissues and joints of the musculoskeletal system, which are caused or aggravated primarily by work itself; they can affect the upper limb extremities, the neck and shoulders, the lower back area and the lower limbs. Work-related MSDs are mostly cumulative disorders as a result of repeated long-term exposure to work hazards.


Psychosocial risk factors at work in the context of MSDs s high job demands, low level of social support either from line managers or colleagues, low level of job control, high work intensity, work-life conflicts, heavy mental load, lack of decision-making authority, lack of recognition for work done, and so on.


Findings from a 2020 report by EU-OSHA show how psychosocial risk factors at work and MSDs are connected:

  • Low social support: a lot of research findings support the relationship between low social support and muscle-related pain in all body regions and specifically pain in the lower back, neck and shoulders.

  • Low level of job control, which includes a lack of decision-making authority: this has been shown to be directly related to pain in the back, neck, shoulders, wrists, elbows, hips and knees.

  • Poor job satisfaction: this seems to be particularly associated with pain in the upper extremities and lower back.

  • Work-life conflicts: several studies have concluded that work-life conflicts are associated with musculoskeletal pain (above all lower back pain).

  • Adverse social behaviour, such as discrimination, harassment and bullying: these risks seem to be directly associated with MSDs. An indirect relationship through psychological strain was also found.

The report concludes that the important factors for a successful return to work include holistic risk assessment of physical and psychosocial risks, a planned return-to-work programme, involving the worker in the process, and a positive and supportive working environment.


The report sets out the principles of good practice for a successful return to work, using good practice examples to illustrate.


It is available in full here.


EU-OSHA June 2021

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