December 2, 2021

EU-OSHA Finds Link Between Stress and Musculoskeletal Disorders

Psychosocial stress at work is linked with the development of musculoskeletal disorders (MSDs), according to a review of occupational health literature published by the European Agency for Safety and Health at Work (EU-OSHA). While the occupational health and safety community is familiar with the association between physical factors and MSDs, EU-OSHA’s report urges OHS professionals to develop workplace interventions that take a holistic approach to addressing work-related MSDs and the causal role that psychosocial stress factors can play in their development.

The executive summary of EU-OSHA’s report states that psychosocial risk factors at work “do not work in isolation, but their effect combines with (and often exacerbates) the effects of physical risk factors.” Due to the wide range and variety of psychosocial risk factors and their effects, which include but are not limited to high workload, lack of support, lack of autonomy, lack of communication, and psychosocial and sexual harassment, the study was unable to identify consistent patterns between specific psychosocial risk factors and particular MSDs. The authors of the report suggest that—as with physical risk factors—it is difficult to isolate the influence of a single psychosocial risk factor on overall health risk. Noting that interventions focusing on single risk factors tend to be ineffective in reducing MSD risk, the authors assert that “all psychosocial risk factors should be assessed and action taken to reduce those most prevalent, without seeking to relate these to specific MSD risks.”

The report also stresses the need for more research to determine the biological mechanisms through which psychosocial stress influences MSDs. Possible mechanisms include increased muscle tension or awareness of physical symptoms caused by psychosocial demands; chronic nervous system disfunction, with physiological and psychological symptoms, triggered by an initial experience of physical pain; and the co-occurrence of changed psychosocial demands with altered physical demands that put workers under biomechanical stress. According to the review, the contribution of psychosocial factors to MSDs is not necessarily negative; improved psychosocial health is also associated with improved MSD symptoms.

Despite the gaps in knowledge, the authors encourage OHS professionals to take approaches to preventing MSDs that address all possible risk factors, including psychosocial ones, and involve the participation of employees at all levels in an organization. The report explains that an effective intervention requires commitment from the entire organization, transparency, focus on risk prevention as the end goal of risk assessment, ongoing review and revision, and the rehabilitation of injured workers.

More information can be found on EU-OSHA’s highlights webpage, and PDFs of the report and executive summary can be accessed through the agency’s website.