Musculoskeletal disorders
from A to Z

Everything you need to know to prevent MSDs in your company

Definition of MSDs

What are MSDs?

Musculoskeletal disorders (MSDs) are conditions that affect the musculoskeletal system, mainly muscles, tendons, ligaments, nerves, joints and other structures. They manifest as work-related difficulties and pain.

Since 2023, cases of MSD have increased by 60% compared with previous years. In 2015, these disorders accounted for over 87% of occupational illnesses resulting in time off work or financial compensation for after-effects. In Europe, average annual growth over the past decade has been 13%.

The origins of MSDs

MSDs are multifactorial in origin, i.e. they arise from different risk factors, namely:

  • Biomechanical factors ;
  • Psychosocial factors
  • Organizational factors;
  • Environmental factors;
  • Individual factors.

 

MSDs are often the result of a complex combination of biomechanical, psychosocial, individual, organizational and environmental factors, and are work-related.

MSD risk factors

Body areas most affected by MSDs

MSDs mainly affect the upper limbs (shoulders, elbows and wrists), neck, back and lower limbs (knees).

Source : Ameli.fr

Occupational diseases

Table 57 (France) lists the occupational diseases caused by certain work gestures and postures, particularly periarticular affections. These are joint-related ailments caused by repeated or long-term gestures and postures.

Carpal tunnel syndrome

Carpal tunnel syndrome refers to disorders caused by compression of the median nerve at the wrist. Symptoms include altered sensitivity, reduced strength and pain in the first three fingers and half of the fourth finger on the thumb side.

Carpal tunnel syndrome is very common, particularly in women between the ages of 30 and 50. It can affect one or both hands.

Le syndrome du canal carpien est très fréquent, notamment chez les femmes entre 30 et 50 ans. Il peut toucher une main ou les deux.

Carpal tunnel syndrome
Causes :
  • Repetitive, fast-paced manual activities involving the upper limbs, whether at work (such as packing, using hand tools, wringing out a mop) or in domestic and leisure activities (DIY, gardening, housework, sport), are predisposing factors.
  • Flexion-extension and prono-supination movements of the wrist.
  • Repeated use of thumb-index pliers with force, as well as work requiring prolonged static force.
  • Activities exposed to vibration (such as jackhammer use) or performed in cold environments.
Consequences :
  • Pain or tingling inside the hand or in the first 3 fingers.
  • Reduced sensitivity of the hand, affecting everyday gestures.
  • Impaired motor skills, with reduced wrist strength. In the long term, motor skills can be severely impaired, leading to real handicaps.

Guyon's canal syndrome

Guyon’s canal syndrome is caused by compression and inflammation of the ulnar nerve as it passes through Guyon’s canal in the wrist. It is characterized by pain in the last two fingers (ring and little fingers), which can extend up to the wrist, elbow and forearm.

Guyon canal syndrome
Causes :
  • Work involving repeated or prolonged wrist extension or hand gripping movements.
  • Using the hand as a tool
  • Use of tools and vibrations
  • Shocks and traumas
  • Some pathologies (rheumatic, endocrine)
Consequences :
  • Pain in the last two fingers (ring and little fingers)
  • Pain in wrist, forearm and elbow
  • Pain at night
  • Maladjusted hand movements
  • Paresthesia (tingling, pins and needles, numbness)
  • Sensation of loss of strength in the hand

Rotator cuff syndrome

Rotator cuff syndrome is a shoulder condition involving damage or irritation to the tendons and muscles that stabilize and facilitate movement of this joint. The rotator cuff is made up of four main muscles (supraspinatus, infraspinatus, lesser tuberosity and subscapularis) and their tendons, which surround the head of the humerus and enable a wide variety of shoulder movements.

Causes :
  • Work involving movement or holding of the shoulder without abduction support:
    • at an angle greater than or equal to 60° for at least two hours a day, cumulatively

       or

    • at an angle greater than or equal to 90° for at least one hour per day, cumulatively.
Consequences :
  • Particularly intense pain at night, when leaning on the shoulder.
  • Muscle weakness that can reduce the ability to lift the arm above the head or move it in certain directions.

Epicondylitis

Epicondylitis is an inflammation of the elbow tendons that causes pain on the outside of the elbow, due to damage to the tendons of the forearm muscles that attach to the epicondyle..

Epicondylitis
Causes :
  • Work usually involving repeated gripping or extension movements of the hand on the forearm or pronosupination movements.
Consequences :
  • A burning sensation or pain on the outside of the elbow, which may spread to the wrist and tend to worsen at night.
  • Stiffness or pain when extending the arm.
  • Weakened grip when trying to grasp or hold objects.

Epitrochleitis

Epitrochleitis is an inflammation of the tendons located on the medial or inner edge of the elbow, inserting at the epitrochlea (medial or inner outgrowth of the humerus). Epitrochleitis is the equivalent of epicondylitis, but on the other side of the elbow, on the little finger side.

Causes :
  • Work usually involving repeated adduction or flexion and pronation movements of the hand and wrist, or pronosupination movements.
Consequences :
  • Sharp pain in the forearm and wrist.
  • Decreased grip strength in the hand.
  • A sensation of numbness and tingling in the hand.

Low back pain

Low back pain, commonly known as “lumbago” or “backache”, is pain, often intense, in the lumbar vertebrae at the base of the back. In the case of low back pain, you may also experience a feeling of blockage or difficulty in making some movements.

Low back pain
Causes :
  • Manual handling.
  • Falls.
  • Whole-body exposure to vibrations.
  • Awkward postures.
  • Traumatic injuries.
  • Heavy exertion.
Consequences :
  • Local pain in the lumbar region. Rather diffuse and continuous.

Knee hygroma

Hygroma of the knee is an inflammation of the bursa located in front of the kneecap. This inflammation leads to an increase in the volume of the bursa, with the appearance of fluid.

Knee hygroma
Causes :
  • Work usually involving prolonged pressure on the knee.
Consequences :
  • Pain in the kneecap at the front of the knee, often accompanied by joint stiffness, redness and/or swelling (tumefaction) corresponding to a high production of synovial fluid.

Source : Table57

Different stages of MSDs

Musculoskeletal disorders present symptoms that evolve according to their location and nature. Their initial manifestation is often discreet, then progresses through several distinct phases.

Initial stage of MSDs

The first signs are pain and functional discomfort during activity, which subsides at rest without affecting work capacity.

Intermediate stage of MSDs

Pain occurs earlier and earlier in the day, persists at rest and reduces work capacity.

Advanced stage of MSDs

Symptoms become more specific, including signs of inflammation, impaired mobility or strength, and even muscle wasting. They lead to an inability to perform routine work.

Cost of TMS to the company

Musculoskeletal disorders (MSDs) are a major cost for companies. There are 3 different types of cost:

MSDs costs

Direct costs :

Direct costs that include health insurance contributions, compensation paid to employees absent due to illness, sums spent on adapting workstations and time spent managing and administering the files of affected employees. In 2017, the direct cost to companies amounted to nearly 2 billion euros.

Indirect costs :

Indirect costs represent between 2 and 7 times the direct costs, according to Anact, and include replacement and administrative management costs, as well as costs linked to organizational malfunctions and the company’s brand image.

Strategic costs :

Strategic costs are linked to the limitations posed by MSDs. These costs cannot be calculated in the same way as the previous ones, since they concern personnel (risk of conflict, QWL, etc.), production (more time required to carry out the same task), orders (due to an increase in product prices) or ethics (poor corporate image).

Costs generated by MSDs :

Photo Canal Carpien

Carpal tunnel

Average cost: €12,780
Length of time off work: 151 days

Photo TMS de l'épaule

Shoulder MSDs

Average cost: €17,000
Length of time off work: 220 days

Photo Tendinite de la coiffe des rotateurs

Tendinitis of the rotator cuff

Average cost: €52,759
Length of time off work: 298 days

Photo Épicondylite

Epicondylitis

Average cost: €18,220
Length of time off work: 195 days

ICONE - Maladies Professionnelles

Occupational diseases

MSDs account for 87% of occupational illnesses.

ICONE - Gravité des TMS

Severity of MSDs

45% of MSDs result in serious after-effects, with a high risk of loss of employment.

ICONE - Accidents du travail

Work accidents

According to the latest figures, MSDs account for 20% of reported workplace accidents.

ICONE - Coût

Cost to companies

The direct cost to companies averages nearly 2 billion euros a year.

ICONE - Absentéisme

Absenteeism

MSDs account for 22 million lost working days.

Sectors most affected by MSDs

Business sectors faced with MSDs

MSDs are present in all sectors of activity, none is spared, and all need to implement actions to combat them.

Those most affected include:

 

-Transport and logistics

-Trade and commerce

-Food processing

-Cleaning services

-Construction and public works

-Metallurgy and manufacturing industry

-Medical and social services (health care and home help)

Les secteurs touchés par les TMS

Source : Ameli.fr

MSD prevention approach

The 3 fundamental principles of the MSD prevention approach

The MSD prevention approach is based on 3 fundamental principles:

1 – A global approach that takes into account all risk factors,
2 – Involvement of all company players
3 – Sharing knowledge and skills.

The 4 key steps of the MSD prevention process

The MSD prevention approach is based mainly on the intervention phase, which comprises 4 key steps:

ICONE - Mobiliser

1 - Mobilize

Understand the stakes

Put in place the necessary resources

Involve the various employees

ICONE - Investiguer

2 - Investigate

Understanding risks

Analyze work situations

Identify risk factors

ICONE - Maîtriser

3 - Control

Reduce work constraints

Train and inform operators

Maintain physical abilities

ICONE - Évaluer

4 - Assess

Use all the means implemented during the investigation phase to assess the improvements made.

Source : INRS

MSDs and ROI

Current situation ROI and MSDs

For every €1 invested by companies, MSD prevention yields a return of €2.18.

Although costly, MSD prevention is far more economical for companies in the long term. Benefits include increased productivity thanks to improved working conditions, a reduction in occupational illnesses and lower employer health insurance contributions.

MSDs and ROI

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