Work-related musculoskeletal disorders: Duties, risks and controls

The Health and Safety Executive (HSE) estimates that 511,000 workers in Great Britain were affected by a work-related musculoskeletal disorder in 2024/25, accounting for 7.1 million working days lost over the year [1]. Musculoskeletal disorders (MSDs) sit alongside stress, depression and anxiety as one of the two largest categories of work-related illnesses.

For employers, MSDs touch both health and safety law and absence management, and they can trigger the duty to make reasonable adjustments under the Equality Act 2010. This article covers what the current data shows, what the legislation requires, and how to approach prevention, assessment and return to work.

Summary

• Work-related MSDs affected 511,000 workers in Great Britain in 2024/25, accounting for 27% of all work-related ill health cases and 7.1 million working days lost [1].
• Construction records the highest rate of any major industry in Great Britain, at approximately 2,000 cases per 100,000 workers [2].
• Common risk factors include manual handling, repetitive movement, awkward or static posture, vibration and poorly designed workstations.
• The Manual Handling Operations Regulations 1992 require employers to avoid hazardous manual handling where reasonably practicable, assess what cannot be avoided, and reduce the risk of injury to the lowest level reasonably practicable [3].
• The Health and Safety (Display Screen Equipment) Regulations 1992 apply to home and hybrid workers as well as to office-based staff. Where additional equipment is identified as necessary, the cost falls to the employer [4].
• HSE's 2026 priorities state that employers should favour engineering controls over administrative measures such as task rotation [5].
• An MSD may amount to a disability under the Equality Act 2010 where it has a substantial and long-term adverse effect on normal day-to-day activities, triggering the duty to make reasonable adjustments [6].
• Certain clinically diagnosed occupational diseases associated with musculoskeletal disorders are reportable to HSE under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) 2013, where they are linked to specified work activities [7].

What musculoskeletal disorders are

Musculoskeletal disorder is an umbrella term used by HSE to describe conditions affecting the muscles, tendons, ligaments, nerves, joints and bones. These are grouped by the part of the body affected: back, upper limbs and neck, or lower limbs. Back disorders consistently account for the largest share of working days lost [1].

Common examples include lower back pain and sciatica, rotator cuff disorders, tennis and golfer's elbow, carpal tunnel syndrome, tendonitis in the hand or forearm, hand-arm vibration syndrome, and knee or hip conditions associated with kneeling or prolonged standing.

MSDs can be acute, developing after a single incident such as a lifting injury. More commonly they are cumulative, developing gradually over weeks, months or years of exposure to one or more risk factors. Cumulative cases are often harder to identify early, which contributes to the length of time they feature in the ill-health data for Great Britain.

The scale of the problem

Headline figures from HSE's 2024/25 statistics are as follows [1]:

• 511,000 workers suffered from a work-related MSD (new or long-standing)
• 173,000 were new cases arising during the year
• 7.1 million working days were lost to work-related MSDs
• MSDs accounted for 27% of all work-related ill health cases
• MSDs accounted for 20% of all working days lost due to work-related ill health.

The 2024/25 figure represents a decrease from the 543,000 cases recorded in 2023/24. However, the gradual year-on-year decline observed before the coronavirus pandemic has not resumed, and recent figures have remained broadly flat [8].

Research by WTW found that 63% of organisations identified musculoskeletal and other long-term conditions as a key absence management concern in 2025, up from 51% in 2023 [9].

MSDs by sector

MSD rates vary considerably by industry. Over the three-year period 2022/23 to 2024/25, HSE data shows that MSDs were most prevalent in construction, agriculture (including forestry and fishing), human health and social work, and transport and storage [1].

Construction records the highest rate. HSE data shows the sector sees approximately 2,000 cases per 100,000 workers, around 70% above the all-industry average [2]. Separate analysis by Intasite, a health and safety technology firm, estimates that between 1.1 and 1.4 million working days are lost in construction each year to MSDs alone [13].

Common causes and risk factors

HSE identifies the following main groups of risk factors for work-related MSDs.

• Manual handling: lifting, carrying, pushing, pulling or lowering loads, particularly where the load is heavy, bulky or awkward to grip.
• Repetitive movement: performing the same motion many times, especially where force or an awkward joint position is involved.
• Awkward and static postures: twisting, stooping, overhead reaching, kneeling or holding a fixed position for prolonged periods.
• Force: gripping, pinching or applying pressure, often in combination with repetition.
• Vibration: hand-arm vibration from power tools, or whole-body vibration from vehicles and plant.
• Environmental factors: cold temperatures, poor lighting, cramped workspaces or poorly designed workstations.
• Work organisation: high workloads, tight deadlines, limited control over work pace, insufficient rest breaks and lack of task variety.

Individual factors such as age, prior injury, fitness and existing health conditions can also influence susceptibility. HSE guidance is clear that effective MSD management focuses on designing out risk at the task and workplace level, rather than relying on individual worker adaptation.

The legal framework

Several pieces of legislation combine to govern how employers must manage MSD risk. The primary duty comes from the Health and Safety at Work etc. Act 1974, which requires employers to ensure, so far as is reasonably practicable, the health, safety and welfare at work of their employees [10].

Management of Health and Safety at Work Regulations 1999

The Management of Health and Safety at Work Regulations 1999 require every employer to carry out a suitable and sufficient risk assessment for work activities that could affect the health and safety of employees or others [11]. Employers with five or more employees must record the significant findings in writing. For MSDs, this involves identifying where exposure to risk factors occurs within the business and documenting the controls in place.

Manual Handling Operations Regulations 1992

The Manual Handling Operations Regulations 1992 (MHOR), as amended in 2002, place a hierarchy of duties on employers [3].

1. Avoid hazardous manual handling operations so far as is reasonably practicable.
2. Assess any hazardous manual handling that cannot be avoided.
3. Reduce the risk of injury so far as is reasonably practicable.

HSE's L23 guidance sets out guideline figures for typical handling operations, but these are intended as a filter for identifying tasks that warrant a full assessment, not as legal weight limits [12]. The assessment itself should consider the Task, the Individual's capability, the Load and the Environment, a framework commonly known as TILE.

Health and Safety (Display Screen Equipment) Regulations 1992

The Health and Safety (Display Screen Equipment) Regulations 1992, as amended in 2002, apply to any worker who uses display screen equipment daily as a significant part of their normal work, typically for continuous periods of an hour or more. Core employer duties include [4]:

• carrying out a suitable and sufficient workstation assessment for every DSE user
• ensuring workstations meet the minimum requirements set out in the schedule to the regulations, covering the screen, keyboard, chair, desk and immediate environment
• providing breaks or changes of activity to reduce continuous screen time
• providing eye and eyesight tests on request, with corrective appliances supplied where needed specifically for screen work
• providing information and training.

The regulations apply equally to home and hybrid workers who meet the definition of a "user". Where an assessment identifies that additional equipment is required, the cost cannot be passed to the employee [4]. For homeworkers, assessments are typically completed through a self-assessment questionnaire reviewed by a trained assessor.

Equality Act 2010

Under the Equality Act 2010, a person has a disability if they have a physical or mental impairment that has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities [6]. "Long-term" means lasting, or likely to last, at least 12 months. A musculoskeletal condition may meet this definition.

Where an employer knows, or ought reasonably to know, that an employee has a disability, the duty to make reasonable adjustments is triggered. In MSD cases, reasonable adjustments may include changes to workstation setup, revised duties, flexible working hours, travel arrangements or workplace access. The test is whether the adjustment is reasonable in the circumstances, taking into account factors such as the size and resources of the employer, how practical the change would be, and the extent to which it would reduce the disadvantage faced by the employee.

Other relevant regulations

Depending on the role, further duties may apply. These include:

• Workplace (Health, Safety and Welfare) Regulations 1992
• Provision and Use of Work Equipment Regulations 1998 (PUWER)
• Lifting Operations and Lifting Equipment Regulations 1998 (LOLER)
• Control of Vibration at Work Regulations 2005.

Assessing MSD risk

HSE publishes several free assessment tools designed for different categories of work:

• Manual Handling Assessment Charts (MAC) for lifting, carrying and team-handling tasks
• Risk Assessment of Pushing and Pulling (RAPP) for load-moving tasks
• Assessment of Repetitive Tasks (ART) for upper-limb repetitive work
• DSE Workstation Checklist (CK1) for display screen equipment users.

Each tool helps score and prioritise tasks so that the highest-risk activities receive the most detailed attention. HSE guidance recommends involving employees who perform the work in the assessment process, as they are often best placed to identify where strain occurs in practice. Assessments should be reviewed where the task, the equipment, the environment or the workforce changes significantly.

For office and hybrid workers, a DSE assessment will typically cover screen position (including height, distance and glare), keyboard and mouse layout, chair adjustability, desk clearance, lighting, and the overall pattern of work including breaks and task variety.

Controlling the risk

In its 2026 priorities, HSE restated that MSDs will remain a focus area and that employers should favour engineering controls over administrative measures such as task rotation [5]. This reflects the standard hierarchy of controls.

1. Elimination: removing the hazard entirely, for example by redesigning a process so that heavy lifting is no longer required.
2. Substitution: replacing the hazard with something less harmful, for example by using smaller or lighter containers.
3. Engineering controls: physical changes to equipment or the workplace, such as mechanical lifting aids, adjustable workstations, conveyor systems or ergonomic tools.
4. Administrative controls: changes to how work is organised, including safe systems of work, task rotation, scheduled breaks, training and supervision.
5. Personal protective equipment (PPE): equipment such as knee pads, vibration-reducing gloves and other task-specific PPE, used only as a supplement to higher-order controls.

The evidence base for PPE as a stand-alone MSD control is limited. The widely cited NIOSH review of back belts found no evidence that back belts prevent injury among healthy workers, and advised against using them as a substitute for an ergonomic approach to task design [14].

Examples of controls by setting

The right mix of controls depends on the work being done. Common examples by setting include:

Training and information

The MHOR require employers to provide employees whose work involves manual handling with information and training on the risks involved and the safe systems of work in place. The DSE Regulations impose a similar duty for display screen equipment users.

Useful training content covers:

• how MSDs develop and the main risk factors
• how to use equipment, lifting aids and workstations correctly
• safer techniques for specific tasks relevant to the role
• the importance of reporting discomfort or pain at an early stage
• how to request a review of the workstation or working arrangements.

HSE guidance notes that training is more effective where it is role-specific, refreshed periodically and reinforced by day-to-day supervision.

Early intervention and return to work

Research consistently indicates that early intervention and workplace adjustments produce better outcomes than extended absence followed by an unsupported return. Practical steps for employers include:

• encouraging employees to report discomfort or pain at an early stage, before it progresses to injury
• maintaining appropriate contact during any absence, in line with the employee's preferences
• holding a return-to-work discussion before duties resume
• considering phased returns, amended duties, flexible hours or temporary workstation changes
• obtaining occupational health advice where the condition is complex, recurring, or likely to require longer-term adjustments
• reviewing the risk assessment for the role in light of what the case has revealed.

Where an MSD meets the Equality Act 2010 definition of disability, the duty to make reasonable adjustments applies regardless of length of service, and may extend into long-term sickness absence if the condition does not resolve. Please ensure you take legal advice if you are unsure whether an MSD condition qualifies as a disability.

Record keeping and reporting

MSD-related absence should be recorded as part of normal absence management. Risk assessments and workstation assessments should be documented and reviewed where circumstances change.

Certain MSD cases also fall within the scope of the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR) [7]. Reportable cases include diagnoses of carpal tunnel syndrome, cramp of the hand or forearm, hand-arm vibration syndrome, tendonitis or tenosynovitis of the hand or forearm, where linked to specified work activities and diagnosed by a doctor. Over-seven-day injuries resulting from a workplace accident, which may include acute manual handling injuries, must also be reported within the prescribed timescale.

Conclusion

MSD cases often escalate because the same situation can trigger several employer duties: a workstation issue missed at DSE assessment later becomes a report of discomfort, then a sickness absence and, where the employee meets the relevant criteria, a discussion about reasonable adjustments under the Equality Act. The pre-pandemic decline in MSD rates has not resumed, and the mix of work most employers are managing has changed, which means the risk now needs to be addressed as actively in hybrid and home-based settings as it is on the warehouse floor.

This article is intended for informational purposes only and does not constitute legal advice. The information is accurate at the time of writing but may be subject to change. For advice specific to your situation, please consult a qualified professional.

[1] HSE, Work-related musculoskeletal disorders statistics in Great Britain, 2025, November 2025.

[2] HSE, Work-related musculoskeletal disorders by industry, 2025.

[3] Legislation.gov.uk, The Manual Handling Operations Regulations 1992, as amended.

[4] HSE, Working with display screen equipment (DSE), 2025.

[5] DAC Beachcroft, HSE Annual Statistics and Report 2025: Trends and Strategic Priorities for 2026, 4 December 2025.

[6] Legislation.gov.uk, Equality Act 2010.

[7] HSE, RIDDOR - Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013.

[8] HSE, Health and safety at work: Summary statistics for Great Britain 2025, November 2025.

[9] WTW, Employee absence becomes growing challenge as rising costs impact more than half of employers, January 2026.

[10] Legislation.gov.uk, Health and Safety at Work etc. Act 1974.

[11] Legislation.gov.uk, Management of Health and Safety at Work Regulations 1999.

[12] HSE, Manual Handling: Manual Handling Operations Regulations 1992, Guidance on Regulations, L23, HSE Books.

[13] Intasite analysis, as reported in UK Construction Media, UK construction loses millions of working days to preventable injuries, new analysis reveals, 2025.

[14] NIOSH (US National Institute for Occupational Safety and Health), Workplace Use of Back Belts: Review and Recommendations, 1994.