Manage people, not musculoskeletal symptoms

Gabrielle Lis

Ignoring the non-physical causes of musculoskeletal problems leads to very poor outcomes in this all too familiar case study.

Employers often believe that, in order to manage musculoskeletal claims effectively, resources need to be focused on fixing physical factors in the workplace. While ergonomic adjustments and hazard checklists are important, the latest research suggests that non-physical factors – things like stress, relationships with managers and unchallenging, repetitive duties – make a huge contribution to the development of musculoskeletal problems.

When employers fail to take these factors into account and do not act to remedy them quickly, they open themselves up to costly, drawn-out claims, reduced productivity and high staff turn-over. Focusing on physical modifications can mask what is really going on: social, emotional or relationship issues in the workplace that may have serious medical consequences, not to mention what they do to claims' costs.

The real life case study below illustrates the consequences of mismanaging the non-physical factors that contribute to musculoskeletal disorders.      

Case study

Ms P is a 32 year old who has worked in the finance industry since completing her studies at age 24. She joined Employer Y (a large services industry company) approximately four years ago.  Her initial position was as a reconciliation officer and she did not have problems in that role. 

In June 2006 there was review of her role. The review occurred when she was on a week’s annual leave. When she returned to work, she was advised that the role of reconciliation officer was not really a full-time job and should only take 25 hours per week to complete.

Ms P was offered part-time work at that rate or the alternative of moving into another position. Needing a full-time wage, she chose to move into another role. She felt there was insufficient communication about the process, but did not articulate this at the time.
The new role was that of a receipting officer. 80% of this job involved regular data entry. Various pieces of information from paperwork needed to be entered into the finance software system by keying numbers via the numeric keypad. 

Ms P’s right wrist became sore within a few months of starting this new job. Her doctor diagnosed her with RSI and she was given a few days off work. She returned to work on modified duties and had ongoing physiotherapy. In her clinical presentation there was a strong emphasis on the lack of training she had been given at induction regarding working postures at a computer. 

Ms P’s employer made adjustments in an attempt to accommodate her condition. Non-repetitive duties such as going to the bank were included in her duties, to break up the repetitive tasks.  Her workstation was reviewed and a document holder was provided. A few months later a gel wrist support pad was provided. The height and ergonomic layout of the workstation was reviewed and found to be satisfactory. 

Ms P continued in the receipting officer role, but indicated mild ongoing arm pain.  Her work pace was an ongoing concern to the employer, and performance management discussions about her slowness in getting the job done were undertaken on two occasions.  She was getting through less than half the workload of others.

While Ms P had previously been chatty at work, she now spoke only to one coworker, and avoided her manager whenever possible. Others in the finance division were resentful of Ms P, because her poor productivity resulted in more work for them. Ms P no longer attended work functions and did not greet her colleagues when she arrived at work.
In June 2007 Ms P requested annual leave. After discussion with her manager she was advised that, as it was the end of the financial year, she needed to get her work up to date before going on leave or the leave would not be approved.  Ms P worked her normal hours and did what she could, but the soreness in her wrist increased. With the increase in pressure at work, Ms P indicated that she developed a further soreness, near her right elbow.  

Ms P’s pain improved while she was on leave but upon return to work her pain became more troublesome. Ms P’s treating doctor then gave her further time off work, following which he advised return to work on restricted duties, limiting her to ten minutes of keyboard work at a time.   5 minute rest breaks were required every hour.

As a result of how this case was handled:

  • Ms P is now less productive;
  • The workplace issues are more of a concern;
  • The work relatedness of the condition is in question and her claim is being investigated; and
  • The work place restrictions have not been associated with a lessening of the symptoms. 

Ms P’s employer was quick to make ergonomic adjustments to her workstation, but slow to manage the stress and pique she felt when her job was restructured, as well as the boredom that resulted from her new, repetitive job.

Ms P has developed a long term health problem, and her employer has exchanged a productive employee for one with low morale and output.   Regardless of whether Ms P’s claim is eventually accepted, outcomes for both employer and employee are poor.