A musculoskeletal disorder (MSD) is an injury or disorder of the muscles, nerves, tendons, joints, cartilage or spinal discs. Work-related MSDs include carpal tunnel syndrome, tendinitis, rotator cuff injuries and back strains caused or made worse by repetitive, forceful or awkward work. They are sometimes called repetitive strain injuries or cumulative trauma disorders.
MSDs matter because they are one of the most common causes of lost work time and workers' compensation costs. Many develop gradually, so by the time a worker reports pain, the damage may already require medical treatment and restricted duty. Most are preventable by fitting the work to the worker.
What Is a Musculoskeletal Disorder?
OSHA describes MSDs as injuries and disorders of the soft tissues and the nervous system. They do not include injuries caused by slips, trips, falls, vehicle accidents or similar sudden events. A work-related MSD is one where the work environment and the way the work is performed contribute significantly to the condition, or where the condition is made worse or lasts longer because of work.
Common Work-Related MSDs
- Carpal tunnel syndrome: compression of the median nerve at the wrist, causing numbness, tingling and weakness in the hand.
- Tendinitis and tenosynovitis: inflammation of tendons or their sheaths, often in the wrist, elbow or shoulder.
- Epicondylitis: often called tennis elbow or golfer's elbow, from repeated forceful gripping and twisting.
- Rotator cuff injuries: damage to the shoulder tendons from overhead work and lifting.
- Low back pain and strains: from lifting, twisting, bending and whole-body vibration.
- Trigger finger: a finger locking in a bent position after repeated gripping.
- Hand-arm vibration syndrome: damage to blood vessels and nerves from vibrating tools.
MSD Risk Factors
- Force: heavy lifting, pushing, pulling and forceful gripping.
- Repetition: the same motions performed many times with little rest or variation.
- Awkward postures: reaching overhead, bending, kneeling, twisting or bent wrists.
- Static postures: holding the same position for long periods.
- Contact stress: hard or sharp edges pressing into the hand, wrist or forearm.
- Vibration: from hand tools or from driving and operating equipment.
- Cold temperatures: which reduce dexterity and increase the force needed.
- Work organization: long shifts, production pressure, too few rest breaks and lack of job rotation.
Risk increases when several factors combine, such as a forceful, repetitive task performed in an awkward posture.
Early Warning Signs
Workers should be encouraged to report early symptoms, including pain, aching, numbness, tingling, burning, swelling, stiffness, reduced grip strength or reduced range of motion. Symptoms that persist after rest or wake a worker at night are especially important. Early reporting allows changes to the job before a minor problem becomes a lost-time injury.
OSHA Rules and Recordkeeping for MSDs
There is no federal OSHA ergonomics standard. OSHA issued one in 2000, but Congress repealed it in 2001 under the Congressional Review Act. OSHA can still cite serious, recognized ergonomic hazards under the General Duty Clause and provides guidance for specific industries on its ergonomics page. California has its own repetitive motion injury standard, Title 8 Section 5110.
For recordkeeping, MSDs are recorded under the same general criteria as other injuries and illnesses in 29 CFR Part 1904. An MSD case is recordable if it is work-related, is a new case and meets one or more general recording criteria, such as days away from work, restricted work or job transfer, or medical treatment beyond first aid. The OSHA 300 log does not have a separate MSD column. See our OSHA recordkeeping guide and the definition of a recordable injury.
Examples of Ergonomic Controls
- Lifting: vacuum lifts, hoists, adjustable-height tables and smaller or lighter loads.
- Repetitive hand work: powered tools, tools with better grips, and rotation between different tasks.
- Overhead work: platforms, lifts or fixtures that bring work to between waist and shoulder height.
- Static work: sit-stand options, anti-fatigue mats and short micro-breaks.
- Vibration: low-vibration tools, tool maintenance and limits on exposure time.
Engineering controls like these reduce risk for every worker on the job, while training alone depends on each person changing how they move.
How to Prevent MSDs Step by Step
- Review data. Look at injury logs, workers' compensation claims and symptom reports to find jobs with MSD problems.
- Involve workers. Ask workers which tasks cause discomfort and what would help.
- Assess risk factors. Use observation and tools such as the NIOSH lifting equation, RULA or REBA to evaluate high-risk tasks.
- Apply engineering controls first. Use lift assists, adjustable workstations, carts, conveyors, better tool design and reduced reach distances.
- Add administrative controls. Use job rotation, rest breaks, team lifts and gradual work-hardening for new or returning workers.
- Train workers. Teach risk factors, symptom recognition and the importance of early reporting.
- Manage symptoms early. Provide prompt evaluation by a health care professional and adjust the job when symptoms appear.
- Evaluate results. Track symptom reports and injuries after changes to confirm the controls worked.
Common Mistakes to Avoid
- Relying on lifting training or back belts instead of redesigning the task.
- Discouraging early symptom reports, which lets problems progress.
- Treating MSDs as unavoidable in physical jobs.
- Fixing one workstation without checking similar jobs.
- Ignoring work organization factors, such as pace and overtime.
How SMS360 Helps
SMS360's Risk Assessment module helps teams evaluate tasks for ergonomic risk factors and record the controls chosen. Early symptom reports and MSD injuries can be captured in Incident Management, and related Claims Management records help show which jobs drive the most cost.
Frequently Asked Questions
What are the most common work-related MSDs?
Back strains, carpal tunnel syndrome, tendinitis, rotator cuff injuries and epicondylitis are among the most common.
Does OSHA have an ergonomics standard?
No. A federal ergonomics standard was repealed in 2001. OSHA can cite serious ergonomic hazards under the General Duty Clause, and some states, such as California, have their own rules.
Are MSDs recordable on the OSHA 300 log?
Yes, when they are work-related and meet the general recording criteria, such as days away, restricted work or medical treatment beyond first aid.
What is the best way to prevent MSDs?
Redesign the job to reduce force, repetition and awkward postures, using engineering controls first, and encourage early reporting of symptoms.
