Treatment for Musculoskeletal Disorders

Health care professionals are responsible for determining the physical capabilities and work restrictions of the affected workers and the employer must give the employee a task consistent with these restrictions.

Until effective controls are installed, employee exposure to ergonomic stressors can be reduced through restricted duty and/or temporary job transfer. Complete removal from the work environment should be avoided unless the employer is unable to accommodate the prescribed work restrictions.

Splints and Supports

Immobilization devices, such as splints or supports, can provide relief to the symptomatic area in some cases. These devices are especially effective off-the-job, particularly during sleep. They should not be used as prophylactic PPE to prevent the development of MSDs. Therefore, these devices should be dispensed to individuals with MSDs only by HCPs who have knowledge of the benefits and possible negatives of these devices.

Wrist splints, typically worn by patients with possible carpal tunnel syndrome, should not be worn at work unless the HCP determines that the employee's job tasks do not require wrist bending. Employees who struggle to perform a task requiring wrist bending with a splint designed to prevent wrist bending can exacerbate symptoms in the wrist because of the increased force needed to overcome the splint. Splinting may also cause other joint areas (elbows or shoulders) to become symptomatic as work techniques are altered.

Recommended periods of immobilization vary from several weeks to months depending on the nature and severity of the disorder. Any immobilization should be monitored carefully to prevent complications (e.g., muscle atrophy caused by nonuse).

The HCP should advise affected employees about the potential risk of continuing hobbies, recreational activities, or other personal habits that may adversely affect their condition as well as the risk of continuing work without job modifications.

Work Restrictions

Provide temporary work restrictions, where necessary, to employees with covered MSDs that are serious enough to require some kind of restrictions. Work restrictions are restrictions on the way in which a job is performed or on the activities that the injured employee performs during the recovery period. Work restrictions include changes to the employee's existing job, such as limiting the tasks the employee may perform. Restrictions also include temporary transfer to a restricted duty job or removal from the workplace during the recovery period or a portion of it.

If a HCP has recommended restricted work, you should consider such restrictions necessary to prevent the employee's condition from worsening and to allow the employee's injured tissues to recover. In those instances where the employee has been referred to a HCP, follow the temporary work restriction recommendations, if any, included in the HCP's written opinion.

Evaluate Control's Effectiveness

A follow-up evaluation is necessary to ensure that the controls reduced or eliminated the ergonomic risk factors and that new risk factors were not introduced. This evaluation should use the same risk factor checklist or other method of job analysis that first documented the presence of ergonomic risk factors. If the hazards are not substantially reduced or eliminated, the problem-solving process is not finished.

Because some changes in work methods may actually make employees feel sore or tired for a few days, follow-up should occur no sooner than one to two weeks after implementation, and a month is preferable. Recognizing this fact may help avoid discarding an otherwise good solution.

In addition to the short-term evaluations using job analysis methods and symptom surveys, long-term indicators of the effectiveness of an ergonomics program can include:

• Reduction in the incidence rate of musculoskeletal disorders.

• Reduction in the severity rate of musculoskeletal disorders.

• Increase in productivity or the quality of products and services.

• Reduction in job turnover or absenteeism.

Company health care management strategies and policies and health care providers can be an important part of the overall ergonomics program.