What Are Musculoskeletal Disorders?

What are Musculoskeletal Disorders?

Musculoskeletal disorders can be any injury, damage or disorder of the joint, or other tissues in the upper/lower limbs or the back. The total number of work related musculoskeletal disorders in 2014/15 in the Great Britain was 553,000, with the number of new cases being 169,000 (HSE 2015).

Upper limb disorders are linked to using equipment with display screens and also with using vibrating tools. Symptoms can include:  aches  redness  pains  swelling  a burning sensation

Lower limb disorders affect the whole leg from hip to foot. The types of activity that can contribute to this type of disorder is: -kneeling or squatting repeatedly -standing in the same position for a prolonged period of more than two hours with no break -frequently jumping from a height. Symptoms can include:  pain  restricted movement.

Back pain can occur due to: -lifting -stooping -pushing or pulling heavy loads -crouching -having a poor grip on the load, -working when tired -repetitive tasks -reaching -driving for long distances or over uneven ground -twisting -poor posture -remaining in one position for a long time

Severe pain that gets worse over a period of a few weeks should be seen by a doctor. Fortunately it is rare for back pain to be due to an issue like a slipped disc, trapped nerve or a serious disease or injury. Serious symptoms that need to been seen by a doctor immediately include incontinence, numbness or pins and needles in legs, or unsteadiness on legs (HSE 2016).

(NQ Physio Solutions 2016)

Manual Handling and Musculoskeletal Disorders For the NHS, poor manual handling can cause a variety of musculoskeletal problems. An estimated 9.5 million working days were estimated to be lost due to musculoskeletal disorders in 2015 (HSE 2015). Musculoskeletal injury caused by manual handling accidents results in 40% of healthcare sickness absence (HSE 2011), of which 10% are from manually handling or supporting a person (HSE 2013). As well as cost implications, there are also risks to health. Nurses have the highest rate of work-related back pain compared to other health professions (Clemes et al 2009, Nelson et al 2006). As regards patient safety, poor manual handling techniques can bruise or tear patients’ skin, increase the risk of pressure sores, and even dislocate patients’ hips (Brooks et al 2011, Cornish et al 2007).

(DFH Ergonomics Limited 2016)

This is still the case, despite the introduction of the following pieces of legislation:

 The Health and Safety at Work act 1974  The Manual Handling Operations Regulations 1992  The Management of Health and Safety at Work Regulations 1999

An ergonomic approach with risk assessments, which is the current form of training in the United Kingdom, is an effective form of manual handling training (Clemes et al 2009). Healthcare professionals do not make clinical decisions in isolation. A multi-layered context exists, that includes the patient and health professional relationship, the NHS as an employer, and the profession itself with its code of conduct, as well as society and government (Gillespie 2010).

(MJ training 2016)

Relating this to manual handling, the patient can influence the healthcare professional to make poor manual handling decisions if the patient shows apprehension of equipment, is aggressive or confused, or raises up their arms in expectation of the drag lift, for example. However, the health and safety of staff and patients should be a primary concern. The healthcare professional's own morals, experiences, confidence and knowledge can influence decision-making. The greater the capacity to be self-aware and reflect on the clinical decisions made, the less likely the healthcare professional will be to make poor decisions that are not in their own or their patient’s best interests (Gillespie 2010). The culture in which a health professional works can influence how one goes about his or her job – if poor, or indeed good practice is the norm, then this is more likely to influence each individual staff member to follow this norm. Moreover, staff shortages and workload can influence the decisions made, as well as what resources are available and the environment in which the healthcare professional works (Gillespie 2010). In relation to manual handling, the Health and Safety at work act 1974 indicates that employees must: 7a) take reasonable care for the health and safety of himself and of other persons who may be affected by his acts or omissions while at work, and employers must provide 2c) the provision of such information, instruction, training and supervision as is necessary to ensure, so far as is reasonably practicable, the health and safety at work of his employees. Therefore employers have the responsibility to provide necessary manual handling equipment, and employees have the responsibility to use it. As regards putting training into practice, memory recall may not be triggered as well by practising manual handling technique on colleagues compared to assisting the mobility of a frail patient (Swain et al 2003). Learning appears to take root more in the real clinical setting rather than the classroom, so the influence of more experienced staff has a strong impact on NHS department practices.

What to do if Musculoskeletal Disorder Occurs If any musculoskeletal symptoms occur, your line manager or other health and safety representative should be informed, so that either rest breaks can be implemented or working tools, equipment or environment can be adapted as needed. A referral to Occupational Health may also be made to determine the main contributors to the musculoskeletal disorder. To reduce chances of musculoskeletal disorder: -take regular breaks -get up and stretch -have your workstation adjusted to suit your height -vary your tasks to avoid repetitive movement -cooperate with your employer when they introduce measures to reduce risk, either through introduction of equipment or systems for reporting incidents (HSE 2016).

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