Musculoskeletal disorders (MSD) continue to be a serious problem for office-based employees and employers. These conditions are the primary drivers of workers' compensation costs and are significant components of healthcare and disability insurance costs. MSD are not managed well in most organizations. The origins of these disorders are viewed as complex and the solutions offered by vendors often seem too expensive and/or inefficacious. A lack of good information about MSD is the primary reason for the continued rise in related costs.
Traditional interventions for reducing MSD in the office environment - ergonomic evaluation and specialized equipment and training-need to be augmented by the creation of new cultural norms and beliefs about the "way we work" in office environments.
The body and the mind are intertwined in the origin of musculoskeletal disorders. The body and the mind are interwoven into an effective solution for MSD. The office environment presents a conducive venue for implementing an MSD solution. With only a little knowledge about the physiology and psychology behind these conditions, MSD and their associated costs can be dramatically reduced without expensive equipment.
In this paper we will present an overview of issues surrounding MSD and its prevention, then offer some nontraditonal approaches to changing worker behavior. First, a brief review of the physiology of MSD will be presented; secondly, simple workstation and worker adjustments will be discussed; finally, the pivotal role of organizational culture will be considered.
MSD have born a number of monikers: cumulative trauma disorders (CTD), repetitive motion injuries (RMI) and repetitive stress injuries (RSI), to name a few. The reason for so many acronyms may be because of the confusion that surrounds the origin of these soft tissue disorders. In the office environment it has been conventional wisdom that repeatedly striking the keys or clicking the mouse is the source of the stress that leads to a musculoskeletal disorder, hence the recurrence of the word 'repetitive' in the terms listed above.
More recently, the notion of 'repetitive stress' has been supplanted by the notion of 'nonrepetitive stress'. In fact, static muscle contraction may be the most important factor for development of MSD in the office environment. The following diagram shows how static stress in the muscle 'cascades' into disorders that involve multiple tissues, resulting in greater disability and greater cost.
Exhibit 1. Musculoskeletal Disorder Cascade Effect (available in full paper)
The process begins with exposure to static contraction of a muscle group (see star above). For example, in the office the muscle of the posterior forearm (the muscles that move the fingers away from the keyboard) are often contracted for extended periods of time, as we hold our hands poised over the keyboard. The muscle contractions are relatively weak, but are maintained for relatively long periods, perhaps several minutes.
