Goodbye work-related musculoskeletal disorders, welcome musculoskeletal health! A call for action

Despite decades of global attention, work-related musculoskeletal disorders (MSD) remain a significant challenge, with substantial personal and societal costs (1). The lack of progress in addressing this prevalent problem is not due to a lack of trying. Legislation and campaigns aimed at primary prevention of work-related MSD have been available in numerous countries (1). In an editorial written already about two decades ago, Wells (2) addressed the question "Why have we not solved the (work-related) MSD problem?". Formulated in six questions, Wells established the key factors to assess our ability to prevent work-related MSD: (i) How well do we understand MSD and their burdens?; (ii) How good are our MSD risk factors?; (iii) How effective and informative are current workplace MSD assessment approaches?; (iv) How effective are the recommended interventions in actually reducing MSD in the workplace?; (v) How intensely and widely implemented are workplace interventions to prevent MSD?; and (vi) How well are we improving disability outcomes for MSD? In our paper on 50 years of research published in the Scandinavian Journal of Work, Environment 50(5):317-328. https://doi.org/10.5271/sjweh.4172 2. Wells R. Why have we not solved the MSD problem? Work. 2009;34(1):117-21. https://doi.org/10.3233/WOR-2009-0937 3. Holtermann A, Sørensen OH, Jacobsen SS, Lindberg L, Andersen LL. Beyond risk reduction of work-related musculoskeletal disorders: The CoWork musculoskeletal health model. Scand J Work Environ Health. 2025 Dec 2:4262. https://doi.org/10.5271/sjweh.4262 4. Andersen LL, Sørensen OH, Calatayud J, López-Bueno R. Societal impact of micro-exercise for work-related musculoskeletal disorders: The case of Denmark. Societal Impacts. 2025;5:100102. https://doi.org/10.1016/j.socimp.2025.100102 5. Schmidt KG, Lerche AF, Christensen MR, Rasmussen CL, Straker L, Mathiassen SE et al. Effectiveness of a Goldilocks Work intervention in childcare workers - A cluster-randomized controlled trial. Scand J Work Environ Health 2024 Apr;50(3):197-207. https://doi.org/10.5271/sjweh.4145 6. Loisel P, Hong QN, Imbeau D, Lippel K, Guzman J, Maceachen E, Corbière M, Santos BR, Anema JR. The Work Disability Prevention CIHR Strategic Training Program: program performance after 5 years of implementation. J Occup Rehabil. 2009 Mar;19(1):1-7. https://doi.org/10.1007/s10926-008-9160-1 7. Proper KI, van Oostrom SH. The effectiveness of workplace health promotion interventions on physical and mental health outcomes - a systematic review of reviews. Scand J Work Environ Health. 2019 Nov 1;45(6):546-559. https://doi.org/10.5271/sjweh.3833 8. Javanmardi S, Rappelt L, Zangenberg S, Heinke L, Baumgart C, Niederer D, Freiwald J. Effectiveness of workplace health promotion programs for industrial workers: a systematic review. BMC Public Health. 2025 Jan 15;25(1):168. https://doi.org/10.1186/s12889-025-21365-8 9. Robroek SJ, Coenen P, Oude Hengel KM. Decades of workplace health promotion research: marginal gains or a bright future ahead. Scand J Work Environ Health. 2021 Nov 1;47(8):561-564. https://doi.org/10.5271/sjweh.3995 10. Foster NE, Anema JR, Cherkin D, Chou R, Cohen SP, Gross DP, Ferreira PH, Fritz JM, Koes BW, Peul W, Turner JA, Maher CG; Lancet Low Back Pain Series Working Group. Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet. 2018 Jun 9;391(10137):2368-2383. https://doi.org/10.1016/S0140-6736(18)30489-6 11. Beenackers MA, Kamphuis CB, Giskes K, Brug J, Kunst AE, Burdorf A, van Lenthe FJ. Socioeconomic inequalities in occupational, leisure-time, and transport related physical activity among European adults: a systematic review. Int J Behav Nutr Phys Act. 2012 Sep 19;9:116. https://doi.org/10.1186/1479-5868-9-116 12. van der Put AC, Mandemakers JJ, de Wit JBF, van der Lippe T. Worksite health promotion and social inequalities in health. SSM Popul Health. 2020 Jan 17;10:100543. https://doi.org/10.1016/j.ssmph.2020.100543 13. van der Molen HF, Hulshof CT, Kuijer PPF. How to improve the assessment of the impact of occupational diseases at a national level? The Netherlands as an example. Occup Environ Med. 2019 Jan;76(1):30-32. https://doi.org/10.1136/oemed-2018-105387 14. Kuijer PPFM, van der Molen HF, Visser S. A health-impact assessment of an ergonomic measure to reduce the risk of work-related lower back pain, lumbosacral radicular syndrome and knee osteoarthritis among floor layers in The Netherlands. Int J Environ Res Public Health. 2023 Mar 6;20(5):4672. https://doi.org/10.3390/ijerph20054672 15. Crielaard L, Nicolaou M, Brown AD, Dijkstra SC, Ter Ellen F, Elsenburg LK, Luna Pinzon A, Waterlander WE, Stronks K. Systems approaches in public health: beyond mapping the causes. Int J Behav Nutr Phys Act. 2025 Jun 12;22(1):74. https://doi.org/10.1186/s12966-025-01766-z 16. Ali N, Ellis B, Woolf A, Hamilton S, Fenton KA. Developing partnerships and a whole-system approach for the prevention of musculoskeletal conditions in England. Public Health Panorama 2018;4:407-414. https://iris.who.int/handle/10665/324935 17. Hagenaars LL, Schmidt LA, Groeniger JO, Bekker MPM, Ter Ellen F, de Leeuw E, van Lenthe FJ, Oude Hengel KM, Stronks K. Why we struggle to make progress in obesity prevention and how we might overcome policy inertia: Lessons from the complexity and political sciences. Obes Rev. 2024 May;25(5):e13705. https://doi.org/10.1111/obr.13705 18. Sundstrup E, Workplace-based prevention of musculoskeletal disorders: effective interventions and future potentials. PREMUS 2025: 12th International Scientific Conference on the Prevention of Work-Related Musculoskeletal Disorders, PREMUS 2025: 12th International Scientific Conference on the Prevention of Work-Related Musculoskeletal Disorders | Publisso.