Musculoskeletal Pain at Work: What Actually Works?
When it comes to managing musculoskeletal pain at work, which approaches — which workplace interventions — actually make a difference? Chronic musculoskeletal disorders (CMSDs) — such as persistent pain in the back, neck, shoulders, wrists or other regions, lasting 12 weeks or more — are among the most common occupational health problems, affecting physical function, quality of life and the ability to work.
A recent systematic review of randomised controlled trials (Skamagki and colleagues, published in BMJ Open in 2026) brought together the latest available evidence on which interventions seem to help most. Below, we explain what its findings mean in practice for workers, HR teams and employers.
Why Chronic Musculoskeletal Disorders Are a Workplace Priority
Musculoskeletal conditions are extraordinarily common: around one in three people in the UK lives with one, experiencing chronic pain and reduced productivity. For businesses, this translates into significant costs through healthcare, absenteeism and presenteeism (working while in pain, with reduced performance).
The shift to remote and hybrid work has added new challenges. Increased sedentary behaviour, inadequate home-office ergonomic set-ups and prolonged sitting have been linked to a rise in musculoskeletal pain, particularly in the upper back, neck and shoulders. In other words, the modern workplace has created new challenges that make effective management more important than ever.
What the Evidence Reviewed
The review synthesised 23 randomised controlled trials involving 2,456 participants, published between 2018 and 2024 across 12 countries and a wide range of jobs — office workers, healthcare professionals, industrial workers, military personnel and manual labourers. The interventions fell into three main categories, which we look at below.
The Three Types of Workplace Interventions
1. Exercise-Based Interventions
Exercise was the most studied approach — including strength training, stretching, neuromuscular exercise and functional rehabilitation. Across studies, it consistently reduced pain and improved function. Notably, exercise programmes delivered digitally (online or app-based) achieved results comparable to face-to-face or on-site delivery, which is promising for remote and hybrid teams. The main caveat is that these improvements in pain and physical capacity did not always translate reliably into better work-related outcomes.
2. Ergonomic Interventions
Only one study tested ergonomics on its own. It found reductions in pain in some regions (neck, shoulder, upper back and wrist/hand) but not others (lower back, hip, knee). On the whole, ergonomic changes in isolation showed limited effects, which appear to depend on the type of work, the body region and how they are applied. They appear to work best as part of a broader programme, and are more closely aligned with preventing physical risk factors — posture, load and repetitive movements — than with managing established chronic conditions.
3. Multicomponent Interventions
These combine several elements — for example, exercise plus ergonomic adjustments plus education or behavioural support. They demonstrated the most consistent and comprehensive benefits across outcomes, improving pain and disability and, in some cases, quality of life and work-related measures. Results still varied depending on how each programme was designed, but the overall pattern was clear: when more than one factor is addressed at the same time, the results tend to be better.
The Key Takeaway: Combined Approaches Work Best
The strongest message from the review is that single-domain interventions may not be enough. Programmes that address both the individual (building physical capacity through exercise) and the workplace (ergonomics, education and organisational support) produce broader, more sustained results. Within this picture, ergonomics functions as an enabling element — reducing ongoing physical strain and supporting participation in work tasks — rather than as a stand-alone fix.
What the Studies Haven’t Measured Well Yet
The clinical benefits above — less pain, better function and, in multicomponent programmes, improved disability and quality of life — are well established. Where the evidence is still thin is in work-related outcomes: work ability, productivity, absenteeism and, especially, presenteeism (being at work but performing below par because of pain) were measured in only a small number of studies. Presenteeism, for instance, was reported in just one.
This does not necessarily mean the interventions don’t affect work. Rather, it shows that work-related outcomes have not yet been measured well enough. The ability to work depends not only on pain, but also on job demands, organisational culture and employer support. In other words, symptom reduction is a strong and consistent result; whether it fully carries over into the workplace remains a priority for future research, with standardised reporting of work-related outcomes.
What This Means for Employers and Workers
For organisations, the evidence supports investing in integrated, context-sensitive workplace health strategies that combine physical exercise, ergonomic adjustments and education or behavioural support — tailored to the specific job and workforce. The goal is to move beyond a purely symptom-focused approach towards one that supports sustainable participation in work. This is especially relevant for ageing workforces and remote or hybrid models, where long-term management and retention are key priorities.
The Specialized Approach of Workplace Physiocare
These findings largely reflect the way we work at Workplace Physiocare. Our interventions are designed and delivered by an occupational health physiotherapist and combine physiotherapy, ergonomics and education in a multicomponent model — tailored to the demands of each role and organisation, and available both on-site and remotely.
Find out more about our specialist services that support employees and businesses:
- Training for the Prevention & Management of Musculoskeletal Disorders
- Musculoskeletal Management & Ergonomics Consulting
- Occupational Health Physiotherapy
How to Build a Healthier, More Productive Workplace
The process for supporting your team’s health is direct and simple. Follow the steps below to get started:
- Get in touch: Send us your request at info@workplace-physiocare.gr or fill in the contact form.
- Initial discussion: We arrange a short call to understand your needs (number of employees, location, working model, current problems).
- Proposal & delivery: We send you a tailored proposal combining exercise, ergonomics and education, suited to your organisation (on-site or online).
Contact us today and let’s design a comprehensive approach together for a healthier, more functional and more productive working environment.
Blog written by Michail Arvanitidis
This information is general and does not replace individual medical or physiotherapy advice. For personalised guidance, consult a qualified health professional.
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