Position Statement

Defining Musculoskeletal Disorders in the Workplace

This Position Statement was developed as an educational tool based on the opinion of the authors. It is not a product of a systematic review. Readers are encouraged to consider the information presented and reach their own conclusions.

The term musculoskeletal disorder (MSD) is commonly used as a catch-all phrase to refer to a variety of diseases or injuries to bones, muscles, tendons, joints, nerves and blood vessels that may occur in the workplace. Grouping these divergent pathologies into a single term can create confusion and muddle thinking among employers, employees, healthcare providers, insurers, and policymakers that must address workers’ compensation and ergonomics issues. To illustrate this point, the 2001 report from the National Academy of Science and the Institute of Medicine, “Musculoskeletal Disorders and the Workplace,” defines MSD no more specifically than the “loss of the sense of well being in a body part.”

Other vague catch-all terms used to describe diseases and injuries that may occur in the workplace include: cumulative trauma disorder, repetitive stress disorder, repetitive stress injury, and work-related disorder.

Use of these unclear terms can lead to erroneous assumptions and conclusions about pathologies that may occur in the workplace. For example, employers and employees sometimes mistakenly believe that the causes for all of the pathologies that fall within the “definition” of MSD are the same, when in fact the causes of these various pathologies might be quite different.

The term MSD, as well as other non-specific phrases, should not be used as a clinical diagnosis in scientific literature or regulatory language because they are vague terms and subject to misinterpretation. Instead, stakeholders in the workers’ compensation and ergonomics arena should use precise terminology to describe pathologies that may occur in the workplace. This allows researchers and scientists to develop reliable scientific evidence for clearly defined pathologies, which in turn allows policymakers to formulate regulations based on sound scientific evidence. Ultimately, this clarity will improve the quality of care provided to injured workers and reduce overall healthcare costs within the workers’ compensation system.

The American Academy of Orthopaedic Surgeons (AAOS) believes “musculoskeletal disorder” and other non-specific phrases should not be used as a clinical diagnosis because these terms are vague and confusing and do not appropriately describe diseases and injuries that may occur in the workplace.

The World Health Organization created a reporting system known as the International Classification of Diseases (ICD) that provides much more specific descriptions of various illnesses, injuries, and diseases. ICD was developed as a method to report and collect data on illnesses, injuries, and diseases. This reporting system uses precise criteria for clinical diagnoses and is widely accepted across the United States and internationally.

Low back pain, carpal tunnel syndrome, trigger finger, lateral epicondylitis, tendonitis, and bursitis are common medical conditions that have been described as MSDs. However, all of these conditions have existing ICD codes that should be used instead of the term MSD so that there is a more clear understanding of the pathologic process and so that communication among employers, employees, healthcare providers, insurers, researchers, and regulators are more consistent and scientific.

The AAOS believes ICD diagnosis codes should be used instead of “musculoskeletal disorder” and other non-specific terms when describing and reporting pathologies that may occur in the workplace.

© December 2004 American Academy of Orthopaedic Surgeons

This material may not be modified without the express written permission of the American Academy of Orthopaedic Surgeons®.

Position Statement 1165

For additional information, contact Public Education and Media Relations Department at 847-384-4031.