Musculoskeletal disorders in construction: causes, risks and prevention
Lifting a pack of blocks, carrying plasterboard through a building or spending hours laying flooring can all put strain on the body. In construction, these demands are part of everyday work, which makes musculoskeletal disorders (MSDs) a significant occupational health risk.
MSDs affect the back, joints and limbs. They may develop gradually through repeated strain or follow a particular task or incident. For employers, the challenge is to identify which activities create the greatest risk and change how the work is done before discomfort or pain becomes a lasting problem.
Why are construction workers at risk of MSDs?
Construction work combines several risk factors that can occur together: heavy or bulky materials, repetitive movements, awkward working positions and changing site conditions. A load that is manageable on level ground may be much harder to carry upstairs or across an uneven terrain. Time pressure can also make it less likely that workers use available lifting aids or take sufficient recovery time.
The Health and Safety Executive (HSE) identifies skilled construction and building trades among the occupations with the highest estimated prevalence of back injuries and upper limb disorders. MSDs are also among the leading contributors to work-related ill health in construction, as we noted in our wider guide to the biggest occupational health risks by industry.
What causes MSDs on a construction site?
The risks become clearer when you look at the tasks commonly undertaken on construction sites:
Moving materials: Carrying blocks, bags of cement, timber or plasterboard can strain the back and shoulders, particularly over long distances or when loads are bulky and difficult to grip.
Repetitive work: Bricklaying, plastering, painting and fixing can involve the same arm, hand or wrist movements for extended periods.
Awkward postures: Kneeling to lay flooring, bending in a trench or reaching overhead to install services can place sustained strain on joints and muscles.
Pushing, pulling and handling equipment: Moving loaded trolleys across uneven ground or manoeuvring materials in restricted spaces can increase the effort required.
The duration and frequency of a task matter as well as the weight of a load. Workers may also be more vulnerable if they are already experiencing pain or recovering from an injury.
What are employers required to do?
Employers must assess and manage risks that could cause or worsen MSDs. Under the Manual Handling Operations Regulations 1992, they should avoid hazardous manual handling where reasonably practicable, assess tasks that cannot be avoided and reduce the risk of injury as far as reasonably practicable.
In practice, that means looking beyond lifting technique. Could materials be delivered closer to where they will be used? Would a hoist, trolley or other lifting aid remove the need to carry them? Could the work area be arranged to reduce bending and reaching? Workers should also know how to report symptoms early, and employers should review controls when tasks or site conditions change. The HSE’s construction guidance makes it clear that training supports these measures but does not replace them.
How can occupational health support prevention and early action?
Preventing musculoskeletal disorders starts with reducing physical strain and improving working practices. However, when an employee begins experiencing pain, discomfort or reduced mobility, employers may not always know what action is needed.
A Musculoskeletal Assessment can help identify musculoskeletal conditions and assess how they may affect an employee's work duties. Following the assessment, a report is provided outlining the findings and any recommendations. Depending on the outcome, recommendations may include manual handling training, a workplace risk assessment, further medical review or additional occupational health support.
Physiotherapy may also be recommeanded for some musculoskeletal injuries and conditions. Early treatment can help support recovery, improve mobility and reduce the impact of symptoms on day-to-day work activities.
Where a musculoskeletal condition is affecting an employee's ability to carry out their role, attendance at work or return following a period of absence, an Occupational Health Referral may be appropriate. This provides an independent assessment of the impact of the condition at work and can include recommendations on fitness for work, workplace adjustments and return-to-work support.
Musculoskeletal disorders should not be accepted as an inevitable part of construction work. Early identification of symptoms and timely intervention can help reduce the risk of more serious or long-term problems.
Express Medicals supports construction employers with Musculoskeletal Assessments, physiotherapy services and Occupational Health Referrals to help manage musculoskeletal health in the workplace.
Frequently asked questions about MSDs in construction
What are the early signs of a musculoskeletal disorder?
Symptoms can include pain, aching, stiffness, swelling, numbness or tingling in the back, neck, shoulders, arms or legs. Workers should be encouraged to report symptoms early, even if they can still carry out their usual tasks.
Can manual handling training prevent MSDs?
Training can help workers use safer handling techniques, but it cannot remove the risks created by heavy loads, awkward working positions or repeated lifting. Employers should first consider whether a task can be avoided or changed, for example by using lifting equipment or delivering materials closer to where they are needed.
When might a construction worker need an occupational health referral?
An occupational health referral may be appropriate when a health condition is affecting an employee's ability to carry out their role, attendance at work or return following a period of absence. An occupational health clinician can assess how the condition affects the individual at work and provide recommendations on fitness for work, workplace adjustments and return-to-work support
