Supervisor, take action when musculoskeletal symptoms occur

When difficulties at work are related to musculoskeletal (MSK) symptoms, you should discuss the restrictions they cause with your employee. Your main concern is not the medical cause of the condition or its treatment. Instead, it is important for you to ask the employee what kind of workload the symptoms are related to and what difficulties the employee experiences in their work. This is your duty, especially if the musculoskeletal condition has been caused or worsened by work or hinders working.

Advice employees to consult occupational health services but do not outsource problem-solving

When you notice that your employee is struggling to perform their work or they report their concerns themselves, follow these steps:

  1. Discuss the matter with your employee as soon as possible. In many cases, you can help the employee perform their work by making some work arrangements.

  2. Encourage the employee to seek advice from occupational health professionals if working has become a struggle due to pain and reduced functional capacity.

  3. In some cases, the employee needs sick leave to support their recovery. The physician’s objective is to limit the duration of sick leave to what is necessary for the recovery.

  4. Keep regularly in touch with the employee on a lengthy sick leave. It is important for you to know how the employee’s recovery is progressing and to plan the return to work.
    • The occupational health physician, nurse, or physiotherapist also monitors the recovery by phone and through appointments.
  5. Ask the occupational health physiotherapist to evaluate the employee’s workload and need for work accommodation. That allows you to make sure that continuing at work or returning to work is successful.

  6. If an employee is on long sick leave, organise a work ability negotiation before their return to work. The participants in the work ability negotiation include you, the employee, and a representative of the occupational health services.
    • In the work ability negotiation, all participants consider the employee’s opinion on their condition and on what work they are able to perform. Based on the discussion, you will know how to support the employee’s return to work and staying at work, and to reduce the risk of a further need of sick leave.
  7. Support your employee’s return to work.
    • Your employee does not usually need sick leave for the whole period of recovery. They can return to work once their functional capacity has been sufficiently restored. That requires work accommodation measures or other arrangements at the workplace. It is important for the demands and opportunities of the job to match the employee’s work ability so that they can continue recovering while working.

Agree with the employee on solutions for continuing at work or returning to work and support them

Suitable work enhances rehabilitation, shortens the duration of musculoskeletal (MSK) symptoms and speeds up recovery. This naturally requires that you have confirmed the suitability and safety of the work well ahead of time.

It is important for your employee’s recovery that they can continue working, return to work, and feel successful. Your employee can continue working even if their work ability has declined. They will succeed in this if you modify the job demands, show flexibility about the requirements of the job, and support the employee.

  1. Modified work is possible when this model exists at your collective agreement and your employer has, together with the occupational health services, agreed on a modified work model for your company. In that case, you can offer your employee other work than their regular work. Modified work means that the employee temporarily performs work that is suitable for their decreased work ability. This can replace the need for sick leave, if recommended by occupational physician.

    Modified work is based on mutual agreement. It must also be based on a medical assessment. Before starting modified work, the employee must make an appointment with an occupational health physician to discuss the situation. As a supervisor, it is your duty to make sure that the modified work is suitable, appropriate and, where possible, similar to the work normally performed by the employee. At its best, modified work can enhance the rehabilitation process. Modified work can also include training.

  2. Suggest a work ability negotiation i.e., an occupational health negotiation, when evaluating an employee’s possibilities to return to work and looking for solutions to support them to stay at work. Discuss at least the following topics together with the employee and a representative of your occupational health team:

    • What are the tasks belonging to the employee?  
    • Which tasks that they can perform without problems? 
    • Which tasks cause problems? 
    • How serious problems and how often?  
    • Proposals for the most common and severe problems related to work performance 
    • Priorities of the solutions, who does what and when? 
    • Follow-up (both the implementation and success of the plan).

    It is not necessary for the employee to immediately return to full-time work or their old tasks, if their musculoskeletal symptoms make it impossible. Returning to work on a part-time basis is possible thanks to Kela’s partial sickness allowance. Work can also be accommodated using a work trial provided by the occupational health services. You can get more information on these from your occupational health physician and nurse.

    Your employee can apply for vocational rehabilitation from Ilmarinen if their work ability is permanently at risk and the other measures to support them to continue working or returning to work do not help. Vocational rehabilitation can be, for example, a work trial. The employee can try doing their old work in a new way or switch to a new, more suitable job.

    Read more about early support opportunities 

    Read more about vocational rehabilitation 

What does work accommodation mean?

Work accommodation means modifying work tasks or working conditions and supporting an employee’s resources when mental or physical symptoms impair their work performance. When accommodating work to reduce physical strain, you must agree with your employee on new ways of working. The new ways of working can be related to, for example, the lifting of heavy loads. You may even have common instructions on this type of physical work accommodation.

Discuss with your employee and suggest work accommodation whenever your employee’s work ability has declined or when they are returning to work after a long absence due to illness. Avoid making assumptions on the need for accommodation and be sure to agree on them together with your employee. Ask questions, listen to the employee, discuss the need for accommodation and make proposals on how you could accommodate their work.

  1. Here are some examples of how you can accommodate your employee’s work:

    1. Work arrangements

    • Clearly defined tasks: focus on tasks that the employee can perform  
    • Dividing the tasks into shorter phases  
    • Accommodating the workload: adapting targets 

    2. Solutions to make commuting easier

    • Alternatives to commuting 
    • Accessible parking spaces 
    • Accessible environment

    3. Modifying the work environment

    • Ensuring the accessibility of the work environment  
    • Modification of workstations  
    • Acquisition of assistive devices or suitable tools 

    4. Providing assistance

    • Working in pairs or agreeing on a support person

    5. Technology solutions 

    • Suitable equipment 
    • Software and settings that support work 
    • Digital services 

    6. Competence development

    7. Work schedule arrangements

    • Avoiding overtime, shorter hours, transferring from work involving evening and night shifts to daytime work, taking breaks during work 
    • Increasing flexibility options: remote work opportunities, dividing up vacation days.

    Monitor your employee’s situation by observing and discussing it with them; if necessary, make more accommodations to their work.

    Accommodate the work tasks for a fixed term or permanently based on the employee’s musculoskeletal symptoms and experiences, for example as follows:

    • Employee with back pain: reduce lifting of loads and twisted work postures 
    • Employee with hand–arm pain (elbow, wrist, fingers): eliminate repetitive movements and tasks that require upper limb strength 
    • Employee with shoulder pain: enable working with the arms below the shoulder level by reorganising the work or acquiring assistive devices, such as extension arms 
    • Employee with lower limb pain: enable alternating sitting and standing at work

    Further options include developing the employee’s competence and to introduce them to a new job. 

    If the MSK symptoms are a result of a work accident, its causes must always be investigated, and corrective action must be taken.

The mere knowledge that work can be accommodated may help

If your employee has symptoms, knowing that their work can accommodated can take away some of their concerns about their ability to perform their work. Once you have discussed things with your employee, agree together when you will discuss their situation again. That shows your employee that you are there for them without them needing to ask you for help. Hold the agreed discussions even if everything is going or seems to be going well.

Propose accommodating the work and accommodate it too soon rather than too late. When you frequently accommodate work at your workplace, it becomes part of your normal activities, and it does not come as a surprise to anyone. When your employee is able to perform their work and enjoy working, work remains an important support and resource for them.