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What can be done? Maintaining work when possible during ill health and returning to work without delay after sickness absence are important for the social and economic well-being of both the individual and society [1, 2]. Work appears to be associated with better health than worklessness and may bring net health benefit both physically and mentally [3]. Musculoskeletal disorders and their resulting disability are common within the workforce worldwide, representing a major cause of sickness absence and often leading to long-term absence. In the UK during 200910, an estimated 572 000 people (2% of the working population) reported a musculoskeletal disorder that they believed was either caused or aggravated by their work [4], taking an average of 13.4 days off work each. Of the 2.5 million people receiving incapacity benefit, a UK entitlement for an individual of working age who is not entitled to statutory sick pay [5], some 9% of the working-age population, 25% was attributed to musculoskeletal disorders. Due to the personal and societal burdens and costs and the health consequences of job loss, effective strategies are needed to guide the employment, health care and vocational rehabilitation of these people. There is now a concerted effort across Europe to address these problems [2, 6]. A recent review identified that few data link the clinical course and management of illness and injury with disability status and employment [7]. Few clinical assessments include measurements of disability or relate clinical status formally to activities of daily living. Generally, the effectiveness of clinical interventions on disability and working life is not known. An important exception is RA, where early diagnosis and prompt treatment can greatly influence progress of the disease and disability [8]. Studies also suggest that the risks of symptoms and disability—and non-employment—are influenced by individual psychology and by societal beliefs and expectations [9]. This has led to an important new research focus in occupational health, investigating the influence of cultural and psychosocial factors on responses to illness and work [10]. Although vocational rehabilitation reaches beyond health-care needs alone, health-care professionals are key in helping people stay in or return to work. Primary-care doctors are especially important, as their advice can have a major impact on whether an individual takes sickness absence and if so, for how long, what steps they take to return to work, and on the challenges to restoring and maintaining the best possible working life. Clinicians are …

Sickness absence and musculoskeletal disorders