While the study of orthopedics has traditionally placed emphasis on the physical influencers impacting our bones, tendons, ligaments and other surrounding soft tissue comprising the musculoskeletal system, new research now spotlights the increasingly important role of workplace “psychosocial” factors on musculoskeletal disorders (MSD).
According to the Canadian Centre for Occupational Health and Safety (CCOHS), a workplace psychosocial factor is defined as “a non-physical aspect of the workplace that is developed by the culture, policies, expectations and social attitude of the organization.” 
Basically, psychosocial factors umbrella the different emotional responses to the demands placed on workers while performing their job – including frustration, dissatisfaction, depression and despair. The resulting stress induces physiological responses that can contribute to the development of musculoskeletal disorders.
New research reported by the CCOHS identifies some physiological responses to psychosocial factors, including:
- Increased blood pressure, which in small joint spaces can increase pressure on tendons, ligaments and nerves.
- Increased fluid pressure over a prolonged period of time can also increase pressure in joints and on surrounding soft tissue as well as the carpal tunnel.
- Reduction of growth functions can reduce production of collagen and consequently the body’s ability to heal or recover after performing work functions.
- Over time a decreased sensitivity to pain can prompt workers to work beyond their body’s physical capacity, predisposing it to injury.
- Increased muscle tension can increase pressure on and around the joints and may cause excessive use of force during certain activities and movements.
- The body’s heightened state of sensitivity may overburden the musculoskeletal system by prompting a person to lift more, work faster, etc.
It is difficult in our current healthcare environment to directly attribute “workplace psychosocial factors” as a cause of workplace MSD, because of the many other factors that contribute to such disorders/injuries (biomechanical, etc.). Increasingly, though, evidence and newly published scientific research studies are helping to spotlight the role that these factors play, and the link between “stress induced physiological changes” and musculoskeletal disorders.
Additionally, a growing number of research studies are reporting a link between emotional disorders (anxiety, depression) and medical and surgical complication rates, lower patient satisfaction scores and readmission risk in joint replacement patients. [2,3]
There will likely be much more research on these topics in the coming years.
This new information underscores the importance of identifying and addressing psychological stressors and our response to them, as they are proving to have a significant impact on not only the cardiovascular but also the musculoskeletal system – two vital contributors to overall health and well-being.
- Canadian Centre for Occupational Health and Safety (CCOHS), cchos.ca , https://www.ccohs.ca/oshanswers/psychosocial/musculoskeletal.html .
- Wood TJ, Thornley P, Petruccelli D, et al. Preoperative predictors of pain catastrophizing, anxiety and depression in patients undergoing total joint arthroplasty. J Arthroplasty. 2016 Dec;31(12):2750-2756.
- Gold HT, Slover JD, Joo L, et al. Association of depression with 90-day hospital readmission after total joint arthroplasty. J Arthroplasty. 2016 Nov;31(11):2385-2388.