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Musculoskeletal disorders (MSDs) are one of the leading underlying causes of presenteeism, which is when employees work through illness either by personal choice or due to cultural pressures.
Presenteeism costs the UK economy several billions annually due to productivity loss, mistakes, lower quality work, and burnout. Unlike sickness absence, presenteeism is largely invisible, but the financial impact is consistently double that of absenteeism1.
In this guide, we explore the link between MSDs and presenteeism, what it looks like in practical day-to-day terms, how much it’s costing you, and what you can do to bring MSD-related presenteeism under control.
How musculoskeletal disorders drive presenteeism
MSDs typically develop gradually through repeated strain over long periods. Often, they start as mild discomfort that employees feel they can shrug off and work through, and even as the strain compounds over time, the pain becomes normalised, particularly in desk-based, manual and hybrid roles.
As MSDs aren’t always perceived as serious, particularly through onset phases, employees are far more likely to stay on the job rather than take time off to recover. Furthermore, cultural expectations around resilience, workload pressure, and fear of being seen as unreliable reinforce this behaviour.
Learn more about the causes of presenteeism.
The more severe the injury becomes, the greater the impact on a worker’s concentration, mobility, and stamina. Tasks that perhaps take a healthy worker an hour to complete take two or three, and instead of a polished final product, there are mistakes and telltale signs of shortcuts.
Output wains over time as fatigue and frustration sets in.
Left unmanaged, MSDs get progressively worse until the severity of the injury means workers are physically incapable of doing their job, resulting in long-term absences as they recover.
In short, what begins as pushing through discomfort can ultimately become a far more disruptive and expensive problem for businesses.
What MSD-related presenteeism actually looks like
MSD-related presenteeism rarely presents as obvious underperformance. Employees still turn up, attend meetings, and meet basic expectations, but they do so while working around pain, stiffness, or fatigue.
In practice, this often looks like slower task completion, reduced concentration, and an increased need for breaks. Employees may avoid certain movements, manual tasks, or prolonged sitting or standing, subtly reshaping how they work to manage discomfort. Over time, this leads to inconsistent output and lower quality work.
There is also a hidden safety and quality risk. Working in pain increases the likelihood of mistakes, near-misses, and errors in judgement, particularly in roles involving machinery, driving, patient care, or detailed decision-making.
Perhaps most damaging is the cumulative effect. Days of reduced productivity turn into weeks, while frustration and exhaustion build. Colleagues may quietly absorb the extra workload, managers may miss early warning signs, and the underlying MSD continues to worsen.
Why MSD-related presenteeism is more damaging than other causes
It’s not always the case, but due to the insidious nature of MSDs, MSD-related presenteeism tends to be significantly more costly than presenteeism driven by other heath issues.
For example, a worker with a musculoskeletal disorder may soldier on for months working 10, 20, 30% below capacity, culminating in a huge hidden loss for the business. On the other hand, a worker enduring a mental health crisis may work on initially, then quickly withdraw as the issue quickly exacerbates.
Again, this isn’t always the way things go in practice, but it’s certainly a possibility employers should be aware of.
Why don’t employees speak up about musculoskeletal pain?
There are several reasons why an employee may be unwilling or feel unable to report concerns over musculoskeletal pain.
Simple lack of awareness is a big factor. Many workers don’t actually understand that they’re placing themselves in harm’s way when working through pain, especially as, at first, discomfort may ease between workdays. In these instances, ergonomics training can be an effective deterrent.
Concerns about being perceived as weak, unreliable, or unable to cope can also prevent people from speaking up. In fact, in some workplace cultures, particularly in male-dominated industries, “pushing through” pain is quietly rewarded, while reporting problems is seen as creating inconvenience.
There is also a practical barrier. Employees may just not know how or who to report issues to, or they may assume that nothing will change even if they do.
Together, these factors allow MSD-related presenteeism to persist unnoticed, until pain becomes unavoidable and far more costly to resolve.
Estimating the cost of MSD-related presenteeism
Presenteeism is a hidden problem, which makes it hard a subject on which to gather data. There is no single published statistic covering the cost of MSDs as they relate to presenteeism, but we can estimate a very general range by looking at data we do have.
The total annual economic burden of presenteeism per year is ~ £100 billion2. If we conservatively assume that MSDs account for between 15% and 30% of total presenteeism costs, a range broadly consistent with their share of work-related ill health, this would imply an annual cost of MSD-related presenteeism of approximately £15–30 billion per year.
This estimate should be treated as indicative rather than precise, but it highlights the potential scale of the issue.
Bring MSD-driven presenteeism under control with Healthy Working
Unfortunately, there is no single solution to presenteeism at large, but there is a way to control MSD-related presenteeism.
Healthy Working and Healthy Working Pro are our end-to-end ergonomics solutions for DSE users and industrial work environments respectively. Both pieces of software are designed, not just to identify DSE and ergonomic hazards, but to resolve them through targeted training, continuous assessment, streamlined admin, and real behavioural change.
Proven to reduce work-related MSDs by up to 80%, our software helps you rule out a significant causal proportion of presenteeism, protecting your workforce and your business.
Request a free trial of Healthy Working for up to 5% of your team, or contact Cardinus today to learn more about Healthy Working Pro for industrial work environments.
