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Joint Pain in the Workplace

Posted on by Brian D. Lowe, PhD, CPE; Brent A. Baker, PhD, ATC; Jim Grosch, PhD, MBA

Musculoskeletal disorders (MSDs) include a number of physical conditions affecting muscles, tendons, nerves, ligaments, joints, and other soft tissues that can be caused, or exacerbated, by work.  It is estimated that MSDs account for approximately one-third of injury and illness costs in U.S. industry.  Many musculoskeletal conditions can result specifically in chronic or short-term joint pain.  One example of joint pain is arthritis, which is the leading cause of work disability, according to the CDC.  Arthritis is a condition in which the cartilage surfaces between bones wears away resulting in bone rubbing on bone.  In 2007, the annual cost of arthritis and other rheumatic conditions was reported to be $128 billion (MMWR, 2007).  This total included an estimated $47 billion in lost earnings.  The prevalence of arthritis in the U.S. is projected to increase to nearly 67 million (25% of the adult population) by the year 2030 with 25 million (9.3% of the adult population) projected to be limited in their physical activity because of the condition (Hootman and Helmick, 2006).  Working-age adults (45-64 years) will account for almost one-third of arthritis cases.  Workplace programs in the areas of safety, ergonomics, wellness, and disability management can all play a role in preventing joint pain and preserving joint health in working individuals of all ages.

Aging is a natural process that encompasses biological changes that tend to be associated with the development of joint pain or that may limit the ability to work with joint pain.  In addition to arthritic joint degeneration, aging is associated with loss of muscle mass and muscle function.  Functional loss is influenced by changes at the cellular and molecular physiology level.  These changes may reduce joint stability and impair normal joint motion that affect the ability to tolerate specific work postures and repetitive motion.  With a loss in muscle strength, the same level of physical effort places a greater demand on an individual relative to her/his capabilities.

The relationship between aging and joint pain in the workplace is complex and influenced by a number of factors.  For example, national surveys of workers across a wide variety of occupations indicate that not all older workers (50 years and older) report a greater risk of joint pain.  Older workers at greatest risk tend to be in jobs that have high physical demands.  And once an MSD has occurred, it may take longer for an older worker to return to work.  In spite of these factors, studies indicate that older workers suffer no decrease in overall job performance.

While chronological age can’t be slowed, evidence suggests ways in which the development of joint pain, or its effects, can be reduced through intervention.  Lifestyle interventions target individual factors that positively affect musculoskeletal health.  For instance, obesity has been shown to be a predictor of osteoarthritis (MMWR, 2010), suggesting a transference of benefits from obesity prevention to the prevention of joint pain.   Exercise, more specifically resistance training, has been shown to slow, or even reverse, the effects of aging (Melov et al. 2007)  and has been suggested to be possibly the most effective mode of exercise for improving quality of life as we age (Hartman et al., 2007).  One of the benefits of a well-designed exercise training program may be improved joint health.  Employers, like Lincoln Industries, are endorsing workplace exercise programs, in which employees participate at work sometimes even during work hours, as a preventive approach to preventing joint pain and musculoskeletal discomfort (see examples in Promising Practices for Total Worker HealthTM).

Lifestyle and wellness program interventions are important, but alone do not fully address the scope of joint pain and its prevalence in an aging workforce.  Workplaces can play an essential role in preserving joint health. To prevent MSDs and joint pain among employees, employers should emphasize workplace equipment and tools that reduce forces, repetition, vibration, and awkward work postures in physically demanding workplaces. Reducing these physical stresses in occupations is paramount to the prevention of joint pain and compliment individual wellness interventions.  These interventions often accommodate the employee with existing joint pain by reducing physical demands and allowing the affected individual to work productively.  In many cases, workplace modifications to achieve these affects are not costly capital investments.  Prevention of a single episode of joint injury is often sufficient for recovery of the cost of the intervention.  

Emerging evidence suggests negative health consequences of sedentary work (van Uffelen et al., 2010).  This is an interesting contrast in that it gives rise to the redesign of office workplaces to increase overall activity level of the worker (see blog: VHA’s Success with Increasing Movement at Work). Sit/stand workstations have long been endorsed as a human factors solution to problems with seated work.  Standing computer workstations are gaining in popularity but are of unproven benefit as prolonged standing has associated health concerns.  Other socio-technical solutions have been proposed to integrate lower levels of dynamic activity into traditionally sedentary work in the form of treadmill workstations, accessible indoor walking trails and the use of these to encourage “walking meetings”.  

We are interested in hearing about your experience in the prevention and management of joint pain in the workplace.  What programs or activities does your organization have in place to prevent and/or reduce the burden of joint pain?  What should NIOSH be doing in this area?

Brian D. Lowe, PhD, CPE; Brent A. Baker, PhD, ATC; Jim Grosch, PhD, MBA

Dr. Lowe is a Research Industrial Engineer and Certified Professional Ergonomist with the Human Factors and Ergonomics Research Team in the NIOSH Division of Applied Research and Technology. 

Dr. Baker  is an Integrative Exercise Physiologist, Board Certified Athletic Trainer, and is Team Leader for the Musculoskeletal Pathomechanics Research Team in the NIOSH Health Effects Labortary Division.  

Dr. Grosch is a Senior Research Psychologist with the Work Organization and Stress Research Team in the Division of Applied Research and Technology.


Hartman MJ, Fields DA, Byrne MM, Hunter GR. 2007 Resistance Training Improves Metabolic Economy During Functional Tasks in Older Adults. JSCR 21(1): 91-95.

Hootman JM, Helmick CG. 2006 Projections of US prevalence of arthritis and associated activity limitations.  Arthritis Rheum. Jan;54(1):226-9.

Melov S, Tarnopolsky MA, Beckman K, Felkey K, Hubbard A. 2007 Resistance Exercise Reverses Aging in Human Skeletal Muscle. PLoS ONE 2(5): e465.

Morbidity and Mortality Weekly Report (MMWR)   National and State Medical Expenditure and Lost Earnings Attributable to Arthritis and Other Rheumatic Conditions – United States, 2003.  January 12, 2007/56(01); 4-7.

Morbidity and Mortality Weekly Report (MMWR)   Prevalence of Doctor-Diagnosed Arthritis and Arthritis-Attributable Activity Limitation — United States, 2007—2009.   October 8, 2010 / 59(39);1261-1265

van Uffelen, J.G.Z. et al. (2010).  Occupational Sitting and Health Risks: A Systematic Review.   American journal of preventive medicine, 39 (4), 379-388.

Posted on by Brian D. Lowe, PhD, CPE; Brent A. Baker, PhD, ATC; Jim Grosch, PhD, MBA

26 comments on “Joint Pain in the Workplace”

Comments listed below are posted by individuals not associated with CDC, unless otherwise stated. These comments do not represent the official views of CDC, and CDC does not guarantee that any information posted by individuals on this site is correct, and disclaims any liability for any loss or damage resulting from reliance on any such information. Read more about our comment policy ».

    This is a very important topic for safety in construction and I have found very little research and virtually no potential solutions. Many guys just wear out their knees, shoulders and other joints until one day some otherwise mundane activity results in pain that leads to surgery. How do we keep people from getting into this condition in the first place? There’s not a lot we can do with everyday activities (or is there?). Are there stretching, warmup, fitness regimens for construction workers? All of these I’ve seen are not well suited to construction – working and standing in the dirt. How can we teach people to take better care of joints, treat minor strains, etc? These are for the most part physically demanding jobs working long hours. They’re not going to go to the gym before or after work. Just as difficult for truck drivers who may be sitting most of the day but are still fatigued after ten or twelve hours in the cab.

    I doubt there’s any magic bullet but are some things we can do at the margins to make things better?

    Thank you for your questions. There are things that can be done to prevent or minimize joint injury and pain. There are numerous examples of workplace interventions that can reduce physical loads in construction work which in turn can reduce injury and pain (see for instance: CPWR’s Construction Solutions; and NIOSH’s Simple Solutions: Ergonomic for Construction Workers There are also examples of targeted exercise programs that may have benefit in addressing specific joint symptoms (e.g. shoulder pain: see “A longitudinal analysis of the effects of a preventive exercise programme on the factors that predict shoulder pain in construction apprentices” These exercises can be performed at home with very little equipment. There are also exercise training programs to promote joint mobility and core strength that have been used by construction workers.

    More scientific studies of the benefits of various forms of exercise are needed. Current evidence suggests that stretching, by itself, may have minimal benefit. Resistance (strength) training appears to be more effective, but more research is needed on the best ways to prescribe intensity, particularly in response to muscle/joint problems. There is much conventional wisdom, but specific types of exercise training programs have not been systematically explored. The good news is that research and practice are growing in this area.

    We agree that we need to educate about the importance of joint health. This blog is one step in the right direction.

    And finally, finding the time to exercise is often a problem. Workers can receive a high-quality return on their exercise investment without a gym membership. The actual exercises prescribed and carried-out are more important than where they are done.

    I wanted to coat tail on Steve Bells comment. Construction has a major issue with the aging workforce that may go beyond just MSD’s. Consider the limited mobility that older workers may have especially when climbing on structures which would include ladders and scaffolds. I know NIOSH has a report on the increased potential to older worker injuries/deaths when climbing, the same for “heavier” workers. This is a challenge from the employee discrimination standpoint and it is not always as simple as saying “don’t climb”.

    Back to point. While there are now several ergo solutions to minimize MSDs older workers have worked without them for most of their career and may already have existing joint issues that, as Mr. Bell remarked, waits for a mundane activity to show itself. Even if the contractor implements a stretching/fitness “progam” as an intervention that may not prevent the pre-existing issues from surfacing. Hopefully, if implemented properly, it will help prevent MSD’s to younger workers but could it take years to see MSD injuries subsiding? And even if the “program” is used on the jobsite the worker is still exposed to multiple stressors off the job which can result in further deterioration. Any “program” needs to be introduced as a 24/7 change proposition. The “new” construction matra “work smarter not harder” is great but often clashes with the “work hard play hard” mindset that also exists.

    As a MPH student and licensed massage therapist, I see the people who are struggling with musculoskeletal pain and dysfunction which affects their work and their leisure pursuits. I decided to pursue an MPH degree because I think that positive culture change will make the biggest impact on musculoskeletal health. I am encouraged that this article discusses workplace culture and the culture of physical activity in Western society as it relates to arthritis, pain and injury.

    Thanks for the post. We need to keep getting the words “work place safety” out there. We’ve come along way but still have a ways to go. I write a blog on building health and safety.

    Getting massage therapy is a great way to improve joint pain. I’d also say that eating a healthy diet and using supplements is another great tool. Increasing the intake of Omega 3s also known as EFAs is powerful and will help lubricate the joints and cells.
    -Julie, owner of Sol Impressions Massage Studio

    I agree that getting massage therapy is a great way to improve joint pain. My mom is a massage therapist and she gives massages to people who are in hospice care and I believe it helps them greatly. I know that shoulder and upper back pain are an issue for people who are terminally ill and can’t get out of bed very easily. Massage therapy definitely helps with that!

    Resistance training is a good way to slow aging.
    Other methods include clean eating and living a low stress life.

    I agree that getting massage therapy is a great way to improve joint pain. I was in the same boat myself a few years ago. Great post!

    I see the people who are struggling with musculoskeletal pain and dysfunction which affects their work and their leisure pursuits. I decided to pursue an MPH degree because I think that positive culture change will make the biggest impact on musculoskeletal health.

    Thanks for the post. We need to keep getting the words “work place safety” out there. We’ve come along way but still have a ways to go. I write a blog on building health and safety.

    Thanks for the post.I agree that getting massage therapy is a great way to improve joint pain. I was in the same boat myself a few years ago.

    I know all about joint pain! I first wrecked my knees squating, no knee wrapes. Then I got into Chinese Martial Arts system, which uses knees a lot to product power. Now, I’m forced to do desk work, and it’s drives me nuts! Glad my bud Mark found your blog.Thanks.

    Awesome blog. I enjoyed reading your articles. This is truly a great read for me. I have bookmarked it and I am looking forward to reading new articles. Keep up the good work!

    As a Massage practitioner I had seen first hand the benefits that massage can have in people suffering with pain. I recently did a training on cupping massage that it’s really good for people that are suffering with Arthritis, back and neck, Sciatica and so on…

    Thanks for the post. We need to keep getting the words “work place safety” out there. We’ve come along way but still have a ways to go. I write a blog on building health and safety.

    Thanks for the great article. I am always on the lookout for health and fitness related articles. I’m a professional bobybuilder, you see. I scoure the internet looking for health journals that might just give me the edge over my competitors. The information here about Musculoskeletal disorders and the physical conditions that affect muscles, tendons, nerves, ligaments, joints are very important to my research about the human muscle building capabilities. I have. I have conducted some tests about muscle growth.

    Great post. We’re a disability management firm up in Canada and we are seeing a similar pattern of increasing MSD claims with our customers. Understanding the value in workplace safety and prevention, ergonomic working conditions, and effective return to work strategies are essential ways to reduce your workers’ compensation claim costs.

    Very nice info dear. There are a lot of medical problems related to workers in different communities and they must be dealt with by these measures of informative procedures.

    The importance of early diagnosis and intervention to contain degenerative disease such as osteoarthritis cannot be overstated enough. The very first intervention when the disease is in initial stages is weight loss. However, one challenge that patients face is losing weight when the mobility itself is painful. In such scenarios, exercises that are low-impact in nature such as aquatic exercises can be a great alternative.

    Weight loss is one potential approach to address osteoarthritis in individuals with a high BMI. However, there are many osteoarthritis cases where individuals do not have a high BMI, particularly among the aging population. Any treatment should be evaluated, approved and prescribed by the appropriate allied health care physician/clinician on an individualized basis.

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