Persistent Pain in the Neck! What Resources Help you Prevent MSDs in the Workplace?

Posted on by Tom Slavin, Kristine Krajnak, Brian D. Lowe, Thais C. Morata

Repetitive tasks, awkward postures, twisting and turning, or forceful exertions at work are often associated with musculoskeletal disorders (MSDs), such as neck or back pain, carpal tunnel syndrome, or tendinitis. These are disorders or injuries that affect muscles, tendons, nerves, discs, ligaments, etc. They remain a leading work-related condition. About 30% of all injuries and illnesses involving lost days from work are associated with repetitive motion and/or overexertion (BLS).

In manufacturing industries, upper limb musculoskeletal injuries account for approximately one-third of the injuries with lost work days.  The prevention of musculoskeletal disorders is one of the priority goals of the National Occupational Research Agenda (NORA) for the Manufacturing Sector.  We are interested in learning what resources you use to help combat  MSDs in your workplace.  Read through this blog and tell us more about where you go for information and what you would like to see made available to you in the future.  Thank you in advance for helping us to provide you with products and information that can help create safer and healthier workplaces.

Finding Quality MSD Prevention Resources

As MSDs are so common, in recent years we have seen a proliferation of advertised solutions and products that are directed at MSD prevention. Internet searches yield many examples, and numerous claims, of success stories in the identification and control of MSD risk factors.   Several sources collect case studies that you can read, and some sources allow users to submit their own success stories. In general these are not centralized, and come in a variety of formats and vary widely in quality.   Many are for the purpose of marketing and commercial interest.  The bottom line is that it can be difficult to decide whether to try any of the solutions.  A word of caution in seeking assistance in preventing MSDs: if you ask experts for advice, ask for evidence that their recommendations are effective at preventing MSDs –AND- consider the quality of the evidence supporting their recommendations.  Unfortunately, evidence supporting effectiveness can range from a “success story” based on a single example to high quality evidence involving formalized testing through cross-sectional or (better yet) prospective experimental design.   The NIOSH 2001 Guide to Evaluating the Effectiveness of Strategies for Preventing Work Injuries:  How to Show Whether a Safety Intervention Really Works covers this.  While the term “best practice” has become commonplace, for practices to be accepted as best, they must truly be supported by evidence of effectiveness and require a stronger quality and quantity of evidence than a single case study in a specific environment with a specific group of affected workers.  CDC has issued guidance to address the criteria for, and development of, a public health best practice (CDC Best Practices Workgroup ).

NIOSH and NIOSH-supported MSD Resources

NIOSH has summarized research-based findings and recommendations for prevention of MSDs, which can be found on the NIOSH Ergonomics Topic Page.   NIOSH has also provided support for other groups to develop resources to reduce MSD.  The Center for Construction Research and Training-CPWR has a publicly accessible library of solutions for construction hazards that includes MSD hazards, and some are applicable to other industries.  This database is structured to facilitate search by type of work, task, or by hazard.  Many of the searchable hazard categories are MSD-related such as stooped postures, lifting and carrying, overhead work, kneeling and squatting, hand-arm-vibration, etc.  Another site, from the University of California Berkeley, lists about 30 case studies, with well-presented description and analysis.  The site contains a template for case study submission.   More recently, NIOSH supported the development of an online database of ergonomics solutions to help reduce the risk factors for workplace MSDs through a Small Business Innovation Research Grant (SBIRG).

More Resources

In an attempt to help safety and health professionals navigate these and other MSD resources, a workgroup within the NORA Manufacturing Sector Council searched for solutions to MSD problems that are specific to or transferable to manufacturing industries.  To be included, the resources needed to be easy to access, understand, and transfer to manufacturing workplaces.  They also needed to be based on documented results of some field-based evaluation.    Below is a list of internet resources (in addition to the NIOSH and NIOSH-supported MSD Resources mentioned above) that met the criteria we used with brief descriptions of each resource.  References to products or services do not constitute an endorsement by NIOSH or the U.S. government.

  1. OSHA’s website contains resources and useful solutions, including training materials.
  2. Washington State Department of Labor and Industries has a searchable Ergonomics Ideas Bank with more than 150 cases.  Input of new cases is encouraged.
  3. ERGOWEB contains 58 case searchable studies describing before, after, risk factor, engineering control, benefits, and comments.
  4. Go Ergo contains more than 70 categorized case studies and presentations on ergonomics that are submitted by users.  It is maintained by the Institute of Industrial Engineers, which presents the Ergo Cup®. New submissions are welcome.
  5. Safework Australia describes several meat packing case studies in a pdf document.  Good technical detail and explanation of interventions.
  6.  The British Health and Safety Executive site contains several case studies and other helpful resources.
  7. The Cochrane Occupational Safety and Health Review Group has 18 systematic reviews on the effectiveness of intervention to prevent or treat MSDs. (look under  2.1.9 Diseases of the musculoskeletal system and connective tissue and 3.1 Measures to rehabilitate workers or facilitate disabled workers to stay at work or return to work). See also Diseases of the musculoskeletal system and connective tissue.
  8. The Campbell Institute Library offers a thoughtful collection of cases studies in safety and health and includes critically examined ergonomic solutions.
  9. While Ergonomics Plus’s website does not include cases, it contains a number of free tools and resources of high quality.

We would like some feedback from you on this resource list.  Have you used any of the NIOSH or other resources?  What did you like or dislike about them?  Your input will help the NORA Manufacturing Sector Council and our readers learn about centralized resources or databases of solutions currently available to companies and safety and health professionals for MSD prevention and control.  Once we have a better understanding of what is available, we can determine what resources are needed and where we can contribute.  Feel free to add   other sources you refer to for ideas, solutions, and other information on MSD prevention and ergonomics specific to manufacturing. Thank you for your assistance in identifying and improving the dissemination of resources that can help tackle work-related musculoskeletal disorders.

Tom Slavin MS, MBA, CIH, CSP, CSHM, CPEA; Kristine Krajnak, Ph.D.; Brian D. Lowe, Ph.D., CPE; Thais C. Morata, Ph.D.

Mr. Slavin is a consulting industrial hygienist for Cardno ChemRisk and a member of the National Occupational Research Agenda (NORA) Manufacturing Sector Council.

Dr. Krajnak is  a research biologist in the NIOSH Health Effects Laboratory Division and a member of the National Occupational Research Agenda (NORA) Manufacturing Sector Council.

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. Morata is a Research Audiologist in the NIOSH Division of Applied Research and Technology and the Coordinator of the National Occupational Research Agenda (NORA) Manufacturing Sector Council.



Posted on by Tom Slavin, Kristine Krajnak, Brian D. Lowe, Thais C. Morata

16 comments on “Persistent Pain in the Neck! What Resources Help you Prevent MSDs 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 ».

    An awesome site for ergonomic evaluation tools and discussions is

    The best part is all the info is free!

    My friend has had neck pains starting the new year and he had to go to a massage therapist. I’m not sure if it worked because his neck pain still persists. I hope these links will help him out.


    As a scientist, it’s sobering to realize the power of stories. We tend to focus on doing good science and to trust the reader to get the gist without too much frilly bits. But in real life we emulate friends, family or some influential others when choosing solutions to problems. It’s a nice challenge to figure out how to deliver the message of a systematic review (unbiased evidence) with the same effect to convince as a case study (biased evidence).

    Thank you for your comment. It is indeed a challenge with today’s information overload to promote the best, unbiased sources, and for users to identify them. With this blog we aimed to start this discussion, to gather an insight on how people are ranking large amounts of information by importance and to recommend that they give attention to that which has been demonstrated as effective.

    Many of the cases on the Campbell Institute Library are winners of the Robert W. Campbell Award, that recognizes excellence through the integration of EHS management in business operations. The Institute is currently seeking applications for the 2014 Campbell Award. For more information on the Campbell Award, see [] (Letters of intent are due February 28, 2014).

    Implementing a strategic ergonomics program and engaging employees to help assess the resources and case studies noted above is an effective approach at reducing workplace musculoskeletal disorders. I appreciate the list of these resources and look forward to sharing it with manufacturers.

    NIOSH has always been one of my “go to” resources for biosafety, biosecurity, and biorisk-related information. I recently used several of the references from this page and other NIOSH ergonomic-related webpages to create an e-training module for veterinarians and other individuals who work with animals: Ergonomics and Your Facility. (See []). Thanks for the great information!

    We at the Institute for Work & Health (a not-for-profit research organization in Toronto, Canada) have some evidence-based tools and case studies that you may find useful.

    Based on a systematic review of participatory ergonomics (PE) — — we developed a lay-friendly guide to making PE programs successful:

    Staying on the PE front, senior scientist Dr. Emile Tompa and his team just got the 2013 Applied Ergonomics best paper award for a case study on an economic evaluation of a participatory ergonomics (PE) program at a textile manufacturing firm:

    We were also one of the system partners in Ontario that contributed to the MSD Tool Kit — guidelines and resource materials for preventing musculoskeletal disorders (MSDs):

    You can access our full list of tools and research related to preventing MSDs at:

    This is a great article for people like me who are constantly bothered by chronic musculoskeletal problems. Thank you for this.

    Great idea to pull authoritative resources together, thanks. But is this evidence based? We now know psychosocial factors are major determinants of musculoskeletal disorders, and these are neglected in this set of references. why? Prof Niki Ellis, Melbourne

    The references we provided are evidence-based but the list certainly is not exhaustive. As we noted, one of the purposes of the blog is to collect references that our readers feel are useful. Please add any psychosocial resources that would be useful to readers and meet the evidence-based criteria. Thank you.

    First of all, congratulations on your site and thanks for all the excellent information that NIOSH makes available to all of us in the field of Occupational Health.

    I would like to inform (those who do not already know it) about the “IEA/ICOH Ergonomics Guidelines for Occupational Health Practice in Industrially Developing Countries”, a joint publication by the International Ergonomics Association (IEA) and the International Commission on Occupational Health (ICOH). These Guidelines are available online and can be downloaded, free of charge, for example, from the ICOH site (where other ICOH documents are also available):

    Occupational exposure to whole body and hand-transmitted vibration can be associated with limb pain and injury to the joints and muscles. Information on these hazards, diagnosis of vibration-induced disorders, and solutions used to reduce the effects of vibration will be the focus of the 5th American Conference on Human Vibration, to be help in Guelph Ontario, June 10-14th 2014.

    Definitely back pain is the most common problem.We need to fight it back.Thanks for your post.It was very informative…….

    This is a great article for people , who are constantly bothered by chronic musculoskeletal problems. back pain is the most common problem.We need to fight it back.Thanks for your post.It was very helpful for everyone. you can also visit to our website we providing chirorpactic services in Australia.

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Page last reviewed: August 25, 2017
Page last updated: August 25, 2017