Working with MSK Conditions during Lockdown: Lessons from Work Changes brought about by the COVID-19 Pandemic
What is the background to this study?
Work that is safe, healthy and which gives individuals some control of their work is good for people's health. However, musculoskeletal (MSK) conditions are often associated with pain, fatigue and loss of function, which can make working difficult for people with these conditions.
The COVID-19 pandemic very quickly changed individuals' working lives, including those with MSK conditions. Some people began working from home, others were furloughed, while others continued working as usual under new constraints and pressures (key workers, for example). These changes to individuals' working circumstances may have in turn impacted on individuals' MSK conditions.
What did we want to find out?
Given the substantial changes made to people's work during the pandemic, we wanted to understand how these changes have impacted people working with MSK conditions (both positively and negatively) in order to shape ideas about how to support healthy working for people with MSK conditions in the future.
What did we do?
People with a diagnosis of axial spondyloarthritis (axSpA), psoriatic arthritis, and people living with chronic pain completed an online or postal questionnaire during the period of June-December 2020, answering questions about their experiences during the pandemic, including any changes to their work. We used this survey to understand how individuals' job circumstances changed - for example, how many people started working from home or were furloughed. We conducted one-on-one interviews over the phone with some of those who completed the survey, in order to understand, in depth, the impact of the pandemic on their lives, including on their work and MSK health.
What did we find?
Survey responses
Over half of participants (55%) who completed the questionnaire and who were working before the UK's first lockdown continued to work as usual (76% of whom were “key workers). Of the remaining participants 24% started working from home; and 21% were furloughed, changed job, or were made redundant.
Interviews
We conducted 18 interviews with a range of survey participants to better understand the detailed experiences of people with MSK conditions during the pandemic. People described changes to both their mental and physical health, and some had a lot of worry about their personal finances. The changes that happened to people's work were often dependent on their personal and home situation. For example, some individuals that had been advised to shield felt that they needed to ignore that so that they could continue working.
Homeworking and changes to commuting gave individuals greater flexibility. For example, some people were able to exercise before starting work in the morning, whereas before this, time would have been spent commuting. This physical exercise in turn helped to improve their symptoms. However, for some, the opposite was the case -some individuals had previously used their commute as an opportunity for exercise, and without this, they found themselves spending more time at their desks.
The flexibility of home working helped some to feel like they could rest when needed, which improved their fatigue and helped them to do their job:
However, individuals who were working from home also sometimes described a feeling of needing to be “present” online so that they were not seen to be “slackers” from their colleagues. Individuals described that this worsened their anxiety and MSK symptoms:
Importantly lockdown, and home working specifically, also impacted on individuals' social interactions. For some, this negatively impacted on mental health, whereas for others, the reduction in social interaction at work helped them to feel less stigmatised:
Why does this matter?
The insights gained from this study help to provide lessons on how to support healthy working for people with MSK conditions, and these findings are also likely to support those working with other long-term conditions. Flexible working, like home working, could help to make the workplace a more inclusive place for people with health conditions. Trust from employers and positive working relationships between employers and employees is key, and the findings from this study could help to promote changes within organisations to think creatively and shape new ways of working that can accommodate everyone.
