Multifactorial diseases

^{Back pain is a very common problem. Like all musculoskeletal diseases, there are many different diagnoses and many different causes of this problem. © Colourbox}

It is difficult to define ‘musculoskeletal diseases’. Fractures and disc prolapses are relatively easy to diagnose and relate to a work task. However, in this area there are also health complaints such as myalgia tendinitis, neck pain and lumbago. These are musculoskeletal diseases that are less well defined in diagnostic terms. They often include a significant subjective aspect, and it is often difficult to yield objective, quantifiable findings during a medical examination of such patients. In addition, it is difficult to tell if a disease of this type is work-related or not. We often call these diseases multifactorial, as they can be caused by many different factors.

Examples are:

• Chemical factors (some heavy metals)

• Medications (cytostatic medication)

• Smoking (smokers report more pain than non-smokers)

• Alcohol consumption (alcoholism is associated with different types of tendinitis)

• Cold (low temperatures)

• Specific diseases (rheumatism and connective tissue diseases)

• Leisure time and sports activities.

Also, we know that a patient’s personality and genetic predisposition can be important in the development of musculoskeletal diseases.

It can be very challenging to try to take into account all possible factors and then to isolate the effect a special work condition. However, it is not impossible. It is a puzzle that can be solved.
Because of the difficulties in isolating a specific work-related factor as being responsible for the development of musculoskeletal diseases, in most countries many do not qualify to be included in lists of “occupational diseases” enabling the worker to receive economic compensation. The question of compensation is made doubly difficult as musculoskeletal diseases are also very common, work related or not. Even middle- and high-income countries are concerned about the cost of compensating for occupational disease.