Listening to Frontline Voices on MSDs
A new NSC report highlights gaps in MSD reporting and safety culture.
- By David Kopf
- Oct 15, 2025
Musculoskeletal disorders (MSDs) have been gaining more attention in recent years, and for good reason. These injuries, which affect muscles, tendons, ligaments, and other soft tissues, are the leading cause of workplace injury and lost time. They can develop gradually through repetitive tasks, awkward postures, or heavy lifting, and their impact is not only physical but also organizational, influencing productivity, morale, and overall safety culture. The impact: These injuries cost U.S. businesses nearly $18 billion annually, and amounted to 2.6 million injuries in 2023, according to the National Safety Council.
Yet despite this rising awareness, a persistent problem remains: underreporting. A new report from the NSC’s MSD Solutions Lab underscores just how serious this issue is. The study, based on survey data from 1,000 workers across multiple industries, found that nearly 30 percent of workers who experience musculoskeletal pain on the job do not report it. That silence has consequences. When pain is not acknowledged early, small problems can escalate into disabling injuries that result lost productivity, absenteeism, etc.
The survey also reveals a troubling disconnect. While most safety leaders believe their organizations communicate effectively and support worker involvement in safety, frontline employees consistently report a different reality. That gap in perception points to a deeper trust issue, and may explain why many workers stay quiet about MSD pain. If they do not feel heard or confident their concerns will be addressed, reporting falls by the wayside.
Another key finding is that workers often lack a clear understanding of MSDs or how to report early symptoms. Older workers, in particular, are less likely to report discomfort promptly and less likely to believe their organization can prevent injuries. Access to ergonomic tools and training also remains inconsistent, with many workers saying they don’t always have what they need to reduce risk.
As Paige DeBaylo, PhD, director of the MSD Solutions Lab at NSC, noted: “These findings offer a powerful reminder that safety cannot be achieved without the voice of those doing the work every day. When we engage frontline workers meaningfully, we unlock new opportunities to reduce injuries, foster trust, and improve organizational safety culture.”
For safety and health leaders, the course forward is clear. Workers need simple, accessible ways to report pain early, paired with consistent communication about ergonomics and injury prevention. Feedback systems must not only exist but also be trusted; employees need to see their input acted upon. And perhaps most importantly, leaders must recognize that strong safety culture is built on partnership, not top-down mandates.
By aligning leadership intentions with frontline realities, organizations can foster early reporting, and ultimately reduce the toll of MSDs. For those interested, the full report is available through the National Safety Council’s MSD Solutions Lab at nsc.org/msd.
This article originally appeared in the October 2025 issue of Occupational Health & Safety.
About the Author
David Kopf is the publisher and executive editor of Occupational Health & Safety magazine.