Five things we learned about musculoskeletal health conditions and employment in the UK
28 October 2026
Musculoskeletal (MSK) conditions - including problems with the back, neck, arms, hands, legs and feet - are common, affecting an average of 13.8% of the working-age population in the UK from 2013 to 2023.
They matter not only for health policy but also for the labour market, as MSK conditions can affect whether people enter work, remain employed, or leave employment, as well as the quality of jobs they hold, including their working hours, pay, and opportunities for career progression.
1. Long-term health problems are rising, and they are becoming more complex.
The proportion of the working-age population reporting a long-term health problem increased from 33.3% in 2013 to 40.7% in 2023. This is consistent with wider ONS evidence showing a rise in economic inactivity due to ill health in the UK.
Although the overall proportion of the working-age population reporting MSK conditions has remained relatively stable over time between approximately 12.5% to 14.5%, MSK conditions increasingly occur alongside other long-term health conditions, including mental health conditions and other physical health conditions
2. MSK prevalence varies by personal characteristics, and is often higher among those where its employment consequences are most acute.
Older individuals, people with lower educational attainment and those living in regions with weaker labour demand report higher MSK prevalence than their respective counterparts.
People with MSK conditions are about 23.1 percentage points less likely to be employed than otherwise comparable individuals with no long-term health condition, and this relationship is magnified among the same groups of individuals mentioned above. This means that the employment consequences of MSK conditions are concentrated among already vulnerable groups: older individuals, people with lower educational attainment, and those living in regions with weaker labour demand.
3. Different long-term health problems have different employment impacts.
MSK, mental health conditions, other long-term health problems, and combinations of these are associated with different employment probabilities.
For MSK specifically, the employment gap for people with MSK relative to those with no long-term health problems is comparable to the gap for people with mental health conditions. The gap is larger for those with comorbidities, especially when MSK conditions occur alongside mental health conditions[MO1.1][JT1.2].
For MSK specifically, the employment gap for people with MSK relative to those with no long-term health problems (at 19.4 percentage points) is comparable to the gap for people with mental health conditions. The gap is larger for those with comorbidities, especially when MSK conditions occur alongside mental health conditions (at 36.1 percentage points).
4. Employment entry matters, especially for young people.
The challenge is not only helping people stay in work after a health problem develops. It is also helping people with MSK conditions get into work. MSK conditions are associated with 39.6% lower rates of entry into employment relative to those with no long-term health condition, with larger gaps for people whose MSK conditions occur alongside other long-term health problems.
These gaps are particularly important for younger people. This links closely to the Milburn Review on young people and work, which argues that the UK faces an “interlocked health, disability and participation issue.” Addressing this requires a holistic approach that considers both demand-side barriers such as inclusive employer practice and supply-side barriers faced by people with MSK conditions such as having appropriate skills and incentives to work.
5. Employment retention risks vary by worker, health condition and job demands.
People with MSK conditions are 2.3% less likely to remain in employment than people with no long-term health condition, but the risk varies by worker characteristics and by whether MSK conditions occur alongside other long-term health conditions. Job demands also matter: MSK conditions appear to have greater implications for employment retention among workers in physically demanding roles.
This links directly to the Mayfield Review’s emphasis on early intervention by employers. For example, occupational health provision might be targeted towards the workers and roles where MSK-related employment retention risks are greatest.
Implications for policy and employer practice
Our analysis provides some key insights for policy and employer practice. Our evidence reinforces the need for policy development to move beyond broad labour market policies for people with long-term health conditions. The type of health condition and the presence of comorbidities matter for labour market outcomes suggesting that more tailored support might be more effective.
Employment support should consider both employment retention and entry. Supporting people to stay in work is essential, but policymakers also need to consider the incentives for work and how to support more inclusive job search and hiring, especially for young people.
Employers similarly can tailor support to those most at risk of exit to retain skilled and experienced workers, as well as consider the barriers for those with long-term health conditions within their own recruitment processes.
Future research
In the next stage of this project, we will explore the relationship between MSK conditions and the characteristics of employment, including pay, as a way of measuring job quality. This is directly relevant to the government’s “good work” agenda and better understanding the implications of ill-health among those in work.
By Melanie Jones (Cardiff University), James Banks (University of Manchester), and JoAnn Tan (Cardiff University)
This project has been funded by the Nuffield Foundation’s Oliver Bird Fund and Arthritis UK, but the views expressed are those of the authors and not necessarily the funders. Visit www.nuffieldfoundation.org and www.arthritis-uk.org. We are grateful to Scope for their helpful comments on an earlier draft of this policy brief. The views expressed, and any remaining errors or omissions, are our own.
This project uses data from the Annual Population Surveys produced by the Office for National Statistics and accessed via the UK Data Service. The Office for National Statistics and the UK Data Service bear no responsibility for the analysis or interpretation of the data. For any questions or follow-up queries, please contact JoAnn Tan at TanJ24@cardiff.ac.uk.
