4 Ways Tobacco Use Makes Musculoskeletal Disorders More Costly

4 Ways Tobacco Use Makes Musculoskeletal Disorders More Costly

Inadequate home working set-ups could be causing thousands of workers discomfort, with many people who began working remotely during the pandemic developing some form of musculoskeletal pain.

This is in addition to those in positions already more likely to experience musculoskeletal disorders (MSD), such as those on manufacturing lines or workers in retail.

However, it isn’t always ergonomics and bad luck that lead to productivity losses from musculoskeletal pain. Instead, is it possible that tobacco is a bigger culprit for workplace sabotage than you think?

Trends with employers to address costly impact of musculoskeletal disorders

When it comes to healthcare costs, many already know that smoking is behind expensive heart and lung disease, as well as numerous cancers. But smokers also have major problems when it comes to bones, joints, tissues, ligaments, and tendons. The result? More sick time for them and more healthcare spending for you.

how common are musculoskeletal disorders

An estimated 126.6 million Americans (one in two adults) are affected by a musculoskeletal disorderscomparable to the total percentage of Americans living with a chronic lung or heart conditioncosting an estimated $213 billion in annual treatment, care, and lost wages.

low back pain cost

But what does that mean on an individual employee basis?

The OSHA’s Safety Pays cost calculator can total up the direct and indirect costs of a common MSD injury. Let’s take back strain as an example, which might have around $30,000 in direct costs related to healthcare expenses and sick leave. That same issue could result in about $35,000 in indirect costs, like lost productivity. And that’s just from one event. What if this employee has a couple back pain events every year?

For many companies, addressing this staggering cost is a high priority. In the 2021 Large Employers’ Health Care Strategy and Plan Design Survey by the Business Group on Health, 2020 was no different from 2019 when it came to the top 5 conditions driving healthcare costs. For both years, employers ranked musculoskeletal disorders (MSD) at the top of the list.

In the survey, employers cited virtual care as a promising way to address MSD, with 29% of employers anticipating that they will offer musculoskeletal management via virtual services this year, and another 39% considering it by 2023. This is mainly because they believe virtual care can deliver cost-effective treatment options while improving access.

This falls in line with a big boom in telehealth in general, with 76% of employers surveyed saying they made changes to provide better access to telehealth services in 2020. In 2021, more than half of respondents (52%) said they plan to offer even more virtual care options.

Yet, there’s another big strategy to consider when trying to manage MSD: Tobacco cessation. Fortunately, it’s also one that could be delivered virtually, giving employees a tailored approach that can affect their MSD, and reduce your direct and indirect costs.

What are musculoskeletal disorders?

MSD includes a wide range of diagnoses, including:

  • Carpal Tunnel Syndrome
  • Tendonitis
  • Muscle/tendon strain
  • Ligament sprain
  • Tension Neck Syndrome
  • Rotator Cuff Tendonitis
  • Radial Tunnel Syndrome
  • Trigger finger/thumb
  • Mechanical Back Syndrome
  • Degenerative Disc Disease
  • Ruptured/herniated disc

These are sometimes referred to as repetitive motion injury, repetitive stress injury, or overuse injury. However, calling them that oversimplifies the fact that many risk factors lead to MSD, including tobacco use.

4 ways tobacco makes musculoskeletal disorders much worse

Providing treatment for MSD without addressing tobacco use is treating the symptom instead of the cause. Here’s why:

  1. Smoking has been shown to have a weakening effect on bones, because it reduces the blood supply to the skeletal system as well as surrounding tissues. Also, nicotine slows production of osteoblasts—the cells responsible for bone formation—so lost bone density isn’t replaced. Smokers absorb less calcium from their food as well, which is another big hit for bone mineral development.
  2. Tobacco use weakens tissues around the joints, which can lead to chronic injury and disease such as bursitis and tendonitis. The American Academy of Orthopaedic Surgeons has found rotator cuff tears in smokers are nearly twice as large as those in nonsmokers, most likely because the tendons in smokers are weaker.
  3. Smoking is linked to higher risk of low back pain, in large part because of the degenerative effect on bones, ligaments, and tendons. Smoking reduces the flow of nutrients to joints and muscles, so if tobacco use isn’t addressed, an employee will continue to weaken that area. That’s a huge deal, considering that back pain is one of the top reasons that employees call in sick and take disability leave.
  4. Tobacco use slows wound healing, because of decreased blood supply to tissues. That means smokers have a higher rate of complications after surgery, as well as higher risk of infection. A wound that may have been healed quickly in a nonsmoker then becomes a potentially long-term problem in a smoker, driving up healthcare expenditures and lowering productivity.

Certain industries have higher prevalence of musculoskeletal disorder than others and also high rates of tobacco use

Certain industries have higher prevalence of MSD, including manufacturing, retail, transportation, agriculture, and construction. Perhaps not coincidentally, these are industries that also see high rates of tobacco use.

Because of these exacerbating effects, tobacco use makes MSD costs even higher. Doing something about tobacco use—and making it digital so employees can access it from anywhere—is key for improving engagement and reach for your quit-tobacco program.

Tailored, innovative approach to help employees quit

Whether they have MSD or not, tobacco users are much more likely to quit successfully when they receive help that is tailored not only to the type of tobacco product they choose, but also specific to how they prefer to receive support and coaching.

For those with MSD, tobacco cessation can make a huge difference in terms of how the disorder progresses—or doesn’t. That can save you enormous healthcare costs in the future, and also strengthen your workforce into one that’s healthier, happier, and more productive.

To do that, employers need innovative programs that meet employees’ needs, including:

  • Live chat coaching to tap into while on a job site
  • An online community to connect 24/7 with peers who are facing the same challenges and who have successfully quit
  • Text messaging for a check-in to get support before or after a shift
  • Free quit medication that’s delivered right to their home
  • A digital, mobile-friendly library of evidence-based resources

The EX Program delivers all of this and more. To start a conversation and learn how we can better meet the unique needs of your workforce, please contact us today.

Amanda Graham Ph.D.

Chief Health Officer

Dr. Amanda Graham leads the Innovations Center within Truth Initiative. The Innovations Center is dedicated to designing and building leading digital products for tobacco cessation, including the EX Program. She is internationally recognized as a thought leader in web and mobile quit-smoking interventions and online social networks and has been awarded over $15 million in research funding. She has published over 120 peer-reviewed manuscripts and serves on National Institutes of Health study sections and numerous journal editorial boards. Graham is Professor of Medicine (adjunct) at the Mayo Clinic College of Medicine and Science.

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