Disorders of the musculoskeletal system affect people of all ages. This book considers the causes, consequences and management of these diverse disorders in the context of working life. They are a major cause of distress, disability, impaired work performance and sickness absence among people of working age. For many, they result in worklessness. In addition, they incur great costs – personal and family costs; the costs of health care, social care and welfare; costs in respect of organisational performance and lost productivity; and cost to the economy.

Of course, these can be the consequences of any significant health condition. It is the magnitude of burden, loss and costs resulting from musculoskeletal conditions that gives them the high priority signalled in this book. Together with mental health problems, they are the most common causes of workplace disability.

The range of problems dealt with by the array of authoritative contributors shows the progress being made towards understanding many of these disorders. It also shows how much remains to be learnt. Our ignorance ranges from a limited understanding not only of the pathophysiology of many common conditions, of appropriate investigation and treatment, but also of their sociological relations, and of rehabilitation and management in respect of working life.

For those reasons, the Arthritis Research UK charity, in partnership with the Medical Research Council (MRC), has established the new Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work. This Centre will focus on research into musculoskeletal disorders and work. The projects to be undertaken will have the common aim of reducing workplace disability from musculoskeletal disorders in a cost-effective manner.

The issues are not for health professionals alone, be they research academics or clinicians, general practitioners, rheumatologists or occupational health specialists. Effective practice and best management also depends upon the knowledge and actions of employers at every level of employing organisations, from senior leaders to line management.

Our evidence base on the effectiveness of workplace health interventions is not strong.

Most of the evidence for investing in health and well-being at work comes from observational studies. These relate measures of health and well-being – or their impairment – to a range of important outcomes that can be influenced: sickness absence and the associated costs, for example. Some examples are persuasive, and they can be quantified and may be costed.

Moreover, the weakness of evidence does not justify inaction in times of need, and the benefits of agreed good employment practice are self-evident. There is wide recognition of the practices and organisational arrangements necessary if we are to meet the clear needs of many people of working age who are afflicted by these painful, long-term, often fluctuating conditions. This book provides authoritative guidance for all who have a part in this endeavour.

Professor Dame Carol Black.

Principal of Newnham College University of Cambridge, Expert Adviser on Work and Health to the Department of Health and Public Health England, and Chair of the Nuffield Trust.