Work-focussed health care: the role of Physiotherapists

17 December 2020

Associate Professor Venerina Johnston and a team of international collaborators recently published a Point of View article in the journal Physical Therapy1.

The paper argues that Physiotherapists treating individuals with musculoskeletal problems should adopt a work-focused approach.

What are musculoskeletal disorders?

Musculoskeletal disorders (MSDs) are characterised by pain and reduced physical functioning that often results in decreased quality of life. Work-related musculoskeletal disorders (WRMDs) are health problems in which working conditions (ie, physically demanding or repetitive activities or a poor work environment) significantly contribute to the onset or progression of a pre-exisitng problem (e.g. Whiplash or osteoarthritis), but are not necessarily the sole cause.

Even if work-related environmental factors do not directly cause MSDs, the symptoms can be work-relevant (i.e., the work can influence the symptoms, or the symptoms can affect the ability to work). WRMDs are burdensome to individuals , employers and society as they are associated with high rates of disability, absenteeism, presenteeism, loss of productivity, longer recovery timeframes and compensation costs.

Associate Professor Venerina Johnston expands:

“In this Point of View, we argue that physiotherapists treating patients with MSDs should adopt a work-focused approach. There is ample evidence showing that being employed is associated with better health. Physiotherapists can improve the health-related quality of life for patients with MSDs through adopting a work-focused approach and promoting participation in work.”


Work focussed approach

This can be defined as ‘Where the healthcare professional acknowledges the importance of work by identifying and addressing obstacles to work participation in the clinical encounter in collaboration with other stakeholders ’.


Physiotherapists are ideally situated to provide work-focused care and to support employees with MSDs.

Therefore, we recommend that:

1. Physiotherapists become familiar with the health benefits of  work and the importance of adopting a work-focused approach in treatment2.

2. Physiotherapists  discuss work participation in clients  with MSDs during the consultation. If the complaints are relevant to the performance of work, physiotherapists should include  work-focused goals and address issues related to work participation during the consultation or refer to the appropriate practitioner or case manager (for compensable clients).

3. Physiotherapists should adopt a self-management approach to treatment for patients with persistent musculoskeletal disorders whenever possible. Problem solving, decision making, resource utilization, the formation of a patient-provider partnership, action planning, self-tailoring, self-monitoring, and patient–health professional partnership are essential components in this approach3

Please contact A/Prof Venerina Johnston at for further information relating to the above topics.


1. Nathan Huttinga, Rose Boucautb, Douglas P. Grossc, Yvonne F. Heerkensa, Johnston, Venerina, Glykeria Skamagkid and Kjerstin Stigmare (2020). Work-focused health care: the role of physical therapists. Physical Therapy 100 (12) 2231-2236.


3. Hutting N, Johnston V, Staal BJ, Heerkens YF. Promoting the Use of Self-Management Strategies for People with Persistent Musculoskeletal Disorders: The Role of Physical Therapists. Journal of Orthopaedic & Sports Physical Therapy (JOSPT). 2019;49:212-215.

Author affiliations

a. HAN University of Applied Sciences, the Netherlands.

b. University of South Australia

c. University of Alberta, Canada.

d. Coventry University, United Kingdom.

e. Lund University, Sweden.