A new exploratory study published by IRSST (Occupational Health and Safety Research Institute Robert-Sauvé) describes in detail, based on a limited number of cases, the various scenarios depicting the differences between clinical judgment, occupational rehabilitation professionals’ understanding of workers’ representations of their MSDs, and workers’ actual representations, during the occupational rehabilitation process.

Work occupies an important place in people’s lives and is a determining factor in shaping adults’ identity and their sense of social belonging. Yet every year, in Quebec, a large number of individuals are absent from work due to musculoskeletal disorders (MSDs), leaving 8% of them unable to continue working. This small number accounts for half of the compensation indemnities paid by the CSST (Commission de la santé et de la sécurité du travail).

Many factors play a part in the development and long-term duration of work disability. Of these, some pertain to the person, workplace, or compensation policies, while others are related to the healthcare and insurance systems. In terms of the person, his representation or understanding of his disease or condition leads to the adoption of behaviours aimed at adapting to or controlling the problem. Clinicians’ representations have not yet been the subject of investigation. At present, it is therefore impossible to understand the factors in the clinician/worker relationship that contribute to a premature end to the rehabilitation management process or to a non-return to work. In the therapeutic context, the existence of differences in representations would appear to be associated with a poor prognosis and to confirm the importance of the clinician understanding the worker’s representations and of defining goals and strategies with the worker’s input.

This study highlights how important it is that clinicians understand the representations held by workers who have a musculoskeletal disability. It also underscores the importance of the objective being acceptable to both parties, or at least of the proposed strategy making sense to the worker.