Ask any HR leader to name their biggest workforce cost drivers and you will hear the usual suspects: health insurance premiums, turnover, recruiting. One category that rarely makes the list, yet quietly touches all three, is musculoskeletal (MSK) injury. Back strains, neck pain, shoulder injuries, carpal tunnel, and repetitive-stress conditions are the most common category of workplace injury in the United States, and they do not confine themselves to warehouses and construction sites. The office administrator hunched over a laptop is accumulating MSK risk just as surely as the forklift operator.

The Scope of the Problem

Musculoskeletal disorders (MSDs) account for more than a million U.S. workplace injuries every year. The Bureau of Labor Statistics has attributed roughly $20 billion in annual workers’ compensation claim costs to MSDs, and NIOSH estimates that total costs of work-related MSK conditions range from $13 billion to more than $50 billion per year once indirect expenses are included. Overexertion injuries alone — lifting, pushing, pulling, carrying — represent roughly a quarter of total workers’ compensation costs nationally, with low back disorders the single largest contributor.
The time-loss picture is just as sobering. Recent BLS data show MSDs generated more than 500,000 days-away-from-work cases in a single reporting period, plus nearly as many days of restricted duty or job transfer, with a median of 14 days away from work per case. Only traumatic injuries to bones, nerves, or the spinal cord cost employers more lost time.

Direct Costs Are Only the Beginning

The direct cost of a single MSD claim, medical treatment plus indemnity, commonly runs from the mid five figures upward, and safety researchers consistently find that indirect costs run two to five times higher than the direct claim. For every dollar visible on a workers’ comp loss run, employers absorb additional dollars in:

• Absenteeism and temporary staffing or overtime to cover the injured employee
• Presenteeism — employees at work but functioning below capacity because of pain
• Retraining, productivity ramp-up, and quality issues when work is reassigned
• Rising experience modification rates (EMR), which raise workers’ comp premiums for years after a claim
• Turnover, as chronic-pain sufferers exit physically demanding roles

There is also a demographic dimension HR leaders should watch: CDC research on workers’ compensation claims found that while MSD claim frequency peaks in mid-career workers, claim cost and days away from work climb steadily with age. As the workforce ages, the average MSK claim gets more expensive.

Why Prevention Beats Reaction

Most employer responses to MSK risk are reactive: the claim is filed, care is managed, return-to-work is negotiated. Ergonomics programs and safe-lifting training are valuable, but they address only the environment not the condition of the employee’s spine and joints, where most of these injuries actually begin. The majority of MSDs are not caused by a single dramatic event. They are cumulative: micro-strain from repetitive motion, sustained postures, and deconditioning that builds silently until a routine task becomes the final straw. That is precisely the kind of problem a preventive care model is built for.

Where Routine Chiropractic Care Fits

Chiropractic care is a non-invasive, drug-free approach focused on the function of the spine and musculoskeletal system, the exact anatomy involved in the majority of workplace injury claims. A growing body of workers’ compensation research supports its role both in treating injuries and in keeping them from recurring:

• A 2022 Workers’ Compensation Research Institute (WCRI) analysis of claims across 28 states found that low back pain claims treated exclusively by chiropractors cost substantially less. One analysis found roughly 47% lower medical costs and about 35% lower indemnity payments, and that those workers returned to work faster.
• A study published in the Journal of Occupational and Environmental Medicine comparing providers for work-related low back pain found that patients under chiropractic care had lower medical expenses, shorter initial disability periods, and fewer disability recurrences than those managed by other provider types.
• Because chiropractic care does not rely on prescription medication, it also aligns with employer efforts to reduce opioid exposure in injured-worker populations, a priority for many risk managers and comp carriers.

The recurrence finding deserves emphasis. Low back injuries are notorious repeat offenders; an employee who files one back claim is significantly more likely to file another. Ongoing, maintenance-style chiropractic care, periodic visits that address joint restriction and postural strain before they become symptomatic, is associated in the research with fewer repeat disability episodes. From an HR and risk standpoint, preventing the second claim may be even more valuable than shortening the first.

Practical Steps for HR Leaders

You do not need to overhaul your benefits plan to begin addressing MSK risk proactively. Consider the following:

• Know your numbers. Pull your loss runs and OSHA logs and quantify what strains, sprains, and back injuries cost you annually, including indirect costs. Most leadership teams are surprised.
• Audit access. Check whether your health plan and workers’ comp network make conservative MSK care (chiropractic, physical therapy) easy to reach, or whether employees default to imaging, injections, and prescriptions first.
• Make prevention convenient and affordable. Wellness stipends, discounted membership-based care arrangements, or on-site/near-site partnerships lower the barrier to routine care before an injury occurs.
• Pair care with ergonomics. Preventive care works best alongside workstation assessments, job rotation, and safe-lifting programs, each addresses a different part of the risk equation.
• Educate managers. Early reporting of discomfort before it becomes a recordable injury should be encouraged, not penalized.

The Bottom Line

MSK injuries are predictable, and predictable problems are preventable problems. Employers that treat spinal and joint health the way they treat dental health, as something maintained routinely rather than repaired catastrophically, consistently see the payoff in lower claim frequency, faster return to work, reduced absenteeism, and a workforce that simply feels better doing its job. For HR professionals looking for a measurable win that benefits both the P&L and the people, musculoskeletal prevention is one of the most underused levers available.

About the Author

Dr. Patrick Greco is a chiropractor and multi-unit franchise owner of The Joint Chiropractic, operating clinics across metro Atlanta and east Georgia as well as Alabama. He also serves as a Regional Developer for The Joint across Alabama, Mississippi, and Louisiana and sits on the brand’s National Franchise Advisory Board. Dr. Greco works with employers throughout Georgia on affordable, membership-based preventive chiropractic care programs for their teams. He can be reached through his clinics or via SHRM Atlanta.