Musculoskeletal injuries: burden estimation and under-reporting in military forces

Musculoskeletal injuries (MSI) occur frequently among military personnel and affect their physical capabilities, occupational fitness, readiness for deployment, mental health, and general wellbeing. Chronic pain often results and injury rehabilitation, no matter how thorough, does not always enable return to work. Commanders must consider associated personnel costs, as over 10% of a military force’s personnel may be on limited duties on any
given day due solely to MSI and their sequelae (1), and recruitment of replacements is challenging; thus better prevention and management of MSI are a force multiplier. Military health services, budget managers, and compensation schemes are also acutely aware of the human and monetary costs MSI and their management pose for the organisation and individuals. For these reasons mitigation, early detection, and optimal management of MSI and their sequelae are critical and, at an organisational level, planning and budgeting for these activities must be informed by accurate estimates of the true MSI burden and knowledge of patterns and sources of MSI. Unless countered though the use of correction
factors, substantial under-reporting of MSI leads to unrealistically low estimates of the MSI burden, resulting in poor MSI management and outcomes.