Why MSK support decides whether your ageing workforce plan works

Organisations that plan well for an older workforce will be those that have understood the MSK risk in their people.

Ageing workforce planning is now a standing item for reward teams. State pension age is rising, more employees are working into their 60s, and the retirement cliff has been replaced by a long tail of later-career employment. The usual response is phased retirement, ﬂexible working and reskilling.

Those measures address how people work. They do not address whether people stay well enough to keep working, which is where the plan quietly breaks.

The latest ONS estimates put healthy life expectancy at birth in the UK at 60.7 years for males and 60.9 years for females in 2022 to 2024, the lowest levels since the series began in 2011 to 2013. Compared with the State Pension age of 66 during that period, this represents a gap of just over ﬁve years. While this does not mean that health suddenly ends at 61, it highlights that many people may spend part of their later working lives in less than good health.

Musculoskeletal conditions are among the leading causes of health-related economic inactivity and can be a major factor in whether someone is able to remain in work.

Age is the wrong variable to base the plan on

What changes with age is where the cost lands. In workers aged 50 and over, pain was signiﬁcantly more likely to disrupt sleep (43.1 against 36.1%), prompt healthcare use (56.9 against 44.1%) and drive absence (24.0 against 18.3%). In under-50s it was more likely to affect productivity (23.1 against 15.9%) and concentration (28.8 against 17.8%).

One caveat frames all of it. Employees with severe chronic MSK conditions are disproportionately likely to have already left desk-based work through ill-health retirement or long-term absence, so the differences we observe are almost certainly underestimates.

What carries someone through the last decade

Musculoskeletal health is often treated as a narrow issue of pain, absence or workstation support. However, the evidence suggests that pain, physical function and activity are also connected with wider health and people’s ability to remain well and effective throughout their working lives.

Longitudinal studies have found associations between lower physical strength, persistent pain and poorer cognitive outcomes over time. Physical inactivity has also been identiﬁed as an important modiﬁable risk factor for long-term health, and musculoskeletal pain can make it more difficult for people to remain active.

This does not prove that MSK support improves cognition. It does reinforce the case for intervening earlier, to help people manage pain, maintain strength and stay physically active. On that reading, MSK support belongs in a wider workforce-health strategy, not just as a response to discomfort or absence.

What this means for benefits design

Segment on function, not age band. Age is a blunt proxy for MSK risk and, on our data, a poor one for pain burden. Workforce-level data shows where risk actually sits.
Fund capability, not only relief. Strength and movement are what carry someone through the last decade of a career, and they are where the cognitive evidence also points.
Treat sleep as an MSK outcome. If two in ﬁve workers over 50 are losing sleep to pain, sleep and MSK support belong in the same programme.
Weight care navigation more heavily. An avoidable progression to joint surgery at 55 is not only a claim. It is a capability event with a decade of working life still to run.

Flexibility and reskilling will not move retention, absence or productivity on their own if the real constraint is physical capability. Extending careers without extending capability does not remove the cost. It moves it from the pension line to the absence, claims and presenteeism lines.

The organisations that plan well for an older workforce will be the ones that understood the actual shape of MSK risk in their people, not the assumed shape, and acted before it became a cost.