Lack of positive practice to support people with musculoskeletal disorders (MSDs) in work is leaving hundreds of thousands at risk of lost earnings, reduced productive working time and early retirement, with an accompanying strain on both household incomes and on the UK welfare system. With musculoskeletal disorders being the leading cause of people going onto Employment and Support Allowance (ESA), the report clearly shows what healthcare professionals, employers and policymakers must do to keep individuals with MSDs in active employment.