Musculoskeletal and orthopaedic conditions account for 28% of all seafarer repatriations — and 72% of those cases could have been treated successfully onboard with earlier clinical intervention, according to data from VIKAND's OneHealth programme.

The figures, released by Ronald Spithout, managing director of oneHealth by VIKAND, show musculoskeletal complaints are the single largest clinical category the maritime health provider encounters, at 13% of all clinical consultations. Low back and lumbosacral conditions alone drive 60% of musculoskeletal repatriations.

For ship operators already wrestling with crewing costs and officer shortages, the commercial consequence is direct: every avoidable repatriation means rebooking travel, sourcing a relief crew member at short notice and absorbing the disruption of an unplanned absence — a hit that deepens when senior or specialist personnel are involved.

Why do crew delay reporting pain?

Shipboard work is inherently punishing on the body. Seafarers climb ladders, lift heavy equipment, work in confined spaces and perform physically demanding tasks while compensating for vessel movement. Strains that never fully heal compound over a contract.

Unlike an accident, musculoskeletal conditions develop gradually. A crew member may keep working for days or weeks, adjusting how they move and avoiding painful motions, before seeking help — by which point a manageable problem has begun to affect mobility and the ability to work safely.

There is also a cultural barrier. "There can also be a reluctance to speak up because they do not want to increase the workload of colleagues or are concerned that reporting pain could result in them being sent home," Spithout said. That perception, he argues, needs to change, because seeking advice early actually improves the chances of remaining onboard.

What does early intervention deliver?

The OneHealth data makes the case numerically: 72% of musculoskeletal cases managed through the programme were successfully treated onboard, returning crew to fit-for-work status.

Telehealth is the enabler. A remote clinician can assess symptoms, evaluate how movement and function are affected, identify warning signs and determine whether specific duties are aggravating the condition. Follow-up consultations then track recovery and flag whether further intervention is needed.

Some cases will still require care ashore — diagnostic imaging, specialist assessment or physiotherapy. The objective is not to keep every seafarer onboard, but to ensure decisions follow timely clinical assessment rather than waiting until the condition has deteriorated and options have narrowed.

Who is being affected?

The demographic profile sharpens the workforce concern: 84% of musculoskeletal cases in the VIKAND dataset involve crew members aged between 30 and 49 — seafarers in what should be the most active years of their careers.

For an industry focused on retaining experienced officers, this matters. Retention debates typically centre on pay, career progression and working conditions, but recurring back, knee or shoulder problems can eventually make moving ashore a physical necessity rather than a career choice.

Prevention, Spithout says, requires a combined approach:

• good ergonomics and safe working practices;
• appropriate strength and mobility programmes;
• a culture where crew feel safe reporting problems early, without fearing that mentioning persistent pain puts their position onboard at risk.

What is the business case?

With 72% of musculoskeletal cases treatable onboard, operators have a clear opportunity to prevent repatriation disruption while protecting seafarers' health and careers. Persistent pain, the argument runs, should not be accepted as an inevitable part of life at sea.

As crew shortages persist across the merchant fleet and operators compete to retain experienced personnel, expect early-access telehealth and preventive health programmes to move from welfare consideration to crewing-cost line item in operators' retention strategies.