Background: Musculoskeletal disorders (MSDs) are commonly encountered in current occupational health practice and comprise up to 45% of the workload for occupational physicians (OPs). Aims: To compare the reported incidence of work-related (WR) MSDs by specialist OPs and specialist rheumatologists and to relate it to self-reported and general practitioners-reported WR MSDs. Methods: Analysis of data reported to surveillance schemes within The Health and Occupation Reporting network and comparison to denominator data derived from the Labour Force Survey and occupational/work activity classifications. Results: There are significant differences between the patterns of WR MSDs seen by the different specialist groups. Thus OPs report three times as many back and lower limb conditions. However, both specialist groups report similar numbers of cases of hand-arm vibration syndrome (12/9%) and 'vague and ill-defined' upper limb conditions (16/14%). The absolute risk of physician reported that WR MSDs increases 5-fold between ages 15-24 and 45-64. Conclusions: The specialist reporting schemes give an indication of current practice and are useful both to update and to strategically inform planning. The data are amenable, with appropriate statistical analysis, for comparison with self-reporting and to the characterization of risk in broad categories of occupation and work activity. © The Author 2009. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved.