This study was based on a questionnaire and included a group of home care workers (HCW) (n = 305) and a reference group of municipal employees (n = 694). The relationship between the work environment and musculoskeletal symptoms was analysed. The HCW were less satisfied with their control over their work and stimulus from their work and had a higher physical work load and prevalence of musculoskeletal symptoms, compared with the reference group. The Rate Ratio (RR) of neck and shoulder symptoms among HCW was 83 and 54%, respectively, higher among those reporting a "high" psychological work load compared with those reporting a "low" load. The highest RR for a single risk indicator was 2.5, and this concerned low-back symptoms among HCW who often worked with twisted postures. A combination of "poor" psychosocial work environment and "high" physical work load produced the highest RR for work-related neck (RR = 2.57) and shoulder (RR = 2.13) symptoms.