Purpose <p>Musculoskeletal disorders (MSDs) are a leading cause of sickness absence from work and early retirement. While structured workplace dialogues about musculoskeletal pain are recommended, their implementation remains challenging. This study explored the implementation of the <i>‘Talk About Pain—Take Action Together’’</i> toolbox in two Danish public workplaces.</p> Methods <p>Qualitative observational implementation study informed by reflexive thematic analysis was conducted. Two workplaces with physically demanding roles were included: one with researcher-initiated implementation during the study period and one with internally initiated implementation prior to the study. Data were collected through observations, memos, emails, and four focus group interviews with 10 participants including employees, managers, and occupational safety and health consultants.</p> Results <p>Workplace 1 (WP1) implemented the toolbox, employing seven strategies: identifying and preparing champions, conducting a local needs assessment, distributing educational materials, reminding clinicians, tailoring strategies, organising implementation team meetings, and creating learning collaboratives. Key enablers included management engagement, ongoing exposure, and creating a safe environment, whereas lack of time was identified as a barrier. At workplace 2 (WP2), three strategies were employed: identifying and preparing champions, distributing educational materials, and conducting educational meetings. However, the toolbox was never fully implemented, hindered by time-related barriers, organisational restructuring, and unclear roles and responsibilities.</p> Conclusions <p>Effective implementation of workplace MSD interventions requires management engagement, time allocation, and clear roles.</p>