Musculoskeletal pain and sedentary behaviour in occupational and non-occupational settings: a systematic review with meta-analysis

Abstract

Background Sedentary behaviour (SB; time spent sitting) is associated with musculoskeletal pain (MSP) conditions; however, no prior systematic review has examined these associations according to SB domains. We synthesised evidence on occupational and non-occupational SB and MSP conditions. Methods Guided by a PRISMA protocol, eight databases (MEDLINE, CINAHL, PsycINFO, Web of Science, Scopus, Cochrane Library, SPORTDiscus, and AMED) and three grey literature sources (Google Scholar, WorldChat, and Trove) were searched (January 1, 2000, to March 17, 2021) for original quantitative studies of adults ≥ 18 years. Clinical-condition studies were excluded. Studies’ risk of bias was assessed using the QualSyst checklist. For meta-analyses, random effect inverse-variance pooled effect size was estimated; otherwise, best-evidence synthesis was used for narrative review. Results Of 178 potentially-eligible studies, 79 were included [24 general population; 55 occupational (incuding15 experimental/intervention)]; 56 studies were of high quality, with scores > 0.75. Data for 26 were meta-synthesised. For cross-sectional studies of non-occupational SB, meta-analysis showed full-day SB to be associated with low back pain [LBP – OR = 1.19(1.03 – 1.38)]. Narrative synthesis found full-day SB associations with knee pain, arthritis, and general MSP, but the evidence was insufficient on associations with neck/shoulder pain, hip pain, and upper extremities pain. Evidence of prospective associations of full-day SB with MSP conditions was insufficient. Also, there was insufficient evidence on both cross-sectional and prospective associations between leisure-time SB and MSP conditions. For occupational SB, cross-sectional studies meta-analysed indicated associations of self-reported workplace sitting with LBP [OR = 1.47(1.12 – 1.92)] and neck/shoulder pain [OR = 1.73(1.46 – 2.03)], but not with extremities pain [OR = 1.17(0.65 – 2.11)]. Best-evidence synthesis identified inconsistent findings on cross-sectional association and a probable negative prospective association of device-measured workplace sitting with LBP-intensity in tradespeople. There was cross-sectional evidence on the association of computer time with neck/shoulder pain, but insufficient evidence for LBP and general MSP. Experimental/intervention evidence indicated reduced LBP, neck/shoulder pain, and general MSP with reducing workplace sitting. Conclusions We found cross-sectional associations of occupational and non-occupational SB with MSP conditions, with occupational SB associations being occupation dependent, however, reverse causality bias cannot be ruled out. While prospective evidence was inconclusive, reducing workplace sitting was associated with reduced MSP conditions. Future studies should emphasise prospective analyses and examining potential interactions with chronic diseases. Protocol registration PROSPERO ID #CRD42020166412 (Amended to limit the scope)

A remote group-mediated daylong physical activity intervention for older adults with chronic pain: Results of the MORPH-II randomized pilot trial

“…Among late middle-aged and older adults in the Korean NHANES study, more time spent sitting—especially over 7 h—was associated with worse pain in the low back. These relationships were strongest among those engaging in the least leisure time physical activity ( 10 , 11 ). In a meta-analysis of pain and sedentary behavior, Dzakpasu ( 10 ) found that more sedentary time was associated with greater pain in general, as well as low back and knee pain.…”

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“…Dzakpasu et al demonstrated evidence to support significant associations between workplace sitting time and MSD in the neck, shoulders and lower back among office workers. This could be explained by static sitting posture for long periods of time that may produce tension, strain and fatigue in the muscles inducing MS pain and discomfort, and other chronic conditions [ 35 ]. Jun et al reviewed many prospective studies and found strong evidence demonstrated sitting for computer work ≥ 4 h/day was a risk factor for neck and shoulder pain among office workers (relative risk = 1.36, 95% CI 1.10–1.88) [ 36 ].…”

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“…A recent review (Dzakpasu et al, 2021) analysing cross‐sectional studies found that sedentary behaviour (regardless of the measure) was associated with low back pain. However, they identified insufficient evidence from prospective cohort studies, which limited their analysis to a narrative description of findings.…”