Predictive risk factors for chronic regional and multisite musculoskeletal pain: A 5-year prospective study in a working population

Abstract

The role of psychosocial and physical factors in the development of musculoskeletal pain (MSP) has now been clearly demonstrated. However, it is unclear whether these factors contribute to specific regional MSP or to multisite pain. The main goal of this study was to assess the impact of work-related factors according to gender on the development of regional and multisite MSP. A total of 12,591 subjects (65% men and 35% women) who were born in 1938, 1943, 1948, and 1953 and were participating in a French longitudinal prospective epidemiological survey (ESTEV) in 1990 to 1995 were eligible. Personal factors and work exposure were assessed by self-administered questionnaires. Statistical associations between chronic MSP (regional body site or multisite), personal factors, and occupational factors were analyzed using logistic regression modeling. The incidence of regional MSP and multisite pain in 1995 were, respectively, 17% and 25.6%. For women, highly repetitive movements predicted neck/shoulder pain; posture and vibrations predicted arm and low back pain; and effort with tools predicted arm pain. For men, forceful effort and vibrations predicted neck/shoulder pain; posture and forceful effort predicted lower limb and low back pain; and forceful effort and effort with tools predicted arm pain. Physical constraints (ie, forceful effort or vibrations) were associated with multisite pain in both genders. Only for women, psychological factors were risk factors predictive of upper limb pain and in 3 or 4 painful anatomical sites. These results support the hypothesis that some physical and psychological work-related factors are predictive of regional or multisite MSP but differ according to gender. Gender differences and risk factors for work-related musculoskeletal pain should be also taken into account to more effectively target preventive measures.

Determinants of occupational multisite musculoskeletal disorders: a cross sectional study among 254 patients

“…In this study, 90% of patients were in job stress situations significantly correlated with MS-MSD involvement. Similar findings have been described by some authors (25,43 (45). The complexity of explanatory models makes it difficult to determine occupational risk factors for MSD.…”

Does leisure time physical activity protect against low back pain? Systematic review and meta-analysis of 36 prospective cohort studies

“…In a meta-analysis of six studies that controlled their risk estimates for some potential confounders, the risk of frequent or chronic LBP was lower by 11% (RR=0.89, CI 0.82 to 0.97, I 2 =31%, six studies, n=48 520, table 2) in physically active individuals, 14% (RR=0.86, CI 0.79 to 0.94, I 2 =0%, two studies, n=33 032) in moderately active individuals and by 16% (RR=0.84, CI 0.75 to 0.93, I 2 =0%, two studies, n=33 032) in highly active individuals in comparison with individuals with no regular physical activity. All the six studies controlled the estimates for age, five controlled also for sex and body mass index, two controlled for smoking,37 51 one controlled for educational level,37 one controlled for job demands,34 one controlled for social class33 and one controlled for occupation 51. Excluding the largest study51 did not change the main results (table 2).…”

“…Of two studies46 47 on frequent LBP and seven4 33 34 37 39 51 52 studies on chronic LBP, eight studies inquired participation in a sport or other leisure time physical activity and one33 participation in an organised sport activity only. Three studies4 37 39 defined the levels of leisure physical activity based on number of hours per week and intensity of activity, two34 47 were based on frequency of weekly physical activity, one51 was based on number of hours per week, one46 was based on frequency and duration of activity, one52 was based on a physical activity index and one33 was based on a yes/no question.…”

“…Three studies4 37 39 defined the levels of leisure physical activity based on number of hours per week and intensity of activity, two34 47 were based on frequency of weekly physical activity, one51 was based on number of hours per week, one46 was based on frequency and duration of activity, one52 was based on a physical activity index and one33 was based on a yes/no question. Of two studies on frequent LBP, one46 defined it as experiencing at least 10 times LBP, while the other study47 did not report the frequency of pain.…”

“…The combined RR across these two studies was 0.87 (CI 0.81 to 0.94, I 2 =25%, n=39 210) for active compared with inactive. Both studies controlled the estimate for age, sex and body mass index; one33 controlled further for social class and one51 controlled for occupation and smoking. However, one51 of the studies defined the levels of leisure time physical activity based on the number of hours spent on physical activity per week, and the other one33 was based on a yes/no question only.…”