Musculoskeletal Pain in the Neck and Lower Back Regions among PHC Workers: Association between Workload, Mental Disorders, and Strategies to Manage Pain

Abstract

Scientific evidence indicates that workers in the health sector are commonly exposed to work-related musculoskeletal pain. Objectives: We aimed to identify the relationship between the presence and intensity of musculoskeletal pain in the neck and lumbar regions reported by Primary Health Care (PHC) workers with workloads and occupational risks, analyze musculoskeletal pain in the presence and absence of self-reported mental disorders based on a medical diagnosis, and identify workers’ strategies to manage pain. Method: This cross-sectional study addressed 338 health professionals working in PHC outpatient services in the extreme South of Brazil. One questionnaire addressed sociodemographic questions concerning occupation, occupational risks, and mental disorders. The Nordic Musculoskeletal Questionnaire was used to assess self-reported musculoskeletal pain. The National Aeronautics and Space Administration Task Load Index (NASA-TLX) measured the workload. A descriptive and inferential analysis was performed using SPSS version 21.0. Results: Most (55.3%) participants reported neck and (64.5%) lower back pain in the previous 12 months, and 22.5% and 30.5% reported intense neck and lower back pain, respectively, in the previous 12 months. The results showed different independent associations with increased musculoskeletal pain among health workers. Dentists presented the highest prevalence of neck pain, while female workers presented the highest prevalence of lower back pain. Furthermore, the perception of ergonomic risk and virtually all self-reported mental disorders (except panic syndrome for neck pain) were associated with pain in the neck and lower back regions and a higher frustration level (mental demand). Additionally, professionals with graduate degrees, nurses, and professionals working the longest in PHC services reported seeking complementary therapies more frequently, while physicians and those with self-reported mental disorders self-medicated more frequently.

Exposure Time to Work-Related Hazards and Factors Affecting Musculoskeletal Pain in Nurses

“…Nurses commonly face various ergonomic risk factors in their work, such as lifting patients, using machines to move objects, repetitive actions, extreme postures, bending, twisting, and sudden movements [4,[8][9][10]. These ergonomic risk factors are known to contribute significantly to musculoskeletal pain [1,3,8].…”

“…A nurse is a healthcare professional who is legally qualified to monitor and record the patient's health status and provide prescribed care and treatment based on a doctor's orders or specific nursing procedures [2]. Nursing services are essential in the healthcare sector, and with the aging population, there is an increasing need for nursing services in nursing homes and residential facilities [3].…”

“…While ergonomic risk factors present the closest association with musculoskeletal pain [1, 3,4,8], there is evidence that exposure to physical and chemical/biological hazards is also related to pain [8]. There is a lack of research analyzing the priority and impact of various risk factors on musculoskeletal pain, taking into consideration nurses' job-related characteristics, as well as the duration of exposure to these risk factors.…”