Prevalence and correlates of regional pain and associated disability in Japanese workers

Abstract

Objectives-To assess the prevalence and correlates of regional pain and associated disability in four groups of Japanese workers.Methods-As part of a large international survey of musculoskeletal symptoms (the CUPID study), samples of nurses, office workers, sales/marketing personnel and transportation operatives in Japan completed a self-administered questionnaire (response rate 83%). The questionnaire covered experience of pain in six anatomical regions, associated disability and sickness absence, and various possible occupational and psychosocial risk factors for these outcomes. Associations with risk factors were assessed by logistic regression.Results-Analysis was based on 2290 subjects. Rates of regional pain were generally less than have been reported in the UK, with a particularly low prevalence of wrist/hand pain among office workers (6% in the past month). The strongest and most consistent risk factor for regional pain in the past month was tendency to somatise (odds ratios (95% confidence intervals) for report of ≥2 v 0 distressing somatic symptoms 3.1 (2.4-4.0) for low back pain, 2.8 (2.1-3.8) for shoulder pain, and 2.5 (1.6-4.1) for wrist/hand pain). Sickness absence for regional pain complaints in the past year was reported by 5% of participants, the major risk factor for this outcome being absence during the same period for other medical reasons (OR 3.7,).Conclusions-Japanese office workers have markedly lower rates of wrist/hand pain than their UK counterparts. In Japan, as in Western Europe, somatising tendency is a major risk factor for regional pain. Sickness absence attributed to regional pain complaints appears to be much less common in Japan than in the UK, and to be driven principally by a general propensity to take sickness absence.

Is peak exposure to computer use a risk factor for neck and upper-extremity symptoms?

“…Some recent studies show interesting results. For example, a cross-sectional study in Japan and the UK found that large differences exist between the countries in wrist or hand pain and sickness absence due to musculoskeletal pain (23). A cross-sectional study in India and the UK found that cultural factors, such as health beliefs and expectations, may have and important influence on musculoskeletal symptoms (24).…”

Psychological and psychosocial determinants of musculoskeletal pain and associated disability

“…have been cross-sectional in design [13,43,[48][49][50][51][52][53][54][55], and these have found relative risks or odds ratios of up to 4-5 for pain at specific anatomical sites. Moreover, the relationship extends to widespread pain [56], and there are indications that relative risks are even higher for pain occurring at multiple sites [10,12].…”

“…Importantly, the relationship is not only with awareness and reporting of musculoskeletal symptoms, but also with disability for everyday activities as a consequence of musculoskeletal pain [10,[12][13][14]49].…”

“…Poor mental health is more common in people with musculoskeletal pain, particularly when it is disabling [10][11][12][13][14]. The relationship has been examined in several systematic reviews, which have indicated, for example, that depressive symptoms are related to higher levels of pain intensity, more functional limitation and disability and worse prognosis [15]; are strongly associated with knee pain [16]; and predict the transition from acute to chronic low back pain [17,18] and neck pain [18].…”

“…Moreover, the relationship extends to widespread pain [56], and there are indications that relative risks are even higher for pain occurring at multiple sites [10,12]. In particular, a large international study which compared associations with risk factors for different patterns of musculoskeletal pain, found that relative to no pain, pain that affected six or more anatomical sites showed a stronger association with tendency to somatise than pain involving fewer than four anatomical sites [57].Importantly, the relationship is not only with awareness and reporting of musculoskeletal symptoms, but also with disability for everyday activities as a consequence of musculoskeletal pain [10,[12][13][14]49].It is possible that the development of a musculoskeletal disorder could sensitise an individual to other symptoms. However, findings from longitudinal studies suggest that causation is in the reverse direction -i.e.…”