Risk factors for new onset and persistence of multi-site musculoskeletal pain in a longitudinal study of workers in Crete

Abstract

Objectives-To explore occupational and psychological risk factors for the incidence and persistence of multi-site musculoskeletal pain.Methods-We conducted a longitudinal investigation of three occupational groups in Crete, Greece. Baseline information was obtained at interview about pain in the past year at each of six anatomical sites, and about possible risk factors for subsequent symptoms. Twelve months later, subjects were re-interviewed about pain at the same anatomical sites in the past month. Pain at two or more sites was classed as multi-site. Associations with new development and persistence of multi-site pain at follow-up were assessed by logistic regression.Results-Analysis was based on 518 subjects (87% of those originally selected for study). At follow-up, multi-site pain persisted in 217 (62%) of those who had experienced it in the year before baseline, and was newly developed in 27 (17%) of those who had not. Persistence of multisite pain was significantly related to physical loading at work, somatising tendency and beliefs about work as a cause of musculoskeletal pain, with ORs (95%CIs) for the highest relative to the lowest exposure categories of 2.3 (1.0-5.6), 2.6 (1.5-4.6) and 1.9 (1.1-3.3) respectively. Competing Interests NoContributor Statement ES designed and analysed the study, did interviews and drafted the paper. LC and MK participated in the design and analysis of the study and in drafting the paper. PB participated in the design of the part on psychological factors of the study and contributed in drafting the paper. DC and KTP are the PIs of the international CUPID study, participated in the design of the study in Greece and in drafting the paper. Licence statementThe Corresponding Author has the right to grant on behalf of all authors and does grant on behalf of all authors, an exclusive licence (or non-exclusive for government employees) on a worldwide basis to the BMJ Publishing Group Ltd and its Licensees to permit this article (if accepted) to be published in Occupational and Environmental Medicine and any other BMJPGL products to exploit all subsidiary rights, as set out in our licence (http://group.bmj.com/products/journals/instructions-for-authors/ licence-forms) and the Corresponding Author accepts and understands that any supply made under these terms is made by BMJPGL to the Corresponding Author. Development of new multi-site pain was most strongly associated with working for ≥ 40 hours per week (OR 5.0, 95%CI 1.1-24.0). Europe PMC Funders GroupConclusions-Our findings confirm the importance of both physical loading at work and somatising tendency as risk factors for multi-site pain, and suggest that persistence of pain is also influenced by adverse beliefs about work-causation.

Developmental pathways of multisite musculoskeletal pain: what is the influence of physical and psychosocial working conditions?

“…Similar findings have also been reported in other studies exploring risk factors for MSP 9 11 19 33. Solidaki et al 33 reported that physical loading was associated with persistence of MSP among occupational groups in Crete. Notably, physical strain also predicted the pathway of developing MSP where the number of pain sites increased from less than one at baseline to more than three at the last follow-up in our study.…”

“…High-perceived physical workload was a strong predictor of a high MSP trajectory among female kitchen workers in Finland 15. Similar findings have also been reported in other studies exploring risk factors for MSP 9 11 19 33. Solidaki et al 33 reported that physical loading was associated with persistence of MSP among occupational groups in Crete.…”

Patterns of biomechanical demands are associated with musculoskeletal pain in the beginning of professional life: a population-based study

“…Particularly, for high and vibrational demands occupations, associations were stronger as we increased the threshold of the number of painful anatomical regions, which is in agreement with previous evidence in long-term workers (46,47). These findings suggest that, from the earliest stages of employment, high demands may rapidly produce musculoskeletal pain in more than one body region (particularly in the neck/ shoulder and upper-/lower-back areas, ie, the regions most frequently reported as painful).…”

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

“…The main pre-existing conditions in our population were metabolic diseases in 18.5%, hypertension (9.1%), hypothyroidism (4.7%) and depression (1.8%). In our study, there was no significant relationship between the pre-existence of comorbidities and the majority of MSD, which is inconsistent with some studies (25,26). According to some authors, and extending beyond the organic pathologies considered to be at risk of MS-MSD, personality type may interfere with the appearance of these lesions.…”

“…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.…”