Objectives The aim of the study was to investigate if perceived muscular tension predicts future neck–shoulder symptoms and arm–wrist–hand symptoms in symptomfree office workers.

Methods Data were used of a prospective cohort of 1951 office workers with a follow-up duration of 2 years (the Prospective Research On Musculoskeletal disorders among Office workers (PROMO) study). Perceived muscular tension and covariates were measured using self-report at baseline and at 1-year follow-up. Symptoms were assessed every 3 months using self-report. According to their perceived muscular tension, participants were classified into three groups: ‘never tensed’, ‘sometimes tensed’ and ‘often tensed’. Neck–shoulder cases and arm–wrist–hand cases were identified based on the transition of ‘no’ or ‘sometimes’ pain to ‘regular’ or ‘prolonged’ pain. Generalised estimating equations were used to estimate rate ratios (RRs) for becoming a new case.

Results Perceived muscular tension predicted future neck–shoulder symptoms and arm–wrist–hand symptoms, even when adjusted for symptoms in the past. The RRs for perceived muscular tension in relation to future neck–shoulder symptoms were higher than for future arm–wrist–hand symptoms. Participants who were sometimes or often tensed had a 2.9 and 4.4 times higher risk, respectively, of becoming a future neck–shoulder case than those who were never tensed. For arm–wrist–hand symptoms, the risk of becoming a future case was 1.5 and 2.3, respectively.

Conclusions Perceived muscular tension predicted future neck–shoulder symptoms and arm–wrist–hand symptoms. Future research should further explore the concept of perceived muscular tension and what role it has in the onset of symptoms in order to make use of it in interventions to prevent symptoms.