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Psychological and psychosocial factors and musculoskeletal pain

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Studies of musculoskeletal pain among workers have usually been cross sectional, have involved established work forces (so that workers with symptoms may have left), have included workers in a single occupation, and have concentrated on pain at a single anatomical site. Researchers in Manchester have performed a prospective study of pain at four different sites (low back, shoulder, wrist/forearm, and knee) involving newly employed workers in a variety of occupations.

The 1081 subjects had been employed in their present work for a mean of eight months and were trainees in 12 occupational groups (fire fighters, police, army (officers, infantry, or clerks), students (dental, nursing, podiatry, or forestry), supermarket workers, postal workers, and ship building apprentices). Questionnaire data were obtained at baseline on workplace psychosocial factors and on personal psychological distress. Follow up data at 12 months were obtained for 829 subjects (77%). One month pain prevalences were 26% (low back), 18% (shoulder), 6% (forearm), and 12% (knee). The prevalence of low back pain varied from 15% (army officers) to 57% (podiatrists). Army infantry had high rates of low back pain (33%), shoulder pain (33%), and knee pain (29%). Pain in at least one anatomical site was reported by 344 subjects (41%) of whom 127 reported pain in more than one site. Job dissatisfaction and unsatisfactory working conditions (stressful, monotonous, or uninstructive work) increased pain prevalence at all anatomical sites and psychological distress (General Health Questionnaire score >0) doubled the prevalence of pain at all sites.

Psychological distress and poor working conditions increase the likelihood of musculoskeletal pains.

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