Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
International Archives of Occupational and Environmental Health
Published in: International Archives of Occupational and Environmental Health 7/2020

01-10-2020 | Musculoskeletal Pain | Original Article

Dose–response association between multi-site musculoskeletal pain and work ability in physical therapists: a cross-sectional study

Authors: Yasmín Ezzatvar, Joaquín Calatayud, Lars L. Andersen, Jonas Vinstrup, Jorge Alarcón, José Casaña

Published in: International Archives of Occupational and Environmental Health | Issue 7/2020

Login to get access

Abstract

Purpose

Multi-site musculoskeletal pain (MP) is common among health care professionals and is considered a threat to work ability and thereby a long and healthy working life. However, literature is scarce regarding these associations among physical therapists (PTs). This study aims to quantify the prevalence of local and multi-site MP among PTs, to investigate the associations between pain intensity and number of pain sites, respectively, with the level of work ability.

Methods

We conducted a survey among 1006 PTs about pain the previous month in different body areas and work ability. Work ability was measured using the Work Ability Index (WAI) including its seven categories. The odds of having lower level of work ability as a function of pain intensity (0–10) and multi-site pain were determined using binary logistic regression controlled for relevant confounders.

Results

The neck (36.3%) and the low back (32.3%) were the most commonly affected body areas. Furthermore, a dose–response relationship was observed between the number of pain sites and lower work ability (trend test, p < 0.001). With low pain intensity as reference, a moderate to strong association existed for lower levels of work ability in PTs who reported pain intensity of > 5 in one to two body regions (OR 2.14, 95% CI 1.27–3.60). This association was stronger when participants reported pain in three to four sites (OR 4.02, 95% CI 2.36–6.82) and even stronger when pain was experienced in five or more sites (OR 6.13, 95% CI 3.31–11.38).

Conclusions

Multi-site MP is strongly associated—in a dose–response fashion—with lower levels of work ability among PTs.
Literature
Adegoke BO, Akodu AK, Oyeyemi AL (2008) Work-related musculoskeletal disorders among Nigerian Physiotherapists. BMC Musculoskelet Disord 9:112
Andersen LL, Clausen T, Burr H, Holtermann A (2012a) Threshold of musculoskeletal pain intensity for increased risk of long-term sickness absence among female healthcare workers in eldercare. PLoS ONE 7:e41287
Andersen LL, Clausen T, Persson R, Holtermann A (2012c) Dose–response relation between perceived physical exertion during healthcare work and risk of long-term sickness absence. Scand J Work Environ Health 38:582–589
Bishop A, Foster NE, Thomas E, Hay EM (2008) How does the self-reported clinical management of patients with low back pain relate to the attitudes and beliefs of health care practitioners? A survey of Uk general practitioners and physiotherapists. Pain 135:187–195
Bork BE, Cook TM, Rosecrance JC et al (1996) Work-related musculoskeletal disorders among physical therapists. Phys Ther 76:827–835
Brooks PM (2006) The burden of musculoskeletal disease—a global perspective. Clin Rheumatol 25:778–781
Buchbinder R, Staples M, Jolley D (2009) Doctors with a special interest in back pain have poorer knowledge about how to treat back pain. Spine 34:1218–1226
Campo M, Weiser S, Koenig KL, Nordin M (2008) Work-related musculoskeletal disorders in physical therapists: a prospective cohort study with 1-year follow-up. Phys Ther 88:608
Casey CY, Greenberg MA, Nicassio PM et al (2008) Transition from acute to chronic pain and disability: a model including cognitive, affective, and trauma factors. Pain 134:69–79
Chiu MC, Wang MJ, Lu CW et al (2007) Evaluating work ability and quality of life for clinical nurses in Taiwan. Nurs Outlook 55:318
Croft PR, Dunn KM, Raspe H (2006) Course and prognosis of back pain in primary care: the epidemiological perspective. Pain 122:1–3
Darragh AR, Huddleston W, King P (2009) Work-related musculoskeletal injuries and disorders among occupational and physical therapists. Am J Occup Ther 63:351–362
De Zwart BCH, Frings-Dresen MHW, Van Duivenbooden JC (2002) Test–retest reliability of the work ability index questionnaire. Occup Med 52:177–181
Demyttenaere K, Bruffaerts R, Lee S et al (2007) Mental disorders among persons with chronic back or neck pain: results from the world mental health surveys. Pain 129:332–342
Eskelinen L, Kohvakka A, Merisalo T, Hurri H (1991) Relationship between the self-assessment and clinical assessment of health status and work ability. Scand J Work Environ Health 17:40–47
Freimann T, Coggon D, Merisalu E et al (2013) Risk factors for musculoskeletal pain amongst nurses in Estonia: a cross-sectional study. BMC Musculoskelet Disord 14:334
Goldblatt F, O’Neill SG (2013) Clinical aspects of autoimmune rheumatic diseases. The Lancet 382:797–808
Hagen EM, Svensen E, Eriksen HR et al (2006) Comorbid subjective health complaints in low back pain. Spine 31:1491–1495
Haukka E, Kaila-Kangas L, Ojajarvi A et al (2015) Multisite musculoskeletal pain predicts medically certified disability retirement among Finns. Eur J Pain 19:1119–1128
Haukka E, Kaila-Kangas L, Ojajärvi A et al (2013) Pain in multiple sites and sickness absence trajectories: a prospective study among Finns. Pain 154:306–312
IJzelenberg W, Burdorf A (2004) Impact of musculoskeletal co-morbidity of neck and upper extremities on healthcare utilisation and sickness absence for low back pain. Occup Environ Med 61:806–810
Ilmarinen J (2007) The work ability index (WAI). Occup Med 57:160–160
Ilmarinen J, Tuomi K, Klockars M (1997) Changes in the work ability of active employees over an 11-year period. Scand J Work Environ Health 23:49–57
Ilmarinen JE (2001) Aging workers. Occup Environ Med 58:546–546
Jay K, Friborg MK, Sjøgaard G et al (2015) The consequence of combined pain and stress on work ability in female laboratory technicians: a cross-sectional study. Int J Environ Res Public Health 12:15834–15842
Kamaleri Y, Natvig B, Ihlebaek CM et al (2008) Number of pain sites is associated with demographic, lifestyle, and health-related factors in the general population. Eur J Pain 12:742–748
Kapteyn A, Smith JP, Van Soest A (2008) Dynamics of work disability and pain. J Health Econ 27:496–509
Kuorinka I, Jonsson B, Kilbom A et al (1987) Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon 18:233–237
Lindegård A, Larsman P, Hadzibajramovic E, Ahlborg G (2014) The influence of perceived stress and musculoskeletal pain on work performance and work ability in Swedish health care workers. Int Arch Occup Environ Health 4:373–379
Losa MI, Becerro RDBV, Salvadores PF (2011) Self-reported musculoskeletal disorders in podiatrists at work. Med Lav 102:502–510
Macfarlane GJ, Hunt IM, Silman AJ (2000) Role of mechanical and psychosocial factors in the onset of forearm pain: prospective population based study. BMJ 321:676
Miranda H, Kaila-Kangas L, Heliövaara M et al (2010) Musculoskeletal pain at multiple sites and its effects on work ability in a general working population. Occup Environ Med 67:449
Nahit ES, Hunt IM, Lunt M et al (2003) Effects of psychosocial and individual psychological factors on the onset of musculoskeletal pain: common and site-specific effects. Ann Rheum Dis 62:755–760
Natvig B, Eriksen W, Bruusgaard D (2002) Low back pain as a predictor of long-term work disability. Scand J Public Health 30:288–292
Neupane S, Miranda H, Virtanen P et al (2011) Multi-site pain and work ability among an industrial population. Occup Med Oxf Engl 61:563–569
Neupane S, Virtanen P, Leino-Arjas P et al (2013) Multi-site pain and working conditions as predictors of work ability in a 4-year follow-up among food industry employees. Eur J Pain 17:444–451
Nordin NAM, Leonard JH, Thye NC (2011) Work-related injuries among physiotherapists in public hospitals-a Southeast Asian picture. Clinics 66:373–378
Nygård C-H, Eskelinen L, Suvanto S et al (1991) Associations between functional capacity and work ability among elderly municipal employees. Scand J Work Environ Health 17:122–127
Ohlsson K, Attewell R, Johnsson B et al (1994) An assessment of neck and upper extremity disorders by questionnaire and clinical examination. Ergonomics 37:891–897
Øverland S, Harvey SB, Knudsen AK et al (2012) Widespread pain and medically certified disability pension in the Hordaland Health Study. Eur J Pain 16:611–620
Phongamwong C, Deema H (2015) The impact of multi-site musculoskeletal pain on work ability among health care providers. J Occup Med Toxicol Lond 10:21–21
Reid KJ, Harker J, Bala MM et al (2011) Epidemiology of chronic non-cancer pain in Europe: narrative review of prevalence, pain treatments and pain impact. Curr Med Res Opin 27:449–462
Saastamoinen P, Leino-Arjas P, Laaksonen M et al (2006) Pain and health related functioning among employees. J Epidemiol Community Health 60:793
Sluka KA, Clauw DJ (2016) Neurobiology of fibromyalgia and chronic widespread pain. Neuroscience 338:114–129
Solidaki E, Chatzi L, Bitsios P et al (2010) Work-related and psychological determinants of multisite musculoskeletal pain. Scand J Work Environ Health 36:54–61
Vargas-Prada S, Serra C, Martínez JM et al (2013) Psychological and culturally-influenced risk factors for the incidence and persistence of low back pain and associated disability in Spanish workers: findings from the CUPID study. Occup Env Med 70:57–62
Vieira ER, Svoboda S, Belniak A et al (2016) Work-related musculoskeletal disorders among physical therapists: an online survey. Disabil Rehabil 38:552–557
von Elm E, Altman DG, Egger M et al (2007) The Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med 4:e296
Metadata
Title
Dose–response association between multi-site musculoskeletal pain and work ability in physical therapists: a cross-sectional study
Authors
Yasmín Ezzatvar
Joaquín Calatayud
Lars L. Andersen
Jonas Vinstrup
Jorge Alarcón
José Casaña
Publication date
01-10-2020
Publisher
Springer Berlin Heidelberg
Published in
International Archives of Occupational and Environmental Health / Issue 7/2020
Print ISSN: 0340-0131
Electronic ISSN: 1432-1246
DOI
https://doi.org/10.1007/s00420-020-01533-6

Other articles of this Issue 7/2020

International Archives of Occupational and Environmental Health 7/2020 Go to the issue

Review

Quantitative skin exposure assessment of metals: a systematic literature review of current approaches for risk assessment using the construction industry as an exposure scenario

Review

Heart rate variability as a measure of mental stress in surgery: a systematic review

Review

Interventions for common mental disorders in the occupational health service: a systematic review with a narrative synthesis

Original Article

Do organisational and ward-level factors explain the variance in multi-site musculoskeletal pain in eldercare workers? A multi-level cross-sectional study

Original Article

Musculoskeletal pain among offshore wind industry workers: a cross-sectional study

Original Article

Chronic diseases, age and gender: examining the contribution to burnout symptoms in a sample of 2075 Canadian workers