Top

BMC Musculoskeletal Disorders

Published in:

Open Access 01-12-2020 | Musculoskeletal Pain | Research article

Neck and upper extremity pain in sonographers – a longitudinal study

Authors: Jenny Gremark Simonsen, Anna Axmon, Catarina Nordander, Inger Arvidsson

Published in: BMC Musculoskeletal Disorders | Issue 1/2020

Abstract

Background

Sonographers have reported a high occurrence of musculoskeletal pain for more than 25 years. Assessments of occupational risk factors have previously been based on cross-sectional surveys. The aim of this longitudinal study was to determine which factors at baseline that were associated with neck/shoulder and elbow/hand pain at follow-up.

Methods

A questionnaire was answered by 248 female sonographers at baseline and follow-up (85% of the original cohort). 208 were included in the analyses. Physical, visual, and psychosocial work-related conditions were assessed at baseline. Pain in two body regions (neck/shoulders and elbows/hands) was assessed at both baseline and follow up.

Results

Pain at baseline showed the strongest association with pain at follow-up in both body regions [prevalence ratio (PR) 2.04; 95% confidence interval (CI) 1.50–2.76], for neck/shoulders and (PR 3.45; CI 2.29–5.22) for elbows/hands. Neck/shoulder pain at follow-up was associated with inability of ergonomic adjustments at the ultrasound device (PR 1.25; CI 1.05–1.49), a high mechanical exposure index (PR 1.66; CI 1.09–2.52), and adverse visual conditions (PR 1.24; CI 1.00–1.54) at baseline. Moreover, among participants with no neck/shoulder pain at baseline, high job demands (PR 1.78; CI 1.01–3.12), and a high mechanical exposure index (PR 2.0; CI 0.98–4.14) predicted pain at follow-up. Pain in the elbows/hands at follow-up was associated with high sensory demands at baseline (PR 1.63; CI 1.08–2.45), and among participants without pain at baseline high sensory demands predicted elbow/hand pain at follow-up (PR 3.34; CI 1.53–7.31).

Conclusion

Pain at baseline was the strongest predictor for pain at follow-up in both body regions. We also found several occupational factors at baseline that were associated with pain at follow-up: inability to adjust equipment, adverse visual conditions, a high MEI, high job demands and high sensory demands. These results point at a possibility to influence pain with better ergonomics.

Sommerich CM, Lavender SA, Evans K, Sanders E, Joines S, Lamar S, et al. Collaborating with cardiac sonographers to develop work-related musculoskeletal disorder interventions. Ergonomics. 2016;59(9):1193–204. https://doi.org/10.1080/00140139.2015.1116613.CrossRefPubMedPubMedCentral

Fisher TF. Radiologic and Sonography Professionals’ Ergonomics: An Occupational Therapy Intervention for Preventing Work Injuries. Journal of Diagnostic Medical Sonography. 2015;31(3):137–47. https://doi.org/10.1177/8756479315580020.CrossRef

NIOSH. Workplace solutions. Preventing Work-Related Musculoskeletal Disorders in Sonography. Cincinnati. US: Department of health and human services. Centers for Disease Control and Prevention. National Institute of Occupational Safety and Health; 2006.

Simonsen JG, Dahlqvist C, Enquist H, Nordander C, Axmon A, Arvidsson I. Assessments of Physical Workload in Sonography Tasks Using Inclinometry, Goniometry, and Electromyography. Saf Health Work. 2018;9(3):326–33. https://doi.org/10.1016/j.shaw.2017.08.007.CrossRefPubMed

Simonsen JG, Gard G. Swedish Sonographers' perceptions of ergonomic problems at work and their suggestions for improvement. BMC Musculoskelet Disord. 2016;17:1–10. https://doi.org/10.1186/s12891-016-1245-y.CrossRef

Lindegard A, Gustafsson M, Hansson GA. Effects of prismatic glasses including optometric correction on head and neck kinematics, perceived exertion and comfort during dental work in the oral cavity--a randomised controlled intervention. Appl Ergon. 2012;43(1):246–53. https://doi.org/10.1016/j.apergo.2011.05.011.CrossRefPubMed

Vanderpool HE, Friis EA, Smith BS, Harms KL. Prevalence of carpal tunnel syndrome and other work-related musculoskeletal problems in cardiac sonographers. J Occup Med. 1993;35(6):604–10.CrossRef

Gremark Simonsen J, Axmon A, Nordander C, Arvidsson I. Neck and upper extremity pain in sonographers - Associations with occupational factors. Appl Ergon. 2017;58:245–53.CrossRef

Arvidsson I, Gremark Simonsen J, Dahlqvist C, Axmon A, Karlson B, Björk J, et al. Cross-sectional associations between occupational factors and musculoskeletal pain in women teachers, nurses and sonographers. BMC Musculoskelet Disord. 2016;17:35. https://doi.org/10.1186/s12891-016-0883-4.CrossRefPubMedPubMedCentral

10.

Karlqvist LK, Harenstam A, Leijon O, Scheele P. Excessive physical demands in modern worklife and characteristics of work and living conditions of persons at risk. Scand J Work Environ Health. 2003;29(5):363–77.CrossRef

11.

Balogh I, Ørbæk P, Winkel J, Nordander C, Ohlsson K, Ektor-Andersen J. Questionnaire-based mechanical exposure indices for large population studies--reliability, internal consistency and predictive validity. Scand J Work Environ Health. 2001;27(1):41–8.CrossRef

12.

Östergren PO, Hanson BS, Balogh I, Ektor-Andersen J, Isacsson A, Ørbæk P, et al. Incidence of shoulder and neck pain in a working population: effect modification between mechanical and psychosocial exposures at work? Results from a one year follow up of the Malmo shoulder and neck study cohort. J Epidemiol Community Health. 2005;59(9):721–8. https://doi.org/10.1136/jech.2005.034801.CrossRefPubMedPubMedCentral

13.

Karasek R, Theorell T. Healthy Work Stress, productivity and the reconstruction of Working Life. USA: Harper Collins; 1990.

14.

Karasek R, Brisson C, Kawakami N, Houtman I, Bongers P, Amick B. The Job Content Questionnaire (JCQ): an instrument for internationally comparative assessments of psychosocial job characteristics. J Occup Health Psychol. 1998;3(4):322–55.CrossRef

15.

Kristensen TS, Hannerz H, Hogh A, Borg V. The Copenhagen Psychosocial Questionnaire--a tool for the assessment and improvement of the psychosocial work environment. Scand J Work Environ Health. 2005;31(6):438–49.CrossRef

16.

Kuorinka I, Jonsson B, Kilbom Å, Vinterberg H, Biering-Sørensen F, Andersson G, et al. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon. 1987;18(3):233–7.CrossRef

17.

Holmström E, Moritz U. Low back pain--correspondence between questionnaire, interview and clinical examination. Scand J Rehabil Med. 1991;23(3):119–25.PubMed

18.

Borg G. Psychophysical scaling with applications in physical work and the perception of exertion. Scand J Work Environ Health. 1990;16(Suppl 1):55–8.CrossRef

19.

Arvidsson I, Arvidsson M, Axmon A, Hansson GA, Johansson CR, Skerfving S. Musculoskeletal disorders among female and male air traffic controllers performing identical and demanding computer work. Ergonomics. 2006;49(11):1052–67. https://doi.org/10.1080/00140130600733816.CrossRefPubMed

20.

Hansson GA, Balogh I, Bystrom JU, Ohlsson K, Nordander C, Asterland P, et al. Questionnaire versus direct technical measurements in assessing postures and movements of the head, upper back, arms and hands. Scand J Work Environ Health. 2001;27(1):30–40.CrossRef

21.

Balogh I, Orbaek P, Ohlsson K, Nordander C, Unge J, Winkel J, et al. Self-assessed and directly measured occupational physical activities--influence of musculoskeletal complaints, age and gender. Appl Ergon. 2004;35(1):49–56. https://doi.org/10.1016/j.apergo.2003.06.001.CrossRefPubMed

22.

Lindegard A, Nordander C, Jacobsson H, Arvidsson I. Opting to wear prismatic spectacles was associated with reduced neck pain in dental personnel: a longitudinal cohort study. BMC Musculoskelet Disord. 2016;17:347. https://doi.org/10.1186/s12891-016-1145-1.CrossRefPubMedPubMedCentral

23.

Petit A, Bodin J, Delarue A, D'Escatha A, Fouquet N, Roquelaure Y. Risk factors for episodic neck pain in workers: a 5-year prospective study of a general working population. Int Arch Occup Environ Health. 2018;91(3):251–61. https://doi.org/10.1007/s00420-017-1272-5.CrossRefPubMed

24.

Jakobsen ELT, Biering K. Long-term prognosis for neck-shoulder pain and disorders: a 14-year follow-up study; 2017. https://doi.org/10.1136/oemed-2017-104422.CrossRef

25.

Andersen JH, Harhoff M, Grimstrup S, Vilstrup I, Lassen CF, Brandt LP, et al. Computer mouse use predicts acute pain but not prolonged or chronic pain in the neck and shoulder. Occup Environ Med. 2008;65(2):126–31. https://doi.org/10.1136/oem.2007.033506.CrossRefPubMed

26.

Lassen CF, Mikkelsen S, Kryger AI, Andersen JH. Risk factors for persistent elbow, forearm and hand pain among computer workers. Scand J Work Environ Health. 2005;31(2):122–31.CrossRef

27.

Sterud T, Johannessen HA, Tynes T. Work-related psychosocial and mechanical risk factors for neck/shoulder pain: a 3-year follow-up study of the general working population in Norway. Int Arch Occup Environ Health. 2014;87(5):471–81. https://doi.org/10.1007/s00420-013-0886-5.CrossRefPubMed

28.

Ostergren PO, Hanson BS, Balogh I, Ektor-Andersen J, Isacsson A, Orbaek P, et al. Incidence of shoulder and neck pain in a working population: effect modification between mechanical and psychosocial exposures at work? Results from a one year follow up of the Malmo shoulder and neck study cohort. J Epidemiol Community Health. 2005;59(9):721–8. https://doi.org/10.1136/jech.2005.034801.CrossRefPubMedPubMedCentral

29.

Fanavoll R, Nilsen TI, Holtermann A, Mork PJ. Psychosocial work stress, leisure time physical exercise and the risk of chronic pain in the neck/shoulders: Longitudinal data from the Norwegian HUNT Study. Int J Occup Med Environ Health. 2016;29(4):585–95. https://doi.org/10.13075/ijomeh.1896.00606.CrossRefPubMed

30.

Keown GA, Tuchin PA. Workplace Factors Associated With Neck Pain Experienced by Computer Users: A Systematic Review. J Manipulative Physiol Ther. 2018;41(6):508–29. https://doi.org/10.1016/j.jmpt.2018.01.005.CrossRefPubMed

31.

Zetterberg C, Forsman M, Richter HO. Effects of visually demanding near work on trapezius muscle activity. J Electromyogr Kinesiol. 2013;23(5):1190–8. https://doi.org/10.1016/j.jelekin.2013.06.003.CrossRefPubMed

32.

Osterhaus W, Hemphala H, Nylen P. Lighting at computer workstations. Work (Reading, Mass). 2015;52(2):315–28. https://doi.org/10.3233/wor-152163.CrossRef

33.

Hemphälä H, Eklund J. A visual ergonomics intervention in mail sorting facilities: effects on eyes, muscles and productivity. Appl Ergon. 2012;43(1):217–29. https://doi.org/10.1016/j.apergo.2011.05.006.CrossRefPubMed

34.

Brewer S, Van Eerd D, Amick BC 3rd, Irvin E, Daum KM, Gerr F, et al. Workplace interventions to prevent musculoskeletal and visual symptoms and disorders among computer users: a systematic review. J Occup Rehabil. 2006;16(3):325–58. https://doi.org/10.1007/s10926-006-9031-6.CrossRefPubMed

35.

Steeds RP. Echocardiography: frontier imaging in cardiology. Br J Radiol. 2011;84 Spec No 3:S237–S245. https://doi.org/10.1259/bjr/77730594.

36.

Long J, Helland M. A multidisciplinary approach to solving computer related vision problems. Ophthalmic Physiol Opt. 2012;32(5):429–35. https://doi.org/10.1111/j.1475-1313.2012.00911.x.CrossRefPubMed

Title: Neck and upper extremity pain in sonographers – a longitudinal study
Authors: Jenny Gremark Simonsen
Anna Axmon
Catarina Nordander
Inger Arvidsson
Publication date: 01-12-2020
Publisher: BioMed Central
Keyword: Musculoskeletal Pain
Published in: BMC Musculoskeletal Disorders / Issue 1/2020
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-020-3096-9

At a glance: The STEP trials

Springer Medicine

Neck and upper extremity pain in sonographers – a longitudinal study

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2020

The global burden of pressure ulcers among patients with spinal cord injury: a systematic review and meta-analysis

K-wire fixation vs 23-gauge percutaneous hand- crossed hypodermic needle for the treatment of distal phalangeal fractures

The incidence of stroke among selected patients undergoing elective posterior lumbar fusion: a retrospective cohort study

Hepatic encephalopathy increases the risk of hip fracture: a nationwide cohort study

The modified cross-suture technique for unilateral pulled-out anchor during all-inside meniscal repair

Utility of CT-based navigation in revision total hip arthroplasty for a patient with severe posterior pelvic tilt-case report-