Risk factors for neck pain in office workers: a prospective study
From: BMC Musculoskeletal Disorders 2006, 7:81
Normal neck function underpins successful performance of activities of daily living. In the general population, neck pain and dysfunction are common, affecting up to 67% of the general population at some time during their life. The one year prevalence of neck pain has been reported as 32% in a population of Hong Kong Chinese. Neck pain may arise from any of the innervated structures in the neck, such as intervertebral discs, muscles, ligaments, zygapophyseal joints, dura or nerve roots. However in the majority of cases, the pathophysiological mechanisms underlying neck pain are unclear. Such “non-specific” neck problems are costly in terms of disability and work loss. Estimates indicate that the economic consequences of treating disabling chronic neck pain are significant. For instance in the Netherlands annual costs associated with chronic non-specific neck pain have been reported at US$868 million.
Many studies have investigated the relationship between neck pain and working conditions. Previous research has identified that office workers are a specific population at high risk of developing neck pain, with one year prevalence rates much higher than in the general population. For example, one year prevalence of neck pain in office workers at a Hong Kong university was found to be 59% and 63% in a Swedish study of medical secretaries. While neck pain is generally believed to be of multifactorial origin, it remains unclear which factors place office workers, in particular, at higher risk. Postulated factors in this occupational group include: individual factors (e.g. sex), work environment factors (e.g. repetitive work, exposure level) psychosocial factors (e.g. stress, high job demands, low decision latitude) and perceived muscular tension. However, methodological considerations limit interpretation of these studies either because of high loss to follow-up (22% to 48%) in the longitudinal studies, which can introduce significant bias into the study findings, or cross-sectional design.
Physical risk factors (such as prolonged sitting and neck flexion) have been identified as predictive of neck pain in the study of a mixed population of workers from various industry, health and professional settings. These and other physical factors (such as posture and neck muscle endurance) have not been prospectively investigated specifically in office workers. Physical risk factors are useful to investigate as they are potentially reversible with exercise-based intervention. It has been argued that both physical and psychosocial contributors to work-related neck pain need to be assessed together in longitudinal designs, to evaluate their relative contribution to the onset of work-related musculoskeletal pain. Such longitudinal studies are lacking, especially in a population of office workers. The incidence and risk factors for work-related neck pain in Australian office workers remain unknown.
The aims of this project are to determine factors that predict neck pain in Australian office workers and to attain an estimate of the incidence of neck pain in this population. Individual, workplace, psychosocial and physical factors will be investigated as potential predictors in this exploratory longitudinal study. It is anticipated that this project will provide data to inform the design of a larger definitive study.
Definitions of episodes of neck pain to be employed in the study:
Type 1 Episode of neck pain – A period of neck pain lasting for more than 24 hours.
Type 2 Episode of care for neck pain – A period of neck pain lasting for more than 24 hours, with consultation or a series of consultations to a health professional.
Type 3 Episode of work absence due to neck pain – A period of neck pain lasting for more than 24 hours and a period of work absence due to neck pain.
This protocol describes a prospective cohort study that aims to determine the incidence of neck pain in Australian office workers and to identify risk factors associated with the onset of work-related neck pain. The results of this study will be useful to inform aspects of design for a larger definitive study, such as determination of sample size, feasibility and recruitment, and the workability of definitions of work-related neck pain. In the longer term, determination of factors that predict neck pain in office workers will be critical in the development of preventative workplace interventions and potentially occupational health and safety policy.
