Prevalence of multisite musculoskeletal symptoms: a French cross-sectional working population-based study

Elsa Parot-Schinkel, Alexis Descatha, Catherine Ha, Audrey Petit, Annette Leclerc, Yves Roquelaure, Elsa Parot-Schinkel, Alexis Descatha, Catherine Ha, Audrey Petit, Annette Leclerc, Yves Roquelaure

Abstract

Background: The musculoskeletal disorders in working population represent one of the most worrying work-related health issues at the present time and although the very great majority of available data on the subject focus on musculoskeletal disorders defined by anatomical site, a growing number of studies indicate the low prevalence of disorders strictly confined to a specific anatomical site. The objective of this study was to describe the prevalence and characteristics of multisite musculoskeletal symptoms (multisite MS) in a large French working population.

Methods: This study was performed on surveillance data of the cross-sectional survey (2002-2005) conducted by a network of occupational physicians in the working population of the Loire Valley region (from 20 to 59 years old). Data concerning MS were collected in the waiting room of the occupational physicians by means of the self-administrated standardized NORDIC questionnaire.

Results: The study population comprised 3,710 workers (2,162 men (58%) and 1,548 women (42%)) with a mean age of 38.4 years (standard deviation: 10.4 years). The prevalence of MS during the past 12 months was 83.8% with 95% confidence interval of [82.8-85.3] for men and 83.9% [82.0-85.7] for women. The prevalence of subacute MS (lasting at least 30 days) over the past 12 months was 32.8% [30.9-34.8] for men and 37.3% [34.9-39.7] for women. Two-thirds of workers reported MS in more than one anatomical site and about 20% reported MS lasting at least 30 days in more than one anatomical site. The anatomical sites most frequently associated with other MS were the upper back, hip, elbow and neck. The majority of these multisite MS were widespread, involving at least two of the three anatomical regions (upper limb, axial region and lower limb).

Conclusions: The frequency and extent of multisite MS reported by workers are considerable. Further research must be conducted in this field in order to provide a better understanding of the characteristics and determinants of these multisite MS.

Figures

Figure 1
Figure 1
Distribution of musculoskeletal symptoms lasting at least 30 days according to the number of symptoms. These figures represent the distribution of musculoskeletal symptoms lasting at least 30 days during the past 12 months according to the number of declared symptoms among men (figure A) and women (figure B): Neck symptoms (N), Shoulder or upper arm symptoms (S), Elbow or forearm symptoms (E), Wrist or hand symptoms (W), Upper back symptoms (UB), Low back symptoms (LB), Hip or thigh symptoms (H), Knee or lower leg symptoms (K), Ankle or foot symptoms (A).

References

    1. Woolf AD. The bone and joint decade 2000–2010. Ann Rheum Dis. 2000;59:81–82. doi: 10.1136/ard.59.2.81.
    1. European Agency for Safety and Health at Work. Work-related neck and upperlimb musculoskeletal disorders. Luxembourg: Office for Official Publications of the European Communities; 1999.
    1. European Foundation for the Improvement of Living and Working Conditions. Third European Survey on Working Conditions 2000. Luxembourg: Office for Official Publications of the European Communities; 2001.
    1. Eurostat. Work and health in the EU: a statistical portrait. Data 1994–2002. Luxembourg: Office for official publications of the European communities; 2004.
    1. Allison TR, Symmons DPM, Brammah T, Haynes P, Rogers A, Roxby M, Urwin M. Musculoskeletal pain is more generalised among people from ethnic minorities than among white people in Greater Manchester. Ann Rheum Dis. 2002;61:151–156. doi: 10.1136/ard.61.2.151.
    1. Carnes D, Parsons S, Ashby D, Breen A, Foster NE, Pincus T, Vogel S, Underwood M. Chronic musculoskeletal pain rarely presents in a single body site: results from a UK population study. Rheumatology (Oxford) 2007;46:1168–1170. doi: 10.1093/rheumatology/kem118.
    1. Davies H, Crombie I, Macrae W. Where does it hurt? Describing the body locations of chronic pain. Eur J Pain. 1998;2:69–80. doi: 10.1016/S1090-3801(98)90048-9.
    1. Gerdle B, Björk J, Cöster L, Henriksson K, Henriksson C, Bengtsson A. Prevalence of widespread pain and associations with work status: a population study. BMC Musculoskelet Disord. 2008;9:102. doi: 10.1186/1471-2474-9-102.
    1. Harkness EF, Macfarlane GJ, Silman AJ, McBeth J. Is musculoskeletal pain more common now than 40 years ago?: Two population-based cross-sectional studies. Rheumatology (Oxford) 2005;44:890–895. doi: 10.1093/rheumatology/keh599.
    1. Jordan KP, Kadam UT, Hayward R, Porcheret M, Young C, Croft P. Annual consultation prevalence of regional musculoskeletal problems in primary care: an observational study. BMC Musculoskelet Disord. 2010;11:144. doi: 10.1186/1471-2474-11-144.
    1. Kamaleri Y, Natvig B, Ihlebaek CM, Benth JS, Bruusgaard D. Number of pain sites is associated with demographic, lifestyle, and health-related factors in the general population. Eur J Pain. 2008;12:742–748. doi: 10.1016/j.ejpain.2007.11.005.
    1. Kamaleri Y, Natvig B, Ihlebaek CM, Bruusgaard D. Localized or widespread musculoskeletal pain: does it matter? Pain. 2008;138:41–46. doi: 10.1016/j.pain.2007.11.002.
    1. Kamaleri Y, Natvig B, Ihlebaek CM, Benth JS, Bruusgaard D. Change in the number of musculoskeletal pain sites: A 14-year prospective study. Pain. 2009;141:25–30. doi: 10.1016/j.pain.2008.09.013.
    1. Kamaleri Y, Natvig B, Ihlebaek CM, Bruusgaard D. Does the number of musculoskeletal pain sites predict work disability? A 14-year prospective study. Eur J Pain. 2009;13:426–430. doi: 10.1016/j.ejpain.2008.05.009.
    1. Picavet HSJ, Schouten JSAG. Musculoskeletal pain in the Netherlands: prevalences, consequences and risk groups, the DMC(3)-study. Pain. 2003;102:167–178. doi: 10.1016/s0304-3959(02)00372-x.
    1. Schmidt CO, Baumeister SE. Simple patterns behind complex spatial pain reporting? Assessing a classification of multisite pain reporting in the general population. Pain. 2007;133:174–182. doi: 10.1016/j.pain.2007.04.022.
    1. Urwin M, Symmons D, Allison T, Brammah T, Busby H, Roxby M, Simmons A, Williams G. Estimating the burden of musculoskeletal disorders in the community: the comparative prevalence of symptoms at different anatomical sites, and the relation to social deprivation. Ann Rheum Dis. 1998;57:649–655. doi: 10.1136/ard.57.11.649.
    1. Alexopoulos EC, Stathi I-C, Charizani F. Prevalence of musculoskeletal disorders in dentists. BMC Musculoskelet Disord. 2004;5:16. doi: 10.1186/1471-2474-5-16.
    1. Alexopoulos EC, Tanagra D, Konstantinou E, Burdorf A. Musculoskeletal disorders in shipyard industry: prevalence, health care use, and absenteeism. BMC Musculoskelet Disord. 2006;7:88. doi: 10.1186/1471-2474-7-88.
    1. Haukka E, Leino-Arjas P, Solovieva S, Ranta R, Viikari-Juntura E, Riihimäki H. Co-occurrence of musculoskeletal pain among female kitchen workers. Int Arch Occup Environ Health. 2006;80:141–148. doi: 10.1007/s00420-006-0113-8.
    1. Kääriä S, Solovieva S, Leino-Arjas P. Associations of low back pain with neck pain: a study of industrial employees with 5-, 10-, and 28-year follow-ups. Eur J Pain. 2009;13:406–411. doi: 10.1016/j.ejpain.2008.05.006.
    1. Morken T, Riise T, Moen B, Hauge SHV, Holien S, Langedrag A, Pedersen S, Saue ILL, Seljebø GM, Thoppil V. Low back pain and widespread pain predict sickness absence among industrial workers. BMC Musculoskelet Disord. 2003;4:21. doi: 10.1186/1471-2474-4-21.
    1. Solidaki E, Chatzi L, Bitsios P, Markatzi I, Plana E, Castro F, Palmer K, Coggon D, Kogevinas M. Work-related and psychological determinants of multisite musculoskeletal pain. Scand J Work Environ Health. 2010;36:54–61. doi: 10.5271/sjweh.2884.
    1. Yeung SS, Genaidy A, Deddens J, Alhemood A, Leung PC. Prevalence of musculoskeletal symptoms in single and multiple body regions and effects of perceived risk of injury among manual handling workers. Spine. 2002;27:2166–2172. doi: 10.1097/00007632-200210010-00017.
    1. Lindell L, Bergman S, Petersson IF, Jacobsson LT, Herrström P. Prevalence of fibromyalgia and chronic widespread pain. Scand J Prim Health Care. 2000;18:149–153. doi: 10.1080/028134300453340.
    1. Neumann L, Buskila D. Epidemiology of fibromyalgia. Curr Pain Headache Rep. 2003;7:362–368. doi: 10.1007/s11916-003-0035-z.
    1. Croft P, Dunn KM, Von Korff M. Chronic pain syndromes: you can’t have one without another. Pain. 2007;131:237–238. doi: 10.1016/j.pain.2007.07.013.
    1. Gummesson C, Atroshi I, Ekdahl C, Johnsson R, Ornstein E. Chronic upper extremity pain and co-occurring symptoms in a general population. Arthritis Rheum. 2003;49:697–702. doi: 10.1002/art.11386.
    1. Hagen EM, Svensen E, Eriksen HR, Ihlebaek CM, Ursin H. Comorbid subjective health complaints in low back pain. Spine. 2006;31:1491–1495. doi: 10.1097/01.brs.0000219947.71168.08.
    1. IJzelenberg W, Burdorf A. Impact of musculoskeletal co-morbidity of neck and upper extremities on healthcare utilisation and sickness absence for low back pain. Occup Environ Med. 2004;61:806–810. doi: 10.1136/oem.2003.011635.
    1. Macfarlane GJ, Hunt IM, Silman AJ. Role of mechanical and psychosocial factors in the onset of forearm pain: prospective population based study. BMJ. 2000;321:676–679. doi: 10.1136/bmj.321.7262.676.
    1. Molano SM, Burdorf A, Elders LA. Factors associated with medical care-seeking due to low-back pain in scaffolders. Am J Ind Med. 2001;40:275–281. doi: 10.1002/ajim.1099.
    1. Saastamoinen P, Leino-Arjas P, Laaksonen M, Martikainen P, Lahelma E. Pain and health related functioning among employees. J Epidemiol Community Health. 2006;60:793–798. doi: 10.1136/jech.2005.043976.
    1. Roquelaure Y, Ha C, Leclerc A, Touranchet A, Sauteron M, Melchior M, Imbernon E, Goldberg M. Epidemiologic surveillance of upper-extremity musculoskeletal disorders in the working population. Arthritis Rheum. 2006;55:765–778. doi: 10.1002/art.22222.
    1. Ha C, Roquelaure Y, Leclerc A, Touranchet A, Goldberg M, Imbernon E. The French Musculoskeletal Disorders Surveillance Program: Pays de la Loire network. Occup Environ Med. 2009;66:471–479. doi: 10.1136/oem.2008.042812.
    1. Hagberg M, Silverstein B, Wells R, Work related musculoskeletal disorders (WMSDs): a reference book for prevention. London: Taylor & Francis; 1995.
    1. Descatha A, Roquelaure Y, Chastang J-F, Evanoff B, Cyr D, Leclerc A. Work, a prognosis factor for upper extremity musculoskeletal disorders? Occup Environ Med. 2009;66:351–352. doi: 10.1136/oem.2008.042630.
    1. Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sørensen F, Andersson G, Jørgensen K. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon. 1987;18:233–237. doi: 10.1016/0003-6870(87)90010-X.
    1. Tschudi-Madsen H, Kjeldsberg M, Natvig B, Ihlebaek C, Dalen I, Kamaleri Y, Straand J, Bruusgaard D. A strong association between non-musculoskeletal symptoms and musculoskeletal pain symptoms: results from a population study. BMC Musculoskelet Disord. 2011;12:285. doi: 10.1186/1471-2474-12-285.
    1. Dickinson CE, Campion K, Foster AF, Newman SJ, O’Rourke AM, Thomas PG. Questionnaire development: an examination of the Nordic Musculoskeletal questionnaire. Appl Ergon. 1992;23:197–201. doi: 10.1016/0003-6870(92)90225-K.
    1. Ohlsson K, Attewell RG, Johnsson B, Ahlm A, Skerfving S. An assessment of neck and upper extremity disorders by questionnaire and clinical examination. Ergonomics. 1994;37:891–897. doi: 10.1080/00140139408963698.
    1. Baron S, Hales T, Hurrell J. Evaluation of symptom surveys for occupational musculoskeletal disorders. Am J Ind Med. 1996;29:609–617. doi: 10.1002/(SICI)1097-0274(199606)29:6<609::AID-AJIM5>;2-E.
    1. Silverstein BA, Stetson DS, Keyserling WM, Fine LJ. Work-related musculoskeletal disorders: comparison of data sources for surveillance. Am J Ind Med. 1997;31:600–608. doi: 10.1002/(SICI)1097-0274(199705)31:5<600::AID-AJIM15>;2-2.
    1. Palmer K, Smith G, Kellingray S, Cooper C. Repeatability and validity of an upper limb and neck discomfort questionnaire: the utility of the standardized Nordic questionnaire. Occup Med (Lond) 1999;49:171–175. doi: 10.1093/occmed/49.3.171.
    1. Nordlund A, Ekberg K. Self reported musculoskeletal symptoms in the neck/shoulders and/or arms and general health (SF-36): eight year follow up of a case–control study. Occup Environ Med. 2004;61:e11. doi: 10.1136/oem.2002.005249.
    1. Dawson AP, Steele EJ, Hodges PW, Stewart S. Development and test-retest reliability of an extended version of the Nordic Musculoskeletal Questionnaire (NMQ-E): a screening instrument for musculoskeletal pain. J Pain. 2009;10:517–526. doi: 10.1016/j.jpain.2008.11.008.
    1. Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sorensen F, Andersson G. Analyse des problèmes de l’appareil locomoteur: questionnaire scandinave. DMT. 1994;58:167–170.
    1. Descatha A, Roquelaure Y, Chastang JF, Evanoff B, Melchior M, Mariot C, Ha C, Imbernon E, Goldberg M, Leclerc A. Validity of Nordic-style questionnaires in the surveillance of upper-limb work-related musculoskeletal disorders. Scand J Work Environ Health. 2007;33:58–65. doi: 10.5271/sjweh.1065.
    1. McBeth J, Jones K. Epidemiology of chronic musculoskeletal pain. Best Pract Res Clin Rheumatol. 2007;21:403–425. doi: 10.1016/j.berh.2007.03.003.
    1. Gureje O, Von Korff M, Kola L, Demyttenaere K, He Y, Posada-Villa J, Lepine JP, Angermeyer MC, Levinson D, de Girolamo G, Iwata N, Karam A, Guimaraes Borges GL, de Graaf R, Browne MO, Stein DJ, Haro JM, Bromet EJ, Kessler RC, Alonso J. The relation between multiple pains and mental disorders: results from the World Mental Health Surveys. Pain. 2008;135:82–91. doi: 10.1016/j.pain.2007.05.005.
    1. Leclerc A, Gourmelen J, Chastang J-F, Plouvier S, Niedhammer I, Lanoë J-L. Level of education and back pain in France: the role of demographic, lifestyle and physical work factors. Int Arch Occup Environ Health. 2009;82:643–652. doi: 10.1007/s00420-008-0375-4.
    1. Madan I, Reading I, Palmer KT, Coggon D. Cultural differences in musculoskeletal symptoms and disability. Int J Epidemiol. 2008;37:1181–1189. doi: 10.1093/ije/dyn085.
    1. Leclerc A, Niedhammer I, Landre MF, Ozguler A, Etore P, Pietri-Taleb F. One-year predictive factors for various aspects of neck disorders. Spine. 1999;24:1455–1462. doi: 10.1097/00007632-199907150-00011.
    1. Walker-Bone K, Reading I, Coggon D, Cooper C, Palmer KT. The anatomical pattern and determinants of pain in the neck and upper limbs: an epidemiologic study. Pain. 2004;109:45–51. doi: 10.1016/j.pain.2004.01.008.
    1. Malmusi D, Artazcoz L, Benach J, Borrell C. Perception or real illness? European Journal of Public Health: How chronic conditions contribute to gender inequalities in self-rated health; 2011.
    1. Messing K, Stock SR, Tissot F. Should studies of risk factors for musculoskeletal disorders be stratified by gender? Lessons from the 1998 Québec Health and Social Survey. Scand J Work Environ Health. 2009;35:96–112. doi: 10.5271/sjweh.1310.
    1. Silverstein B, Fan ZJ, Smith CK, Bao S, Howard N, Spielholz P, Bonauto D, Viikari-Juntura E. Gender adjustment or stratification in discerning upper extremity musculoskeletal disorder risk? Scand J Work Environ Health. 2009;35:113–126. doi: 10.5271/sjweh.1309.
    1. Natvig B, Bruusgaard D, Eriksen W. Localized low back pain and low back pain as part of widespread musculoskeletal pain: two different disorders? A cross-sectional population study. J Rehabil Med. 2001;33:21–25. doi: 10.1080/165019701300006498.
    1. Schneider S, Mohnen SM, Schiltenwolf M, Rau C. Comorbidity of low back pain: representative outcomes of a national health study in the Federal Republic of Germany. Eur J Pain. 2007;11:387–397. doi: 10.1016/j.ejpain.2006.05.005.
    1. Salaffi F, De Angelis R, Stancati A, Grassi W. Health-related quality of life in multiple musculoskeletal conditions: a cross-sectional population based epidemiological study. II. The MAPPING study. Clin. Exp. Rheumatol. 2005;23:829–839.
    1. Miranda H, Kaila-Kangas L, Heliövaara M, Leino-Arjas P, Haukka E, Liira J, Viikari-Juntura E. Musculoskeletal pain at multiple sites and its effects on work ability in a general working population. Occup Environ Med. 2010;67:449–455. doi: 10.1136/oem.2009.048249.
    1. Nyman T, Grooten WJA, Wiktorin C, Liwing J, Norrman L. Sickness absence and concurrent low back and neck-shoulder pain: results from the MUSIC-Norrtälje study. Eur Spine J. 2007;16:631–638. doi: 10.1007/s00586-006-0152-6.
    1. McBeth J, Symmons DP, Silman AJ, Allison T, Webb R, Brammah T, Macfarlane GJ. Musculoskeletal pain is associated with a long-term increased risk of cancer and cardiovascular-related mortality. Rheumatology (Oxford) 2009;48:74–77.

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