The influence of work related psychosocial factors and psychological distress on regional musculoskeletal pain: a study of newly employed workers

Objective. To determine the influence of short term work related psychosoci al factors (work demands, job control, and social support) and psychologica l distress on regional pain syndromes, Methods, Newly employed workers were recruited from 12 occupational groups and information collected by questionnaire. Subjects indicated on a blank b ody manikin any low back, shoulder, wrist/forearm, or knee pain that had oc curred during the past month and lasted more than one day. Data were also c ollected on work related psychosocial factors and on levels of psychologica l distress [using the General Health Questionnaire (GHQ)I. The relationship s between psychosocial factors and psychological distress and each area of pain were calculated as odds ratios with 95% confidence intervals. Adjustme nt was made for age, sex, and occupational group. Results. 1081 subjects (median age 23; interquartile range 20-27) were recr uited to the study shortly after commencing employment: 261 (24%) reported low back pain, 221 (20%) reported shoulder pain, 93 (9%) reported wrist/for earm pain, and 222 (21%) reported knee pain. High levels of psychological d istress were associated with increased likelihood of pain, with a trend obs erved between scores on the GHQ and the odds of pain in each of the 4 sites . Those who perceived their work as stressful most of the time were more li kely to report back (OR 1.8, 95% CI 1.01-3.1) or shoulder pain (OR 1.9, 95% CI 1.02-3.4) than those who considered their work seldom stressful. Pace o f work or job autonomy was less markedly related to pain at individual site s. Strong relationships were observed between psychological distress, job d emands (stressful work, hectic work), low job control, and pain at multiple sites. Conclusion. The study has shown that adverse work related psychosocial fact ors, in particular aspects of job demand and control, influence the reporti ng of regional musculoskeletal pain. This occurs even after only short term exposure. The odds of reporting these adverse exposures are increased when pain is reported at multiple sites.