Abstract
BackgroundPrevious research has indicated that wide international variation in the prevalence of disabling low back pain among working populations is largely driven by factors predisposing to musculoskeletal pain more generally. This paper explores whether the same applies to disabling wrist/hand pain (WHP).MethodsUsing data from the Cultural and Psychosocial Influences on Disability (CUPID) study, we focused on workers from 45 occupational groups (office workers, nurses and other workers) in 18 countries. Among 11,740 participants who completed a baseline questionnaire about musculoskeletal pain and potential risk factors, 9082 (77%) answered a further questionnaire after a mean interval of 14 months, including 1373 (15%) who reported disabling WHP in the month before follow-up. Poisson regression was used to assess associations of this outcome with baseline risk factors, including the number of anatomical sites other than wrist/hand that had been painful in the 12 months before baseline (taken as an index of general propensity to pain).ResultsAfter allowance for other risk factors, the strongest associations were with general pain propensity (prevalence rate ratio for an index ≥6 vs. 0: 3.6, 95% confidence interval 2.9–4.4), and risk rose progressively as the index increased. The population attributable fraction for a pain propensity index > 0 was 49.4%. The prevalence of disabling WHP by occupational group ranged from 0.3 to 36.2%, and correlated strongly with mean pain propensity index (correlation coefficient 0.86).ConclusionStrategies to prevent disability from WHP among working populations should explore ways of reducing general propensity to pain, as well as improving the ergonomics of occupational tasks.
Highlights
Musculoskeletal pain, in the low back and upper limb, is a major cause of disability in working populations
As in our earlier study of low back pain (LBP), which used a slightly different measure of pain propensity [4], higher pain propensity was observed in women, at older ages, and among those with low mood and tendency to somatise
A total of 1373 participants (15%) reported disabling wrist/hand pain (WHP) in the month before follow-up, and Table 1 summarises its associations with personal risk factors ascertained at baseline
Summary
Musculoskeletal pain, in the low back and upper limb, is a major cause of disability in working populations. Using longitudinal data from the Cultural and Psychosocial Influences on Disability (CUPID) study, we have shown previously that after allowance for occupation and known psychosocial risk factors, prevalent disabling low back pain (LBP) at follow-up was strongly related to the number of anatomical sites other than low back that. Across the 45 occupational groups studied, the mean number of anatomical sites with pain at baseline (again excluding the low back) correlated with the prevalence of disabling LBP at follow-up, and in combination with the other risk factors examined, explained most of its large variation between occupations and countries. This paper explores the extent to which, within the CUPID dataset, similar relationships can be discerned for disabling wrist/hand pain (WHP). This paper explores whether the same applies to disabling wrist/hand pain (WHP)
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