Work-related Pain Research Articles

Frequency of Musculoskeletal Pain among Surgeons in Karachi

To determine the dynamic physical strain exerted on an individual during work, an evaluation of all physical performances is necessary. For surgeons, sustaining healthy ergonomics is essential, particularly for cases requiring long standing hours. Indeed, the absence of proper ergonomics may lead to multiple musculoskeletal issues. Failure to check these problems may lead to future degenerative changes and eventually career-ending damages. Pain among surgeons is expected since they spend many hours caring for patients that they ignore their health, standing for prolonged hours. Lack of attention to work ergonomics often leads to work-related muscle pain and increased risk of problems.

Characterization and general health conditions of workers in a Chilean industrial area: a worrying reality.

Within the occupational field, changes in the characteristics of work have revealed risks associated with static, repetitive work and litle physical activity, which together with individual health conditions of workers can trigger diseases and musculoskeletal disorders. To obtain a preliminary characterization of workers in an industrial area, including their health and working conditions. This is a cross-sectional study with a quantitative approach, developed with 69 men who worked in the industrial area of Viña del Mar, Chile. A clinical and occupational evaluation was carried out with the application of the International Physical Activity Questionnaire as well as the Standardized Nordic Questionnaire. The following risk factors were identified: 53.6% of the workers were smokers, 92.8% presented low levels of physical activity, and 70.3% reported feeling pain in body segments that were physically required during their work tasks. Among all workers, 63% were overweight according to their body mass index and 62% presented high systolic pressure. Pain was mostly detected in the spine, and it was slightly associated with forklif operation by older workers (t-test p < 0.05). Workers were in the presence of cardiovascular and occupational risks. It is necessary to promote timely education and training on health conditions and to evaluate risks associated with machinery operation in order to prevent work-related pain.

WORK RELATED MUSCULOSKELETAL NECK PAIN: A NEGLECTED OCCUPATIONAL DISEASE AMONG DENTISTS IN PESHAWAR, PAKISTAN

Objective:To determine the frequency and risk factors of work-related neck pain among dentists working in Public sector Hospitals in Peshawar, Pakistan.Materials and Methods: A cross sectional study was conducted in Khyber College of Density, Lady Reading Hospital and Hayatabad Medical Complex, Peshawar, Pakistan from 23rd September 2018 to23rd February 2019. A total of 150 dentists who were working in public sector hospitals and were willing to participate were included in the study by convenience sampling. The Standardized Nordic Questionnaire (SNQ) was used for data collection. Data was analyzed with SPSS, version 23.Results:The total number of participants in our study were 150. Males were 105(70%) and females were 45(30%).The mean age was 31.4200± 6.1 years. Majority(72.7%,n=109) of dentists were reported to have work related musculoskeletal pain while 41(27.3%) dentists had no such complaints. The commonly affected dentists were trainee medical officers(61.3%,n=92).The frequency of neck pain was more common among dentists who examined more than 15 patients per day(49.3%,74%) and worked 6 days per week(64%,n=96).Dentists performing root canal treatment(70.7%,n=106) were more prone to have neck pain than others.Conclusion:The frequency of musculoskeletal neck pain among the dentists was high. The risk factors were prolong working hours, examining more patients and prolong dental procedures.

Comparison of the Effects of Neurocognitive Therapeutic Exercise(CTE) and Conventional Therapy on the Reduction of Shoulder Pain in Farm Worker

Comparison of the effects of neurocognitive therapeutic exercise(CTE) and conventional therapy on the reduction of shoulder pain in farm workers. The aim of this randomized controlled pilot study was to evaluate the effectiveness of neurocognitive therapeutic exercise(CTE) and conventional exercise therapy in reducing work-related shoulder pain. Twenty elderly patients with work-related shoulder pain were randomly assigned to one group: neurocognitive group or conventional group. Both sessions lasted 30 min, three times a week for 8 weeks, and the assessments were blinded. Outcome measures included the visual analog scale (VAS) score, structured questionnaire, and rapid entire body assessment (REBA). Active range of motion (AROM) of shoulder abduction and parametric statistical tests were performed using paired and independent t-tests. Both groups experienced improvements in all outcomes measures relative to the baseline values. Changes in VAS score (p=.151) showed no significant differences between the two groups. The neurocognitive therapeutic exercise could be a safe and more useful strategy for improving REBA (p=.001) and AROM (p=.001). Neurocognitive rehabilitation is effective in reducing and improving function in farm workers with shoulder pain.

Prevalence of Neck Pain related to working hours among Bankers, A cross-sectional Study

Introduction: Work-related neck pain is demonstrated as neck pain that is produced or provoked by labor or the working atmosphere. It is one of the most common complaints especially among workers who use computer extensively at their workplace. Office work demands long time in front of computer screens and if there is lack of ergonomic use, lack of awareness of proper body positioning and the positioning of the desk, keyboard, and screen all lead to pain neck. Objective: The objective of this study was to find the frequency of neck pain due to necktie among bankers. Methods: It was a cross sectional study. Data was taken from 277 participants through Neck disability index questionnaire through convenient sampling technique from all the male workers of banks who were wearing tie on regular basis. Data was presented as bar charts and pie charts by using Statistical Package for social sciences version 25. Results: About 184 (66.4%) were having pain in neck in past 6 months. About half of those who were suffering from pain have moderate pain 145 (86.8%), 14 (8.3) have mild pain and 8 (4.7%) were having severe pain in neck. Conclusion:It is concluded that about 66.4% bankers were having pain and majority of bankers have moderate level neck pain due to prolong working hours.

Aberrant Neuronal Activity in a Model of Work-Related Upper Limb Pain and Dysfunction

Work-related musculoskeletal disorders associated with intense repetitive tasks are highly prevalent. Painful symptoms associated with such disorders can be attributed to neuropathy. In this study, we characterized the neuronal discharge from the median nerve in rats trained to perform an operant repetitive task. After 3-weeks of the task, rats developed pain behaviors and a decline in grip strength. Ongoing activity developed in 17.7% of slowly conducting neurons at 3-weeks, similar to neuritis. At 12-weeks, an irregular high frequency neuronal discharge was prevalent in >88.4% of slow and fast conducting neurons. At this time point, 8.3% of slow and 21.2% of fast conducting neurons developed a bursting discharge, which, combined with a reduction in fast-conducting neurons with receptive fields (38.4%), is consistent with marked neuropathology. Taken together, we have shown that an operant repetitive task leads to an active and progressive neuropathy that is characterized by marked neuropathology following 12-weeks task that mainly affects fast conducting neurons. Such aberrant neuronal activity may underlie painful symptoms in patients with work-related musculoskeletal disorders. PerspectiveAberrant neuronal activity, similar to that reported in this study, may contribute to upper limb pain and dysfunction in patients with work-related musculoskeletal disorders. In addition, profiles of instantaneous frequencies may provide an effective way of stratifying patients with painful neuropathies.

Prevalence and Risk Factors of Work-Related Lower Back Pain among Radiographers in the State of Kuwait.

Background Work-related lower back pain (WrLBP) is a global health issue and a rising concern in the State of Kuwait. The prevalence and the risk factors of WrLBP among radiographers are not well documented. Objective The purpose of the study was to determine the one-year prevalence, characteristics, impact, and physical risk factors of WrLBP among radiographers in the State of Kuwait. Methods A self-administered questionnaire was distributed to 200 radiographers. The questionnaire collected data on demographics, physical risk factors, and the occurrence of WrLBP in the previous 12 months. Descriptive statistics, frequency calculations, and chi-square analyses were performed. Results One hundred forty-six radiographers completed and returned the questionnaires with a response rate of 73% (146/200). The one-year prevalence of WrLBP was 16%. The prevalence of WrLBP was not significantly associated with the participants' demographics. Although WrLBP was significantly associated with work demands, the overall impact of WrLBP on work duties was minimal. Conclusions The occurrence of WrLBP among radiographers in Kuwait was low, particularly when compared to healthcare providers involved in more patient handling and direct contact. However, various physical risk factors were identified. Further research is needed to investigate the effect of a treatment and prevention program on the prevalence of WrLBP.

The Efficacy of Deep Cervical Flexor Training with Feedback Reducing Pain and Disability in Individuals with Work-Related Neck Pain

Introduction: The most common trouble when doing task is work related neck pain. Neck pain can have negative effect on workers related to the resulting work productivity. To conquer this, there is deep cervical flexor training with feedback training to solve that problems. This study aims to find out whether deep cervical flexor training with feedback is powerful in reducing pain and disability the work-related neck pain.&#x0D; Methods: This study using a literature review by conducting data studies related to deep cervical flexor training with feedback, neck pain, and working. The initial search in 4 databases found a total of 36 articles. After the selection using inclusion and exclusion criteria obtained 28 articles.&#x0D; Results: Based on some literature, it shows that deep cervical flexor training with feedback aims to activate the deep cervical flexor muscle effectively in reducing pain through the release of endorphins and decreasing pain and changes in muscle function have an effect on reducing disability in work related neck pain.&#x0D; Conclusion: Providing deep cervical flexor training with feedback is powerful in decreasing the level of pain and disability in work-related neck pain.

Wrist flexion and extension strength in patients with work-related chronic elbow pain: the isokinetic effort factor and its implications.

The validity of isokinetic strength findings relating to forearm muscles in patients with chronic elbow pain and/or epicondylitis is not well established. Furthermore, given the nature of this disorder, ensuring maximal effort in performing the tests is an essential prerequisite. The isokinetic-based DEC parameter (defined as the difference between high- and low-velocity eccentric-to-concentric ratios of a given muscle) has been shown to efficiently detect maximal effort. The purpose of this study was therefore to assess the validity of isokinetic strength tests in patients with chronic elbow pain and/or epicondylitis. A cohort consisting of 44 male patients with chronic elbow pain (average evolution time, 262 ± 193.04 days) was recruited. The wrist extensor and flexor concentric and eccentric isokinetic strength of the involved and uninvolved sides was measured. The involved-uninvolved and flexor-extensor (F/E) ratios, as well as the DEC (eccentric-concentric difference), were computed based on peak moment values. Work disability and relapse within the first year were registered. In maximal performers, associations between deficits, F/E ratios, work disability, and symptom relapse were explored applying multiple comparisons. Of the patients, 68.2% met the maximal-effort criteria, with the involved-side muscles being significantly weaker than their uninvolved-side counterparts in most cases. Although the mean deficit in this group was not associated with either work disability or relapse, patients with a relapse of symptoms within the first year had a significantly higher F/E ratio than those without relapse. In patients presenting with chronic elbow pain who perform at the maximal level of effort, high wrist F/E strength ratios may predict symptom relapse.

A gender-based analysis of predictors and sequelae of burnout among practicing American vascular surgeons

ObjectiveSurgeons report higher burnout and suicidal ideation (SI) rates than the general population. This study sought to identify the prevalence and gender-specific risk factors for burnout and SI among men and women vascular surgeons to guide future interventions. MethodsIn 2018, active Society for Vascular Surgery members were surveyed confidentially using the Maslach Burnout Index embedded in a questionnaire that captured demographic and practice-related characteristics. Results were stratified by gender. Univariate and multivariate logistic regression models were developed to identify predictors for the end points of burnout and SI. ResultsOverall survey response rate was 34.3% (N = 878) of practicing vascular surgeons. A higher percentage of women responded (19%) than compose membership in the Society for Vascular Surgery (13.7%). Women respondents were significantly younger, with fewer years in practice, and were less likely to be in private practice than the men who responded. Women were also less likely to be married/partnered, or to have children. The prevalence of burnout was similar for women and men (42.3% and 40.9%; P = nonsignificant); however, the prevalence of SI was significantly higher in women (12.9% vs 6.6%; P < .007). Whereas there was no difference in mean hours worked or call taken, women were more likely to have had a recent conflict between work and home responsibilities and to have resolved this conflict in favor of work. Although men and women had the same incidence of reported recent medical errors, women were less likely to self-report a recent malpractice suit or to think that a fair resolution was reached. There was no gender difference in reported work-related pain. Multivariable analysis revealed that not enough family time and work-related pain were predictors for burnout in both men and women. Additional factors were associated with burnout in men, such as malpractice and electronic medical record dissatisfaction. Multivariable analysis revealed that work-related pain was an independent predictor for SI for the entire cohort. ConclusionsThe prevalence of burnout among vascular surgeons is high. Women vascular surgeons have double the rates of SI compared with male vascular surgeons. Taken together, this study demonstrated that many of the same factors are associated with burnout in women and men, which include not enough family time, conflict between work and personal life, and work-related pain. Additional factors in men included conflict between work and family, work-related pain, and electronic medical record dissatisfaction.

Surgeon Strength: Ergonomics and Strength Training in Cardiothoracic Surgery

With the high prevalence of musculoskeletal pain in surgeons and interventionalists, it is critical to analyze the impact of ergonomics on cardiothoracic surgeon health. Here, we review the existing literature and propose recommendations to improve physical preparedness for surgery both in and outside the operating room. For decades, cardiothoracic surgeons have suffered from musculoskeletal pain, most commonly in the neck, and back due to a lack of proper ergonomics during surgery. A lack of dedicated ergonomics curriculum during training may leave surgeons at a high predisposition for work-related musculoskeletal disorders. We searched PubMed, Google Scholar, and other sources for studies relevant to surgical ergonomics and prevalence of musculoskeletal disease among surgeons and interventionalists. Whenever possible, data from quantitative studies, and meta-analyses are presented. We also contacted experts and propose an exercise routine to improve physical preparedness for demands of surgery. To date, many studies have reported astonishingly high rates of work-related pain in surgeons with rates as high as 87% in minimally-invasive surgeons. Several optimizations regarding correct table height, monitor positioning, and loupe angles have been discussed. Lastly, implementation of ergonomics training at some programs have been effective at reducing the rates of musculoskeletal pain among surgeons. Surgical work-related stress injuries are more common than we think. Many factors including smaller incisions and technological advancements have led to this plight. Ultimately, work-related injuries are underreported and understudied and the field of surgical ergonomics remains open for investigative study.

Prevalence of Self-Reported Work-Related Lower Back Pain and Its Associated Factors in Ethiopia: A Systematic Review and Meta-Analysis.

Introduction Low back pain is the commonest musculoskeletal disorder affecting every socioeconomic group of the world's population. The lifetime risk of developing low back pain is about 60%–80%. The pooled prevalence and associated factors of low back pain have not yet been determined in Ethiopia. Thus, this study was aimed at assessing the overall prevalence of low back pain and its associated factors in Ethiopia. Methods A systematic search of PubMed, Scopus, Science Direct, and Google Scholar for observational studies reporting data on the prevalence and associated factors of low back pain was conducted. Relevant data were extracted with a standardized data extraction excel form. Stata 14 was employed for the meta-analysis. Heterogeneity was assessed by Cochran's Q test and I2 values of a forest plot. Publication bias was checked using a funnel plot and Egger's test. A random-effects model was used in the analysis. Result A total of thirty-two studies were included for the systematic review. Twenty-four and sixteen studies were used to pool the overall low back pain prevalence and associated factors, respectively. The overall pooled annual prevalence of low back pain in Ethiopia was estimated to be 54.05% (95% CI: 48.14–59.96). Age, sex, body mass index, work experience, working hours, lack of safety training, awkward working posture, work shift, prolonged standing, lifting heavy objects, sleeping disturbance, history of back trauma, previous medical history of musculoskeletal disorder, and lack of adequate rest interval at work were significantly associated with low back pain. Conclusion The current systematic review and meta-analysis revealed a higher prevalence of lower back pain in Ethiopia. Most of the low back pain epidemiological studies conducted in Ethiopia focused on specific occupational settings, making pooling of data and comparison with other countries challenging. Thus, further general population studies are recommended.

Prevalence of Work-Related Musculoskeletal Disorders: Psychological and Physical Risk Factors.

Purpose—This study aimed to estimate the prevalence and risk factors of MSD pain in various anatomical regions among nurses. Method—A cross-sectional study involving a self-administered questionnaire by registered nurses with clinical experience. Data was collected using convenience sampling after obtaining informed consent. The results were drawn from a total of 300 nurses. Results—The nurses presented with occasional mental exhaustion (44.3%) and often physical exhaustion (44.0%). Almost all (97.3%) the nurses complained of having work-related pain during the last 12 months. Body parts with the most pain were the lower back (86.7%), ankles (86.7%), neck (86.0%), shoulders (85.0%), lower legs (84.7%) and upper back (84.3%). The pain frequency was rated as occasional pain for the neck and upper back, pain was often felt for the rest of the parts. Nurses complained of severe pain in the lower back (19.7%), right shoulder (29.7%) and left shoulder (30.3%). The frequency of having musculoskeletal symptoms in any body region was increased with age, lower education level, female gender, high BMI, job tenure and lifestyle. Conclusions—Nurses’ WRMSD complaints should be taken seriously to curb further risk and musculoskeletal hazards.

EFFECT OF 6 WEEKS GREEVA SANCHALAN ON CERVICAL SPINE HEALTH AMONG MALE IT PROFESSIONALS

Purpose of present research was to study the effect of 6 weeks Greeva Sanchalan on Cervical Spine Health or work-related neck pain among male IT professionals. Quasi Pre-test Post-test Non-Equivalent research design used to achieve this objective. Non-Probability based Judgemental Sampling Technique, was used to screen samples from 2 different IT firms from Pune city, who were falling under the criteria of using laptop/desktop/computer for ≥5hours/day, between 30-50years of age group, experiencing neck pain/stiffness and were willing to participate in study. Neck Disability Index Questionnaire (NDI) includes 10 measuring sections such as neck pain, personal care, headache, lifting, reading, concentration, sleeping, work, driving, and recreation was used to collecting data. Using ABBA method, total selected 26 IT professionals, were divided into two groups, i.e., experimental (n=13) and control group (n=13). 6 weeks Greeva Sanchalan intervention was developed and implemented to experimental group’s IT professionals only. After 6 weeks, post-test NDI scores were collected for all 26 IT professionals. NDI pre and post test scores were statistically analysed through Descriptive and Inferential statistics using SPSS software. Mean of pre and post NDI scores for experimental group was 7.92 (±1.89) and 5.62 (±1.26) respectively. Similarly Mean of pre and post NDI scores for control group was 7.54 (±2.44) and 7.77 (± 2.98) respectively. On comparing the Mean of pre and post NDI scores with Neck Disability Index standard norms, all 26 IT professionals were falling within mild neck disability category. Mean of change in performance for experimental and control group’s IT professionals were 2.31 (±2.06) and 0.23 (±1.74) respectively. Calculated mean difference of change in performance was 2.54 for 26 IT professionals. Calculated t-value was 3.40(24) at 0.05 significance level (p=0.002; p less than 0.05). According to statistical outcome, 6 weeks Greeva Sanchalan intervention benefitted in reducing neck pain/stiffness related to work among IT professionals, which relieved muscular tension of neck-shoulder region. It improves range of motion (CROM) of cervical pivot joint along with regaining neck muscles flexibility, which also strengthens neck muscles.

MP10-11 USING WEARABLE TECHNOLOGY TO DETERMINE RELATIONSHIP BETWEEN NECK POSTURE AND PAIN DURING UROLOGIC OPEN AND ROBOTIC SURGERY

You have accessJournal of UrologySurgical Technology & Simulation: Instrumentation & Technology I (MP10)1 Sep 2021MP10-11 USING WEARABLE TECHNOLOGY TO DETERMINE RELATIONSHIP BETWEEN NECK POSTURE AND PAIN DURING UROLOGIC OPEN AND ROBOTIC SURGERY Joseph Bigham, Edward Chang, Mathew Sorensen, Howard Chansky, and Scott Telfe Joseph BighamJoseph Bigham More articles by this author , Edward ChangEdward Chang More articles by this author , Mathew SorensenMathew Sorensen More articles by this author , Howard ChanskyHoward Chansky More articles by this author , and Scott TelfeScott Telfe More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001983.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Chronic neck pain is the most prevalent work-related musculoskeletal issue among surgeons. 70% of urologists experience neck pain while 17% report degenerative cervical spine disease. Many attribute this pain to non-ergonomic positions while operating. Our goal was to use wearable technology to quantify the relationship between neck posture and pain during open and robotic surgery. METHODS: Subjects included urologic faculty and residents from one institution who spent at least 1 day per week performing surgery for ≥6 hours. Data were collected from subjects on 2 separate days (Sept 2019 to Oct 2020). The Neck Disability Index, a validated questionnaire assessing baseline neck pain, and 0-10 numeric analogue pain scales were completed by participants throughout their workday. Those with pre-existing cervical spinal conditions were excluded. Neck posture was measured in real time while operating using inertial measurement devices attached at the occipital protuberance and 7th cervical vertebrae. A mixed effect model was used to determine the relationship between neck posture and pain scores. Neck posture and pain were then compared between open vs robotic surgery and faculty vs residents. RESULTS: A total of 30 participants were included in the study (21 faculty, 9 residents). 202 hours of data were collected. Neck pain was found to be correlated with longer duration of severe neck flexion, defined as ≥30° (p=0.01). Surgeons performing open procedures spent on average 147 minutes with their heads in neck flexion postures of ≥30° compared to 68 minutes for those performing robotic procedures. This greater duration and degree of neck flexion was associated with increased neck pain (p=0.007) (Figure). Surgeons performing open procedures reported a mean increase in neck pain of 2.0 on the pain scale, compared to 1.3 for those performing robotic procedures (p=0.04). There were no differences in neck flexion/pain when faculty and residents were compared. CONCLUSIONS: Real time measurements of neck flexion during urologic surgery show that longer duration and greater degree of neck flexion were associated with increased neck pain. Urologists spend more time in severe neck flexion during open surgery compared to robotic surgery, increasing their risk of work-related neck pain. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e172-e173 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Joseph Bigham More articles by this author Edward Chang More articles by this author Mathew Sorensen More articles by this author Howard Chansky More articles by this author Scott Telfe More articles by this author Expand All Advertisement Loading ...

Influence of an on-body lifting aid (HAL® for Care Support) on kinematics during repetitive lifting in healthy men

Work-related lower back pain (LBP) leads to socio-economic burden and demands solutions. The hybrid assistive limb (HAL) for Care Support (Cyberdyne Inc., Ibaraki, Japan) is an active on-body lifting aid to assist joint motion according to the wearer’s voluntary motor drive to reduce the lumbar load. A few studies investigated HAL and stated efficacy in terms of enhanced performance and reduced fatigue, yet the question remained if the use of HAL may result in a different execution of movement, for example by influencing the kinematics of the lower extremities. The aim of this study was to determine the influence of HAL on kinematics of the lower limbs and the spinal column during repetitive freestyle symmetrical lifting. Kinematic data was recorded by an inertial measurement unit sensor system in 11 healthy men lifting and lowering a 19.5 kg barbell under three conditions (no HAL, HAL Level 3/5, HAL Level 5/5). Outcome parameters were maximum and minimum angles as well as range of motion (ROM) of thoracic spine, lumbar spine, hip- and knee joint in sagittal plane. We found a significantly decreased ROM of the lumbar spine as well as a significantly reduced maximum and minimum thorax extension when starting lifting and in upright position after lifting, respectively, while using HAL. Influence of HAL on the kinematics of the lower limbs was not significant. Differences between both evaluated HAL conditions were not significant. This study proved limited lumbar spine ROM and reduced thorax extension without alterations of lower limbs kinematics when using HAL. This might potentially decrease the risk of work-related LBP.

THE DESIGN OF WORK FACILITIES BASED ON WORKERS POSTURE ANALYSIS IN TOFU PRODUCTION MSME

Work facilities following the user's needs are critical because they support the production process for increased productivity. Currently, the tofu production process at Mr Samingin's MSMEs uses manual equipment to feel pain in their body parts when doing work every day. Making tofu begins with washing the soybeans thoroughly, then soaking the soybeans in water for 2 to 3 hours. Sometimes, it needs 7 hours, depending on the type of soybeans. In this soaking process, the soybeans will expand and then cleaned again by washing them several times. The next step is to grind the soybeans into powder with a grinding machine then boiled them. Then, filter the soybean porridge with a cloth to separate the pulp to be processed and the rest of the cooking water. This stage is very tiring as it is done manually by filtering in a shake. In addition, in the process of pressing tofu, there is a lack of attention to workers' work posture, which will impact work-related pain, especially if it is done monotonously and repeatedly. This study used the Rapid Upper Limb Assessment (RULA) analysis method as a guide in designing tofu screening work facilities. It is expected that improvements to work facilities can increase worker productivity at tofu production MSME.

Epidemiology of work-related lower back pain among rehabilitation professionals in Saudi Arabia.

Occupational and physical therapists are at risk of musculoskeletal pain and injuries possibly due to their work-related activities, posture and affected body mechanics. To investigate the epidemiology of lower back pain among rehabilitation professionals. A cross-sectional survey of 259 physical and occupational therapists in rehabilitation centres in Saudi Arabia was conducted during July-August 2019, using the Modified Nordic Questionnaire. Data on different measures of lower back pain, and its consequences and risk factors were collected. Logistic regression analysis was done to identify significant predictors of lower back pain. Rehabilitation professionals experienced 73.7% 1-year lower back pain prevalence, 52.5% intense pain that lasted ≥ 1 day, 22.4% chronic lower back pain, 23.9% sick-leave-seeking lower back pain and 18.5% medical-care-seeking lower back pain. Difficult/impossible activities of daily living in standing up (45.5%), employment (44.0%), climbing stairs (33.9%), walking (33.0%), sitting (29.3%), sleeping and travel (29.8% each), awakening (23.0%), social life (26.2%), and personal care (15.7%) were reported. Lower back pain was responsible for stopping work in 32.5% of participants, with a mean 1.38 (±2.96) days off work during the last year. One half of participants (50.3%) were treated by physiotherapy, 25.1% by medical care, and 39.3% requested rest days and/or sick leave. Physical stress and < 10 years' experience were significant predictors of lower back pain. Prevalence of lower back pain was high among rehabilitation professionals, with a high impact on activities of daily living. Physiotherapy was the main management adopted. Educational programmes are necessary to teach proper use of body mechanics, and sports activity programmes to reduce the risk of lower back pain and arrange for proper rest periods.

Naturalistic assessment of patterns and predictors of acute headache medication use among women with comorbid migraine and overweight or obesity.

Given the potential for obesity to complicate migraine treatment outcomes, there is a need to understand patterns and correlates of acute medication use among individuals with this comorbidity. Experience sampling methodology (ESM) was used to characterize patterns of acute medication use among those with migraine and overweight/obesity and to examine individual and momentary factors related to medication use (both migraine-specific and nonspecific medications). Women with migraine and overweight/obesity (N = 170) seeking behavioral migraine treatment completed questionnaires followed by 28 days of daily ESM headache diaries. Participants used medications to treat 71.9% of attacks, 20% of which were treated with migraine-specific medications. Participants were more likely to use medication in the context of longer and more severe attacks that started earlier in the day. Presence of aura and greater work-related pain interference uniquely related to migraine-specific medication use. Questionnaire-assessed factors were not related to medication use, although older age and higher educational attainment related to more frequent use. A substantial proportion of attacks were left untreated, suggesting unmet treatment needs in this population. Results also suggest that ESM-assessed factors are more salient correlates of medication use compared to questionnaires. Additional investigation of barriers to medication use is needed.

Heightened pain facilitation rather than impaired pain inhibition distinguishes those with moderate/severe disability in work-related neck pain.

To better understand the mechanisms underpinning work-related neck pain, this cross-sectional and single-blinded study compared somatosensory profiles among sonographers with varied neck disability levels. Based on K-mean cluster analysis of scores on the neck disability index (NDI), participants were classified into no (NDI ≤ 8%, n = 31, reference group), mild (NDI = 10%-20%, n = 43), or moderate/severe (NDI ≥ 22%, n = 18) disability groups. Data were collected on bodily pain distribution and severity and psychological measures including depression, anxiety, pain-catastrophizing, and fear-avoidance beliefs using validated scales. Participants attended 1 session of quantitative sensory testing performed according to a standardized protocol, including local and remote thermal and mechanical pain thresholds, temporal summation of pain (TSP), conditioned pain modulation, and an exercise-induced analgesia paradigm. Compared with participants with no and mild disability, those with moderate/severe disability showed more widespread pain, cold and mechanical hyperalgesia at a remote nonpainful site, and significantly higher TSP. Participants with mild disability demonstrated significantly higher TSP than those with no disability. These group differences were attenuated after adjusting for depression or anxiety, indicating these psychological factors may mediate the somatosensory changes associated with neck disability. Group differences were not found for conditioned pain modulation or exercise-induced analgesia. These findings suggest that heightened pain facilitation, rather than impaired pain inhibition may underpin nociplastic pain in participants with moderate/severe disability, and it may be associated with depression and anxiety. Clinicians should be aware that individuals with work-related neck pain presenting with moderate/severe disability display distinct somatosensory features and tailor management strategies accordingly.