Skip to main content
Occupational and Environmental Medicine logoLink to Occupational and Environmental Medicine
. 2001 Aug;58(8):528–534. doi: 10.1136/oem.58.8.528

A prospective study of work related factors and physical exercise as predictors of shoulder pain

H Miranda 1, E Viikari-Juntura 1, R Martikainen 1, E Takala 1, H Riihimaki 1
PMCID: PMC1740169  PMID: 11452048

Abstract

OBJECTIVES—To evaluate the effects of work related and individual factors as well as physical activity and sports on the incidence and persistence of shoulder pain among forestry workers.
METHODS—Workers in a large Finnish forestry company replied to a questionnaire (a modified version of the Nordic questionnaire) on musculoskeletal pain and its possible risk factors for 4 consecutive years 1992-5. This 1 year follow up study covers the time 1994-5. Year 1994 was chosen as baseline because in that year the questionnaire contained for the first time more detailed questions about different sports. The response rate in 1995 was 90%. The effects of the predictors on 1 year incidence and persistence of shoulder pain were studied with multivariate logistic regression modelling.
RESULTS—At baseline, 2094 subjects had been free of shoulder pain during the preceding 12 months. After 1 year, 14% (n=285) reported having mild or severe shoulder pain. Higher age, obesity, and mental stress as well as physically strenuous work and working with trunk forward flexed or with a hand above shoulder level increased the risk of incident shoulder pain. Of the different sports activities, dancing increased the risk of incident pain whereas jogging decreased the risk significantly. Of those 419 workers who had severe shoulder pain at baseline, 55% (n=230) still had severe pain 1 year later. Higher age, overload at work, and working with a hand above shoulder level increased the risk of persistent severe shoulder pain whereas cross country skiing and general sports activity decreased the risk.
CONCLUSION—Our results support the current view that shoulder pain is the result of many factors, including occupational and individual factors. In this longitudinal study, physical work with a heavy load, awkward work postures, mental stress, and obesity were the risk factors at which preventive measures could be aimed. As a new finding, physical exercise had more protective than impairing effects on the shoulders.


Keywords: mental stress; physical work load; sports

Full Text

The Full Text of this article is available as a PDF (135.1 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Chasan-Taber S., Rimm E. B., Stampfer M. J., Spiegelman D., Colditz G. A., Giovannucci E., Ascherio A., Willett W. C. Reproducibility and validity of a self-administered physical activity questionnaire for male health professionals. Epidemiology. 1996 Jan;7(1):81–86. doi: 10.1097/00001648-199601000-00014. [DOI] [PubMed] [Google Scholar]
  2. Ekberg K., Björkqvist B., Malm P., Bjerre-Kiely B., Karlsson M., Axelson O. Case-control study of risk factors for disease in the neck and shoulder area. Occup Environ Med. 1994 Apr;51(4):262–266. doi: 10.1136/oem.51.4.262. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Felson D. T. Epidemiology of hip and knee osteoarthritis. Epidemiol Rev. 1988;10:1–28. doi: 10.1093/oxfordjournals.epirev.a036019. [DOI] [PubMed] [Google Scholar]
  4. Holmström E. B., Lindell J., Moritz U. Low back and neck/shoulder pain in construction workers: occupational workload and psychosocial risk factors. Part 2: Relationship to neck and shoulder pain. Spine (Phila Pa 1976) 1992 Jun;17(6):672–677. doi: 10.1097/00007632-199206000-00006. [DOI] [PubMed] [Google Scholar]
  5. Kaergaard A., Andersen J. H. Musculoskeletal disorders of the neck and shoulders in female sewing machine operators: prevalence, incidence, and prognosis. Occup Environ Med. 2000 Aug;57(8):528–534. doi: 10.1136/oem.57.8.528. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Kohl H. W., Blair S. N., Paffenbarger R. S., Jr, Macera C. A., Kronenfeld J. J. A mail survey of physical activity habits as related to measured physical fitness. Am J Epidemiol. 1988 Jun;127(6):1228–1239. doi: 10.1093/oxfordjournals.aje.a114915. [DOI] [PubMed] [Google Scholar]
  7. Kujala U. M., Taimela S., Antti-Poika I., Orava S., Tuominen R., Myllynen P. Acute injuries in soccer, ice hockey, volleyball, basketball, judo, and karate: analysis of national registry data. BMJ. 1995 Dec 2;311(7018):1465–1468. doi: 10.1136/bmj.311.7018.1465. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. 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 Sep;18(3):233–237. doi: 10.1016/0003-6870(87)90010-x. [DOI] [PubMed] [Google Scholar]
  9. Leino P. I., Hänninen V. Psychosocial factors at work in relation to back and limb disorders. Scand J Work Environ Health. 1995 Apr;21(2):134–142. doi: 10.5271/sjweh.20. [DOI] [PubMed] [Google Scholar]
  10. Lo Y. P., Hsu Y. C., Chan K. M. Epidemiology of shoulder impingement in upper arm sports events. Br J Sports Med. 1990 Sep;24(3):173–177. doi: 10.1136/bjsm.24.3.173. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Oliveria S. A., Felson D. T., Cirillo P. A., Reed J. I., Walker A. M. Body weight, body mass index, and incident symptomatic osteoarthritis of the hand, hip, and knee. Epidemiology. 1999 Mar;10(2):161–166. [PubMed] [Google Scholar]
  12. Pope D. P., Croft P. R., Pritchard C. M., Silman A. J., Macfarlane G. J. Occupational factors related to shoulder pain and disability. Occup Environ Med. 1997 May;54(5):316–321. doi: 10.1136/oem.54.5.316. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Punnett L., Fine L. J., Keyserling W. M., Herrin G. D., Chaffin D. B. Shoulder disorders and postural stress in automobile assembly work. Scand J Work Environ Health. 2000 Aug;26(4):283–291. doi: 10.5271/sjweh.544. [DOI] [PubMed] [Google Scholar]
  14. Stenlund B., Goldie I., Hagberg M., Hogstedt C., Marions O. Radiographic osteoarthrosis in the acromioclavicular joint resulting from manual work or exposure to vibration. Br J Ind Med. 1992 Aug;49(8):588–593. doi: 10.1136/oem.49.8.588. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Stenlund B. Shoulder tendinitis and osteoarthrosis of the acromioclavicular joint and their relation to sports. Br J Sports Med. 1993 Jun;27(2):125–130. doi: 10.1136/bjsm.27.2.125. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Viikari-Juntura E., Rauas S., Martikainen R., Kuosma E., Riihimäki H., Takala E. P., Saarenmaa K. Validity of self-reported physical work load in epidemiologic studies on musculoskeletal disorders. Scand J Work Environ Health. 1996 Aug;22(4):251–259. doi: 10.5271/sjweh.139. [DOI] [PubMed] [Google Scholar]
  17. Viikari-Juntura E., Riihimäki H., Tola S., Videman T., Mutanen P. Neck trouble in machine operating, dynamic physical work and sedentary work: a prospective study on occupational and individual risk factors. J Clin Epidemiol. 1994 Dec;47(12):1411–1422. doi: 10.1016/0895-4356(94)90085-x. [DOI] [PubMed] [Google Scholar]
  18. van Mechelen W. Running injuries. A review of the epidemiological literature. Sports Med. 1992 Nov;14(5):320–335. doi: 10.2165/00007256-199214050-00004. [DOI] [PubMed] [Google Scholar]
  19. van der Windt D. A., Thomas E., Pope D. P., de Winter A. F., Macfarlane G. J., Bouter L. M., Silman A. J. Occupational risk factors for shoulder pain: a systematic review. Occup Environ Med. 2000 Jul;57(7):433–442. doi: 10.1136/oem.57.7.433. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Occupational and Environmental Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES