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. 2005 Jan;62(1):41–48. doi: 10.1136/oem.2003.011296

Understanding work related musculoskeletal pain: does repetitive work cause stress symptoms?

J Bonde 1, S Mikkelsen 1, J Andersen 1, N Fallentin 1, J Baelum 1, S Svendsen 1, J Thomsen 1, P Frost 1, A Kaergaard 1, t and 1
PMCID: PMC1740840  PMID: 15613607

Abstract

Background: Pain in the neck and upper extremity is reported with high frequency in repetitive work. Mechanical overload of soft tissues seems a plausible mechanism, but psychological factors have received considerable attention during the past decade. If psychological factors are important for development of regional pain in repetitive work, stress symptoms would likely be on the causal path.

Aims: To examine whether objective measures of repetitive monotonous work are related to occurrence and development of stress symptoms.

Methods: In 1994–95, 2033 unskilled workers with continuous repetitive work and 813 workers with varied work were enrolled. Measures of repetitiveness and force requirements were quantified using video observations to obtain individual exposure estimates. Stress symptoms were recorded at baseline and after approximately one, two, and three years by the Setterlind Stress Profile Inventory.

Results: Repetitive work, task cycle time, and quantified measures of repetitive upper extremity movements including force requirements were not related to occurrence of stress symptoms at baseline or development of stress symptoms during three years of follow up.

Conclusions: The findings do not indicate that repetitive work is associated with stress symptoms, but small effects cannot be ruled out. Thus the results question the importance of mental stress mechanisms in the causation of regional pain related to repetitive work. However, the findings should be interpreted with caution because the stress inventory has not been validated against a gold standard.

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Selected References

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  1. Andersen J. H., Kaergaard A., Mikkelsen S., Jensen U. F., Frost P., Bonde J. P., Fallentin N., Thomsen J. F. Risk factors in the onset of neck/shoulder pain in a prospective study of workers in industrial and service companies. Occup Environ Med. 2003 Sep;60(9):649–654. doi: 10.1136/oem.60.9.649. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Andersen Johan Hviid, Kaergaard Anette, Frost Poul, Thomsen Jane Frølund, Bonde Jens Peter, Fallentin Nils, Borg Vilhelm, Mikkelsen Sigurd. Physical, psychosocial, and individual risk factors for neck/shoulder pain with pressure tenderness in the muscles among workers performing monotonous, repetitive work. Spine (Phila Pa 1976) 2002 Mar 15;27(6):660–667. doi: 10.1097/00007632-200203150-00017. [DOI] [PubMed] [Google Scholar]
  3. Bongers P. M., de Winter C. R., Kompier M. A., Hildebrandt V. H. Psychosocial factors at work and musculoskeletal disease. Scand J Work Environ Health. 1993 Oct;19(5):297–312. doi: 10.5271/sjweh.1470. [DOI] [PubMed] [Google Scholar]
  4. Bongers Paulien M., Kremer Anja M., ter Laak Jolanda. Are psychosocial factors, risk factors for symptoms and signs of the shoulder, elbow, or hand/wrist?: A review of the epidemiological literature. Am J Ind Med. 2002 May;41(5):315–342. doi: 10.1002/ajim.10050. [DOI] [PubMed] [Google Scholar]
  5. Carayon P., Smith M. J., Haims M. C. Work organization, job stress, and work-related musculoskeletal disorders. Hum Factors. 1999 Dec;41(4):644–663. doi: 10.1518/001872099779656743. [DOI] [PubMed] [Google Scholar]
  6. Fallentin N., Juul-Kristensen B., Mikkelsen S., Andersen J. H., Bonde J. P., Frost P., Endahl L. Physical exposure assessment in monotonous repetitive work--the PRIM study. Scand J Work Environ Health. 2001 Feb;27(1):21–29. doi: 10.5271/sjweh.583. [DOI] [PubMed] [Google Scholar]
  7. Frost Poul, Bonde Jens Peter E., Mikkelsen Sigurd, Andersen Johan H., Fallentin Nils, Kaergaard Anette, Thomsen Jane F. Risk of shoulder tendinitis in relation to shoulder loads in monotonous repetitive work. Am J Ind Med. 2002 Jan;41(1):11–18. doi: 10.1002/ajim.10019. [DOI] [PubMed] [Google Scholar]
  8. Holness D. L., Beaton D., House R. A. Prevalence of upper extremity symptoms and possible risk factors in workers handling paper currency. Occup Med (Lond) 1998 May;48(4):231–236. doi: 10.1093/occmed/48.4.231. [DOI] [PubMed] [Google Scholar]
  9. Houtman I. L., Bongers P. M., Smulders P. G., Kompier M. A. Psychosocial stressors at work and musculoskeletal problems. Scand J Work Environ Health. 1994 Apr;20(2):139–145. doi: 10.5271/sjweh.1419. [DOI] [PubMed] [Google Scholar]
  10. Huang Grant D., Feuerstein Michael, Sauter Steven L. Occupational stress and work-related upper extremity disorders: concepts and models. Am J Ind Med. 2002 May;41(5):298–314. doi: 10.1002/ajim.10045. [DOI] [PubMed] [Google Scholar]
  11. Kasl S. V. Measuring job stressors and studying the health impact of the work environment: an epidemiologic commentary. J Occup Health Psychol. 1998 Oct;3(4):390–401. doi: 10.1037//1076-8998.3.4.390. [DOI] [PubMed] [Google Scholar]
  12. Kasl S. V. The influence of the work environment on cardiovascular health: a historical, conceptual, and methodological perspective. J Occup Health Psychol. 1996 Jan;1(1):42–56. doi: 10.1037//1076-8998.1.1.42. [DOI] [PubMed] [Google Scholar]
  13. Kilbom s, Armstrong T, Buckle P, Fine L, Hagberg M, Haring-Sweeney M, Martin B, Punnett L, Silverstein B, Sjøgaard G. Musculoskeletal Disorders: Work-related Risk Factors and Prevention. Int J Occup Environ Health. 1996 Jul;2(3):239–246. doi: 10.1179/oeh.1996.2.3.239. [DOI] [PubMed] [Google Scholar]
  14. Kromhout H., van Tongeren M. How important is personal exposure assessment in the epidemiology of air pollutants? Occup Environ Med. 2003 Feb;60(2):143–144. doi: 10.1136/oem.60.2.143-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Linton S. J., Kamwendo K. Risk factors in the psychosocial work environment for neck and shoulder pain in secretaries. J Occup Med. 1989 Jul;31(7):609–613. doi: 10.1097/00043764-198907000-00012. [DOI] [PubMed] [Google Scholar]
  16. Lundberg U. Stress responses in low-status jobs and their relationship to health risks: musculoskeletal disorders. Ann N Y Acad Sci. 1999;896:162–172. doi: 10.1111/j.1749-6632.1999.tb08113.x. [DOI] [PubMed] [Google Scholar]
  17. Lundberg Ulf. Psychophysiology of work: stress, gender, endocrine response, and work-related upper extremity disorders. Am J Ind Med. 2002 May;41(5):383–392. doi: 10.1002/ajim.10038. [DOI] [PubMed] [Google Scholar]
  18. Pope D. P., Silman A. J., Cherry N. M., Pritchard C., Macfarlane G. J. Association of occupational physical demands and psychosocial working environment with disabling shoulder pain. Ann Rheum Dis. 2001 Sep;60(9):852–858. [PMC free article] [PubMed] [Google Scholar]
  19. Rissén D., Melin B., Sandsjö L., Dohns I., Lundberg U. Surface EMG and psychophysiological stress reactions in women during repetitive work. Eur J Appl Physiol. 2000 Oct;83(2-3):215–222. doi: 10.1007/s004210000281. [DOI] [PubMed] [Google Scholar]
  20. Scheike T. H., Jensen T. K. A discrete survival model with random effects: an application to time to pregnancy. Biometrics. 1997 Mar;53(1):318–329. [PubMed] [Google Scholar]
  21. Sluiter J. K., van der Beek A. J., Frings-Dresen M. H. W. Medical staff in emergency situations: severity of patient status predicts stress hormone reactivity and recovery. Occup Environ Med. 2003 May;60(5):373–375. doi: 10.1136/oem.60.5.373. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Steptoe A., Cropley M., Griffith J., Kirschbaum C. Job strain and anger expression predict early morning elevations in salivary cortisol. Psychosom Med. 2000 Mar-Apr;62(2):286–292. doi: 10.1097/00006842-200003000-00022. [DOI] [PubMed] [Google Scholar]
  23. Taris Toon W., Kompier Michiel. Challenges in longitudinal designs in occupational health psychology. Scand J Work Environ Health. 2003 Feb;29(1):1–4. doi: 10.5271/sjweh.697. [DOI] [PubMed] [Google Scholar]
  24. Toomingas A., Theorell T., Michélsen H., Nordemar R. Associations between self-rated psychosocial work conditions and musculoskeletal symptoms and signs. Stockholm MUSIC I Study Group. Scand J Work Environ Health. 1997 Apr;23(2):130–139. doi: 10.5271/sjweh.190. [DOI] [PubMed] [Google Scholar]
  25. Vasseljen O., Jr, Westgaard R. H. Can stress-related shoulder and neck pain develop independently of muscle activity? Pain. 1996 Feb;64(2):221–230. doi: 10.1016/0304-3959(95)00103-4. [DOI] [PubMed] [Google Scholar]
  26. Westgaard R. H. Effects of physical and mental stressors on muscle pain. Scand J Work Environ Health. 1999;25 (Suppl 4):19–24. [PubMed] [Google Scholar]

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