Work-Related Pain Common
Most Painful Jobs Involve Squatting, Monotonous Tasks
May 6, 2004 -- Fifteen out of 100 workers report widespread
pain after a year on the job, a British study shows.
The jobs most likely to involve widespread pain: podiatry (foot
doctors) and army infantry. Jobs requiring repetitive motion and jobs that
require prolonged squatting were most likely to cause pain.
The findings come from Elaine F. Harkness and colleagues at the
University of Manchester in England.
"We demonstrated that the new onset of widespread pain is
common and the risk [comes from many factors]," they report in the May
issue of Arthritis & Rheumatism. "The strongest independent
predictors of symptom onset were, however, work-related psychosocial
The researchers looked at a wide range of jobs notorious for
high rates of muscle and/or skeletal pain. They specifically defined
"widespread pain" as pain in the spinal area, or pain on both sides of
the body. This kind of pain is typical of the painful condition known as
fibromyalgia -- although true fibromyalgia includes other specific signs and
symptoms as well.
In previous studies of workplace pain, it's been hard to tell
how much a job contributes to a person's pain. That's because people in pain
often have to leave their jobs -- leaving behind workers who have less pain, or
who have higher pain thresholds. It's also been hard to tell whether people had
pain before starting their jobs.
Harkness and colleagues solved this problem by looking at newly
hired workers. Only those free of pain from the outset were included in the
study. The researchers then checked on the workers one and two years later.
Several factors were linked to reports of widespread pain:
But in a statistical test that analyzed all of these factors at
once, only two of the items still predicted widespread pain: prolonged
squatting and monotony.
After a year on the job, nearly a third of podiatrists and army
infantry had widespread pain. That's about double the rate in army clerks,
dentists, nurses, forestry workers, retail workers, and shipbuilders. At 6%,
postal workers had the lowest rate of pain after a year on the job. However,
after two years they were about equal, with a 12% widespread pain rate.
What's going on? It's easy to blame whiney workers. But that's
not helpful, writes Edward Yelin, PhD, of the University of California, San
Francisco, in an editorial accompanying the study.
"Attempts to reduce the number of malingerers and
complainers in the work place often have the perverse effect of subjecting
perseverant workers to intolerable conditions," he notes.
Yelin argues that it's a better idea to change the workplace
than to change workers. The Harkness team's work, he says, shows that
"ergonomically unsound and monotonous work" may result in widespread
"It is incumbent on us in the healing professions to do
whatever we can to reduce the expression of pain, psychogenic or
otherwise," he writes. "Reconstituting work may be a tool at our
disposal and one that, given the high prevalence of work disability associated
with pain syndromes, is worth a try."