Work-Related Pain Common

Most Painful Jobs Involve Squatting, Monotonous Tasks

From the WebMD Archives

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 factors."

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:

  • Lifting more than 15 pounds with one hand
  • Lifting more than 24 pounds with two hands

  • Pulling more than 56 pounds

  • Prolonged squatting

  • Low job satisfaction

  • Low social support

  • Monotonous work

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.

Continued

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 pain.

"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."

WebMD Health News Reviewed by Charlotte E. Grayson Mathis, MD on May 06, 2004

Sources

SOURCES: Harkness, E.F. Arthritis & Rheumatism, May 2004; vol 50: pp 1655-1664. Yelin, E. Arthritis & Rheumatism, May 2004; vol 50: pp 1357-1359.

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