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Occup Environ Med. Sep 2003; 60(9): 649–654.
PMCID: PMC1740607

Risk factors in the onset of neck/shoulder pain in a prospective study of workers in industrial and service companies


Aims: To quantify the relative contribution of work related physical factors, psychosocial workplace factors, and individual factors and aspects of somatisation to the onset of neck/shoulder pain.

Methods: Four year prospective cohort study of workers from industrial and service companies in Denmark. Participants were 3123 workers, previously enrolled in a cross sectional study, where objective measurement of physical workplace factors was used. Eligible participants were followed on three subsequent occasions with approximately one year intervals. Outcomes of interest were: new onset of neck/shoulder pain (symptom cases); and neck/shoulder pain with pressure tenderness in the muscles of the neck/shoulder region (clinical cases).

Results: During follow up, 636 (14.1%) participants reported neck/shoulder pain of new onset; among these, 82 (1.7%) also had clinical signs of substantial muscle tenderness. High shoulder repetition was related to being a future symptom case, and a future clinical case. Repetition was strongly intercorrelated with other physical measures. High job demands were associated with future status as a symptom case, and as a clinical case. A high level of distress predicted subsequent neck/shoulder pain, and neck/shoulder pain with pressure tenderness.

Conclusions: High levels of distress, and physical and psychosocial workplace factors are predictors of onset of pain in the neck and/or shoulders, particularly pain with pressure tenderness in the muscles.

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Selected References

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  • Ariëns GA, van Mechelen W, Bongers PM, Bouter LM, van der Wal G. Physical risk factors for neck pain. Scand J Work Environ Health. 2000 Feb;26(1):7–19. [PubMed]
  • Ariëns GA, Bongers PM, Douwes M, Miedema MC, Hoogendoorn WE, van der Wal G, Bouter LM, van Mechelen W. Are neck flexion, neck rotation, and sitting at work risk factors for neck pain? Results of a prospective cohort study. Occup Environ Med. 2001 Mar;58(3):200–207. [PMC free article] [PubMed]
  • Miranda H, Viikari-Juntura E, Martikainen R, Takala EP, Riihimäki H. A prospective study of work related factors and physical exercise as predictors of shoulder pain. Occup Environ Med. 2001 Aug;58(8):528–534. [PMC free article] [PubMed]
  • Macfarlane GJ, Hunt IM, Silman AJ. Role of mechanical and psychosocial factors in the onset of forearm pain: prospective population based study. BMJ. 2000 Sep 16;321(7262):676–679. [PMC free article] [PubMed]
  • McBeth J, Macfarlane GJ, Hunt IM, Silman AJ. Risk factors for persistent chronic widespread pain: a community-based study. Rheumatology (Oxford) 2001 Jan;40(1):95–101. [PubMed]
  • 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. [PubMed]
  • Kaergaard A, Andersen JH. 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. [PMC free article] [PubMed]
  • Kaergaard A, Andersen JH, Rasmussen K, Mikkelsen S. Identification of neck-shoulder disorders in a 1 year follow-up study. Validation Of a questionnaire-based method. Pain. 2000 Jun;86(3):305–310. [PubMed]
  • Fallentin N, Juul-Kristensen B, Mikkelsen S, Andersen JH, Bonde JP, 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. [PubMed]
  • Scheike TH, Jensen TK. A discrete survival model with random effects: an application to time to pregnancy. Biometrics. 1997 Mar;53(1):318–329. [PubMed]
  • Bildt C, Alfredsson L, Punnett L, Theobald H, Torgén M, Wikman A. Effects of drop out in a longitudinal study of musculoskeletal disorders. Occup Environ Med. 2001 Mar;58(3):194–199. [PMC free article] [PubMed]
  • McBeth J, Macfarlane GJ, Benjamin S, Silman AJ. Features of somatization predict the onset of chronic widespread pain: results of a large population-based study. Arthritis Rheum. 2001 Apr;44(4):940–946. [PubMed]

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