Andersen J H, Kaergaard A, Mikkelsen S, Jensen U F, Frost P, Bonde J P, Fallentin N, Thomsen J F
Department of Occupational Medicine, Herning Hospital, Gl. Landevej 61, DK-7400 Herning, Denmark.
Occup Environ Med. 2003 Sep;60(9):649-54. doi: 10.1136/oem.60.9.649.
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.
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).
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.
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.
量化与工作相关的身体因素、工作场所心理社会因素、个体因素以及躯体化方面对颈部/肩部疼痛发作的相对贡献。
对丹麦工业和服务公司的工人进行为期四年的前瞻性队列研究。参与者为3123名工人,他们之前参加过一项横断面研究,该研究使用了对工作场所身体因素的客观测量。符合条件的参与者在随后的三个时间点进行随访,间隔约一年。感兴趣的结果包括:颈部/肩部疼痛新发(症状病例);以及颈部/肩部区域肌肉有压痛的颈部/肩部疼痛(临床病例)。
在随访期间,636名(14.1%)参与者报告了新发颈部/肩部疼痛;其中,82名(1.7%)还出现了明显肌肉压痛的临床体征。肩部高重复次数与未来成为症状病例以及未来成为临床病例相关。重复次数与其他身体测量指标高度相关。高工作要求与未来成为症状病例以及临床病例的状态相关。高水平的痛苦预示着随后的颈部/肩部疼痛以及伴有压痛的颈部/肩部疼痛。
高水平的痛苦以及工作场所的身体和心理社会因素是颈部和/或肩部疼痛发作的预测因素,尤其是肌肉有压痛的疼痛。