Department of Social Medicine, University of Crete, Heraklion, Crete, Greece.
Scand J Work Environ Health. 2010 Jan;36(1):54-61. doi: 10.5271/sjweh.2884. Epub 2009 Dec 11.
Musculoskeletal pain is associated with occupational physical activities and psychosocial risk factors. We evaluated the relative importance of work-related and psychological determinants of the number of -anatomical sites affected by musculoskeletal pain in a cross-sectional survey.
The survey focused on musculoskeletal pain in six body regions (low-back, neck, shoulder, elbow, wrist-hand, and knee) among 224 nurses, 200 office workers and 140 postal clerks in Crete, Greece (response rate 95%). Information was collected about demographic characteristics, occupational physical load, psycho-social aspects of work, perceptions about the causes of pain, mental health, somatization, and experience of pain in the past 12 months. We used Poisson regression to assess associations of risk factors with the number of painful anatomical sites and explored interactions using classification and regression trees (CART).
Two-thirds of the study sample reported pain in >or=2 body sites during the past 12 months, and in 23%, >3 sites were affected. The number of painful anatomical sites was strongly related to both physical load at work and somatization (with relative risks increased 5-fold or more for frequent and disabling multisite pain) and was also significantly associated with work-related psychosocial factors and beliefs about work causation. The CART analysis suggested that somatization was the leading determinant of the number of painful body sites.
In the population studied, pain at multiple anatomical sites was common and strongly associated with somatization, which may have a more important influence on multisite pain than pain that is limited to a single anatomical site.
肌肉骨骼疼痛与职业体力活动和心理社会风险因素有关。我们评估了与工作相关的和心理决定因素在横断面研究中对肌肉骨骼疼痛受累解剖部位数量的相对重要性。
该调查侧重于希腊克里特岛的 224 名护士、200 名办公室工作人员和 140 名邮政职员的六个身体部位（下背部、颈部、肩部、肘部、腕部和手部以及膝关节）的肌肉骨骼疼痛（应答率为 95%）。收集了有关人口统计学特征、职业体力负荷、工作心理社会方面、对疼痛原因的看法、心理健康、躯体化以及过去 12 个月的疼痛经历等信息。我们使用泊松回归评估危险因素与疼痛解剖部位数量的关联，并使用分类和回归树（CART）探索交互作用。
研究样本中有三分之二的人报告在过去 12 个月中有≥2 个身体部位疼痛，23%的人有≥3 个部位疼痛。疼痛的解剖部位数量与工作中的体力负荷和躯体化密切相关（频繁和致残的多部位疼痛的相对风险增加了 5 倍或以上），并且与工作相关的心理社会因素和对工作病因的看法也有显著关联。CART 分析表明，躯体化是疼痛解剖部位数量的主要决定因素。
在研究人群中，多个解剖部位的疼痛很常见，并且与躯体化密切相关，躯体化对多部位疼痛的影响可能比仅限于单一解剖部位的疼痛更为重要。
