Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?

Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake. A study of bank employees published in JMPT provides us with a correlation between the amount of stress (subjective mental workload) in a person's job and the likelihood of experiencing musculoskeletal disorders (MSDs).¹

According to the authors, subjective mental workload (SMWL) "refers to the amount of effort done by the mind during an individual function, and is basically related to an individual's mental capacity.² SMWL consists of two components: work stress due to an occupation's demands and the effects of work strain due to tension of a duty's demands.³" For this study, SMWL was calculated based on a weighted average for six subscales: mental demands, physical demands, temporal demands, performance, effort and frustration.

The study defined musculoskeletal disorders as "aches, pains, and discomfort due to inflammatory and degenerative conditions affecting the muscles, tendons, ligaments, joints, and nerves in the spine and extremities.⁴" The pain was measured in nine areas of the body: neck, shoulders, elbows, wrists, hands, upper back, lower back, hips / thighs, knees and ankles / feet.

Mental Workload and Musculoskeletal Health

• Nearly 80 (78.5) percent of the bank employees experienced MSD in at least one region within the past year, with neck (48 percent), lower back (44 percent) and upper back (36 percent) the most prevalent.
• The odds of MSDs were almost 4.5 times greater for married employees over single employees. (The authors note there is an indication "that the married individuals had greater work experience.")
• "The odds of MSDs in individuals who had between 10 and 20 years of work experience were almost 3 times those who have less than 10 years of work experience."
• SMWL appears to be a risk factor in the incidence of MSDs, such that the odds of MSDs increased by 11 percent with each additional one-point increase in SMWL score.

The Next Step: Talk to Your Patients

The above information should lead to many important conversations with your patients. While you may understand the relationship between stress and MSDs, it would be a mistake to assume your patients do.

This paper strongly supports the need for regular chiropractic care. Take time during each patient's next appointment to instruct them about the impact of their job stress, work posture, work-station design, etc., on their musculoskeletal health. They need to understand how their stress at work is impacting their spinal pain and their overall health. A few minutes of conversation can lead to a lifetime of improved health.

References

1. Darvishi E, Maleki A, Giahi O, Akbarzadeh A. Subjective mental workload and its correlation with musculoskeletal disorders in bank staff. JMPT, 2016;39:420-426.
2. Marras W, Karwowski W. Fundamentals and Assessment Tools for Occupational Ergonomics, 2nd Edition. Boca Raton, FL: CRC Press, Taylor & Francis Group, 2006 [sec 37-7].
3. Rubio S, Díaz E, Martín J, et al. Evaluation of subjective mental workload: a comparison of SWAT, NASA-TLX, and workload profile methods. J Appl Psychol, 2004;53(1):61-86.
4. Punnett L, Wegman D. Work-related musculoskeletal disorders: the epidemiologic evidence and the debate. J Electromyography Kinesiol, 2004;14(1):13-23.

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