These Lifestyle Factors Contribute to Musculoskeletal Pain

A new study analyzed various lifestyle factors in relation to their impact on musculoskeletal pain. The researchers concluded that a healthy diet and regular exercise reduced the risk of pain in the general population, while smoking may increase this risk.

“Work-related musculoskeletal pain is a major cause of work disability and sickness absence. While pain is a multifactorial phenomenon being influenced by work as well as lifestyle, less is known about the association between specific lifestyle factors and the type of musculoskeletal pain,” the study authors wrote.

Low back pain and neck-shoulder pain are common in the general population, affecting anywhere between 51% and 90% and 14% and 71%, respectively, of people at some point during their life. In this study, the researchers evaluated the following factors in relation to pain: physical activity, consumption of vegetables and fruits, alcohol intake, and smoking.

The study included 10,427 working adults in Denmark, who completed a survey in 2010 pertaining to work environment, lifestyle, and health. Researchers performed adjusted logistic regression analyses to evaluate the association between alcohol intake, physical activity, fruit and vegetable intake, and smoking (explanatory variables) with low back pain and neck-shoulder pain intensity (outcomes variables on a nine-point scale; score ≥4 is high pain).

Two questions were asked pertaining to alcohol: (1) “How much alcohol do you drink on average on weekdays (Monday to Thursday)?”, and (2) “How much alcohol do you drink on average Friday, Saturday and Sunday?” Responses were converted to units per day, and responses from both questions were combined to calculate units per week: 0-7, 8-14, 15-21, and > 21.

For physical activity, respondents were asked, “How much time did you on average spend on each of the following leisure-time activities during the last year (including commuting to and from work)?” along with three sub-questions: 1) low, 2) moderate and 3) high-intensity exercise: 1) “Walking, biking or other low-intensity exercise, where you do not get out of breath or sweaty (e.g. Sunday walks or low-intensity gardening)?” 2) “Exercise training, heavy gardening or fast walk/cycling, where you get out of breath and sweaty?” and 3) “Vigorous exercise or competitive sports?” The sub-questions had four response options: Do not perform this activity; < 2 h per week; 2–4 h per week; or > 4 h per week.

Smoking status was determined by asking, “Do you smoke?” with four response categories: (1) “Yes, daily”; (2) “Yes, sometimes”; (3) “Used to smoke but not anymore”; (4) “Have never smoked.” Upon analyses, these answers were converted to “No, never”; “Ex-smoker”; or “Yes.” For smokers, daily cigarette quantity was also assessed: 0, 1-9, 10-20, or ≥ 20.

Fruit and vegetable consumption was assessed by asking, “How often do you eat fruit, salad / raw food, cooked vegetables – apart from potatoes?”; responses included (1) “At least 3 times per day”; (2) “Twice per day”; (3) “1 time per day”; (4) “3-6 times per week”; (5) “1-2 times per week”; or (6) “Rarer” and then categorized as “≤ 2 days per week”; “3-6 days per week”; or “Daily.”

In the minimally adjusted model, smoking was correlated with a higher risk of low back pain, while physical activity during leisure and daily fruit and vegetable intake was correlated with a lower risk. Fully adjusted analyses found that only high physical activity level was correlated with a lower risk of low back pain and neck-shoulder pain.

The research was published in BMC Musculoskeletal Disorders.

“Being physically active during leisure associated with lower risk of having musculoskeletal pain, while smoking habits and healthy eating were associated with higher pain when adjusting for age and gender,” summarized the authors, adding, “Considering the relatively high prevalence of unhealthy habits in the general working population, initiatives to promote healthy habits should still be a political priority to help the workers to stay healthy and cope to their work.”