Work characteristics predict the development of multi-site musculoskeletal pain

  • Jodi OakmanEmail author
  • Astrid de Wind
  • Swenne G. van den Heuvel
  • Allard J. van der Beek
Original Article



Musculoskeletal pain in more than one body region is common and a barrier to sustaining employment. We aimed to examine whether work characteristics predict the development of multi-site pain (MSP), and to determine differences in work-related predictors between age groups.


This study is based on 5136 employees from the Study on Transitions in Employment, Ability and Motivation (STREAM) who reported no MSP at baseline. Measures included physical, emotional, mental, and psychological job demands, social support and autonomy. Predictors of MSP were studied by logistic regression analyses. Univariate and multivariate analyses with age stratification (45–49, 50–54, 55–59, and 60–64 years) were done to explore differences between age groups.


All work characteristics with the exception of autonomy were predictive of the development of MSP, with odds ratios varying from 1.21 (95% CI 1.04–1.40) for mental job demands to 1.63 (95% CI 1.43–1.86) for physical job demands. No clear pattern of age-related differences in the predictors of MSP emerged, with the exception of social support, which was predictive of MSP developing in all age groups except for the age group 60–64 years.


Adverse physical and psychosocial work characteristics are associated with MSP. Organisations need to comprehensively assess work environments to ensure that all relevant workplace hazards, physical and psychosocial, are identified and then controlled for across all age groups.


Multi-site pain Ageing Physical hazards Psychosocial hazards Musculoskeletal disorders 


Compliance with ethical standards

Ethical statement

The Medical Ethical Committee of the VU University Medical Center Amsterdam, the Netherlands, declared that the Dutch Medical Research Involving Human Subjects Act does not apply to STREAM. The Medical Ethical Committee had no objection to the execution of this study.


No funding was received for the development of this paper.

Conflict of interest

The authors declare that they have no conflict of interest.


  1. Blekesaune M, Solem PE (2005) Working conditions and early retirement: a prospective study of retirement behavior. Res Aging 27(1):3–30. doi: 10.1177/0164027504271438 CrossRefGoogle Scholar
  2. Carnes BA, Olshansky SJ (2007) A realist view of aging, mortality, and future longevity. Popul Dev Rev 33(2):367–381CrossRefGoogle Scholar
  3. Coggon D et al (2013) Patterns of multisite pain and associations with risk factors. Pain 154(9):1769–1777. doi: 10.1016/j.pain.2013.05.039 CrossRefGoogle Scholar
  4. Croft P (2009) The question is not “have you got it”? But “how much of it have you got”? Pain 141(1–2):6–7CrossRefGoogle Scholar
  5. Dhondt S, Houtman I, Nelemans R (2000) Handleiding NOVA-WEBA: een vragenlijst om arbeidsorganisatorische knelpunten op te sporen: hernieuwde versieGoogle Scholar
  6. Eatough E, Way J, Chang C (2012) Understanding the link between psychosocial work stressors and work-related musculoskeletal complaints. Appl Ergon 43(3):554–563CrossRefGoogle Scholar
  7. Elovainio M, Forma P, Kivimaki M, Sinervo T, Sutinen R, Laine M (2005) Job demands and job control as correlates of early retirement thoughts in Finnish social and health care employees. Work Stress 19(1):84–92CrossRefGoogle Scholar
  8. de Cássia Pereira Fernandes R, da Silva Pataro SM, de Carvalho RB, Burdorf A (2016) The concurrence of musculoskeletal pain and associated work-related factors: a cross sectional study. BMC Public Health 16:628. doi: 10.1186/s12889-016-3306-4 CrossRefGoogle Scholar
  9. Gerr F, Fethke N, Anton D, Merlino L, Rosecrance J, Marcus M (2014a) A prospective study of musculoskeletal outcomes among manufacturing workers: II. Effects of psychosocial stress and work organization factors. Hum Factors. doi: 10.1177/0018720813487201 CrossRefGoogle Scholar
  10. Gerr F, Fethke N, Merlino L, Anton D, Rosecrance J, Jones M (2014b) A prospective study of musculoskeletal outcomes among manufacturing workers: I. Effects of physical risk factors. Hum Factors. doi: 10.1177/0018720813491114 CrossRefGoogle Scholar
  11. Haukka E, Leino-Arjas P, Solovieva S, Ranta R, Viikari-Juntura E, Riihimäki H (2006) Co-occurrence of musculoskeletal pain among female kitchen workers. Int Arch Occup Environ Health 80(2):141–148CrossRefGoogle Scholar
  12. Haukka E, Leino-Arjas P, Ojajarvi A, Takala EP, Viikari-Juntura E, Riihimaki H (2011) Mental stress and psychosocial factors at work in relation to multiple-site musculoskeletal pain: a longitudinal study of kitchen workers. Eur J Pain (London, England) 15(4):432–438. doi: 10.1016/j.ejpain.2010.09.005 CrossRefGoogle Scholar
  13. Haukka E, Ojajärvi A, Takala E-P, Viikari-Juntura E, Leino-Arjas P (2012) Physical workload, leisure-time physical activity, obesity and smoking as predictors of multisite musculoskeletal pain. A 2-year prospective study of kitchen workers. Occup Environ Med 69(7):485–492. doi: 10.1136/oemed-2011-100453 CrossRefGoogle Scholar
  14. Haukka E et al (2015) Multisite musculoskeletal pain predicts medically certified disability retirement among Finns. Eur J Pain 19(8):1119–1128. doi: 10.1002/ejp.635 CrossRefGoogle Scholar
  15. Herin F, Vezina M, Thaon I, Soulat J-M, Paris C (2014) Predictive risk factors for chronic regional and multisite musculoskeletal pain: a 5-year prospective study in a working population. Pain 155(5):937–943CrossRefGoogle Scholar
  16. Hildebrandt V, Bongers P, Van Dijk F, Kemper H, Dul J (2001) Dutch musculoskeletal questionnaire: description and basic qualities. Ergonomics 44(12):1038–1055CrossRefGoogle Scholar
  17. Kamaleri Y, Natvig B, Ihlebaek C, Bruusgaard D (2008) Localized or widespread musculoskeletal pain: does it matter? Pain 138(1):41–46CrossRefGoogle Scholar
  18. Kamaleri Y, Natvig B, Ihlebaek C, Benth J, Bruusgaard D (2009) Change in the number of musculoskeletal pain sites: a 14-year prospective study. Pain 141(1–2):25–30CrossRefGoogle Scholar
  19. Karasek R, Brisson C, Kawakami N, Houtman I, Bongers P, Amick B (1998) The job content questionnaire (JCQ): an instrument for internationally comparative assessments of psychosocial job characteristics. J Occup Health Psychol 3(4):322CrossRefGoogle Scholar
  20. Kenny GP, Yardley JE, Martineau L, Jay O (2008) Physical work capacity in older adults: implications for the aging worker. Am J Ind Med 51(8):610–625CrossRefGoogle Scholar
  21. Koppes L, de Vroome E, Mol M, Janssen B, van den Bossche S (2010) sNationale Enquête Arbeidsomstandigheden 2009: Methodologie en globale resultaten [The Netherlands Working Conditions Survey 2009: Methodology and overall results]. Hoofddorp, the Netherlands: TNOGoogle Scholar
  22. Kristensen TS, Hannerz H, Høgh A, Borg V (2005) The copenhagen psychosocial questionnaire-a tool for the assessment and improvement of the psychosocial work environment. Scand J Work Environ Health 31(6):438–449CrossRefGoogle Scholar
  23. Leijten FR, de Wind A, van den Heuvel SG, Ybema JF, van der Beek AJ, Robroek SJ, Burdorf A (2015) The influence of chronic health problems and work-related factors on loss of paid employment among older workers. J Epidemiol Community Health 69(11):1058–1065CrossRefGoogle Scholar
  24. Macdonald W (2006) Managing workloads to optimise performance, health and wellbeing. In: Karwowski W (ed) International encyclopedia of ergonomics and human factors. Taylor and Francis, London, pp 2170–2174Google Scholar
  25. Macdonald W, Oakman J (2015) Requirements for more effective prevention of work-related musculoskeletal disorders. BMC Musculoskelet Disord 16(1):1–9. doi: 10.1186/s12891-015-0750-8 CrossRefGoogle Scholar
  26. Miranda H, Kaila-Kangas L, Heliovaara M, Leino-Arjas P, Haukka E, Liira J, Viikari-Juntura E (2010) Musculoskeletal pain at multiple sites and its effects on work ability in a general working population. Occup Environ Med 67(7):449–455. doi: 10.1136/oem.2009.048249 CrossRefGoogle Scholar
  27. Neupane S, Miranda H, Virtanen P, Siukola A, Nygård CH (2011) Multi-site pain and work ability among an industrial population. Occup Med 61(8):563–569. doi: 10.1093/occmed/kqr130 CrossRefGoogle Scholar
  28. Neupane S, Miranda H, Virtanen P, Siukola A, Nygård CH (2013) Do physical or psychosocial factors at work predict multi-site musculoskeletal pain? A 4-year follow-up study in an industrial population. Int Arch Occup Environ Health 86(5):581–589. doi: 10.1007/s00420-012-0792-2 CrossRefGoogle Scholar
  29. Nyman T, Grooten WJA, Wiktorin C, Liwing J, Norrman L (2007) Sickness absence and concurrent low back and neck–shoulder pain: results from the MUSIC-Norrtälje study. Eur Spine J 16(5):631–638CrossRefGoogle Scholar
  30. Oakman J, Wells Y (2013) Retirement Intentions: what is the role of push factors in predicting retirement intentions? Ageing Soc 33(6):988–1008CrossRefGoogle Scholar
  31. Oakman J, Neupane S, Nygård C-H (2016) Does age matter in predicting musculoskeletal disorder risk? An analysis of workplace predictors over 4 years. Int Arch Occup Environ Health 82(9):1–10Google Scholar
  32. Sembajwe G et al (2013) Psychosocial stress and multi-site musculoskeletal pain: a cross-sectional survey of patient care workers. Workplace Health Saf 61(3):117–125. doi: 10.3928/21650799-20130226-01 CrossRefGoogle Scholar
  33. Solidaki E, Chatzi L, Bitsios P, Coggon D, Palmer KT, Kogevinas M (2013) Risk factors for new onset and persistence of multi-site musculoskeletal pain in a longitudinal study of workers in Crete. Occup Environ Med 70(1):29–34. doi: 10.1136/oemed-2012-100689 CrossRefGoogle Scholar
  34. Sommer TG, Frost P, Svendsen SW (2015) Combined musculoskeletal pain in the upper and lower body: associations with occupational mechanical and psychosocial exposures. Int Arch Occup Environ Health 88(8):1099–1110. doi: 10.1007/s00420-015-1036-z CrossRefGoogle Scholar
  35. Ybema JF, Ybema GA, Geuskens SG, van den Heuvel A, de Wind A, Leijten FR, Joling C, Blatter BM, Burdorf A, van der Beek AJ, Bongers PM (2014) Study on transitions in employment, ability and motivation (STREAM): the design of a four-year longitudinal cohort study among 15,118 persons aged 45–64 years. Br J Med Med Res 4(6):1383CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.School of Psychology and Public Health, Centre for Ergonomics and Human FactorsCollege of Science, Health and Engineering, La Trobe UniversityBundooraAustralia
  2. 2.Department of Public and Occupational HealthEMGO+ Institute for Health and Care Research, VU University Medical CenterAmsterdamThe Netherlands
  3. 3.Body@Work, Research Center on Physical Activity, Work and Health, TNO-VUmcAmsterdamThe Netherlands
  4. 4.Netherlands Organisation for Applied Scientific Research TNOLeidenThe Netherlands

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