Interactive effects from self-reported physical and psychosocial factors in the workplace on neck pain and disability in female office workers

Impact of neck posture and insulating stick use on neck disability in Korean line workers: a cross-sectional study

Background

Occupational neck disability is a prevalent issue, especially among line workers, who are often exposed to elevated levels of cervical ergonomic stress. The aim of this study was to investigate the impact of neck posture and insulating stick use on neck disability in a specific occupational group in Korea.

Methods

This cross-sectional study was conducted among 483 line workers in Gwangju and Jeonnam, Korea. Data were collected using the Neck Disability Index, Cervical Degenerative Index, and a structured questionnaire focusing on demographic and occupational factors. Logistic regression analysis was applied to determine the adjusted odds ratio (OR) and 95% confidence interval (CI) for neck posture and factors related to neck disability.

Results

Neck disability prevalence was 17.2% among the participants. Multivariate logistic regression analysis showed that factors related to neck disability included age over 60 years (adjusted OR: 3.08; 95% CI: 1.63-5.83), depression (adjusted OR: 8.33; 95% CI: 3.85-18.00), a history of cervical trauma (adjusted OR: 2.13; 95% CI: 1.04-4.40), and radiological degenerative changes in the cervical spine (adjusted OR: 2.33; 95% CI: 1.26-4.33). In particular, the adjusted OR of neck disability among live-line workers was 2.10 (95% CI: 1.12-3.92) when compared with support workers (model 1). Other analysis models showed that use of insulating sticks for more than 10 hours per week (adjusted OR: 2.46; 95% CI: 1.32-4.61) and higher neck extension (adjusted OR: 2.98; 95% CI: 1.14-3.46) were significant work-related risk factors (model 2,3).

Conclusions

Neck posture, age, depression, cervical trauma history, degenerative changes in the cervical spine, and use of insulating sticks are significant risk factors for neck disability among line workers in Korea. These findings highlight the need to improve the working environment and reduce the burden of cervical ergonomic stress among line workers.

Network analyses reveal the interaction between physical features, fear of movement and neck pain and disability in people with acute and chronic whiplash-associated disorders

BACKGROUND AND OBJECTIVE

A network analysis can be used to quantitatively assess and graphically describe multiple interactions. This study applied network analyses to determine the interaction between physical and pain-related factors and fear of movement in people with whiplash-associated disorders (WAD) during periods of acute and chronic pain.

METHODS

Physical measurements, including pressure pain-thresholds (PPT) over neural structures, cervical range of motion, neck flexor and extensor endurance and the cranio-cervical flexion test (CCFT), in addition to subjective reports including the Tampa Scale of Kinesiophobia (TSK-11), Neck Disability Index (NDI) and neck pain and headache intensity, were assessed at baseline in 47 participants with acute WAD. TSK-11, NDI and pain intensity were assessed for the same participants 6 months later (n = 45). Two network analyses were conducted to estimate the associations between features at baseline and at 6 months and their centrality indices.

RESULTS

Both network analyses revealed that the greatest weight indices were found for NDI and CCFT at baseline and for neck pain and headache intensity and NDI and TSK-11 at both time points. Associations were also found betweeen cervical muscle endurance and neck pain intensity in the acute phase. Cervical muscle endurance assesssed during the acute phase was also associated with NDI after 6 months - whereas PPT measured at baseline was associsated with headache intensity after 6 months.

CONCLUSION

The strongest associations were found for headache and neck pain intensity and neck disability and fear of movement, both during acute pain and when mesured 6 months later. The extent of neck endurance and measures of PPT at baseline may be associated with neck disability and headache, respectively, 6 months after a whiplash injury.

SIGNIFICANCE

Through two network analyses, we evaluated the interaction between pain-related factors, fear of movement, neck disability and physical factors in people who had experienced a whiplash injury. We demonstrated that physical factors may be involved in the maintenance and development of chronic pain after a whiplash injury. Nevertheless, the strongest associations were found for headache and neck pain intensity and neck disability and fear of movement, both during acute and chronic phases.

Working from home in Australia during the COVID-19 pandemic: cross-sectional results from the Employees Working From Home (EWFH) study

OBJECTIVES

To investigate the impacts, on mental and physical health, of a mandatory shift to working from home during the COVID-19 pandemic.

DESIGN

Cross sectional, online survey.

SETTING

Online survey was conducted from September 2020 to November 2020 in the general population.

PARTICIPANTS

Australian residents working from home for at least 2 days a week at some time in 2020 during the COVID-19 pandemic.

MAIN OUTCOME MEASURES

Demographics, caring responsibilities, working from home arrangements, work-related technology, work-family interface, psychosocial and physical working conditions, and reported stress and musculoskeletal pain.

RESULTS

924 Australians responded to the online questionnaire. Respondents were mostly women (75.5%) based in Victoria (83.7%) and employed in the education and training and healthcare sectors. Approximately 70% of respondents worked five or more days from home, with only 60% having a dedicated workstation in an uninterrupted space. Over 70% of all respondents reported experiencing musculoskeletal pain or discomfort. Gendered differences were observed; men reported higher levels of family to work conflict (3.16±1.52 to 2.94±1.59, p=0.031), and lower levels of recognition for their work (3.75±1.03 to 3.96±1.06, p=0.004), compared with women. For women, stress (2.94±0.92 to 2.66±0.88, p<0.001) and neck/shoulder pain (4.50±2.90 to 3.51±2.84, p<0.001) were higher than men and they also reported more concerns about their job security than men (3.01±1.33 to 2.78±1.40, p=0.043).

CONCLUSIONS

Preliminary evidence from the current study suggests that working from home may impact employees' physical and mental health, and that this impact is likely to be gendered. Although further analysis is required, these data provide insights into further research opportunities needed to assist employers in optimising working from home conditions and reduce the potential negative physical and mental health impacts on their employees.

Interaction Effects of Physical and Psychosocial Working Conditions on Risk for Sickness Absence: A Prospective Study of Nurses and Care Assistants in Sweden

Employees in health and social care are often simultaneously exposed to both physical and psychosocial challenges that may increase their risk for sickness absence. The study examines interaction effects of physical and psychosocial work conditions on the future risk for sickness absence among nurses and care assistants in Sweden. The study was based on 14,372 participants in any of the Swedish Work Environment Surveys conducted during the years 1993-2013 with linked register information on background factors and compensated sickness absence. Adjusted hazard ratio (HR), stratified by occupation, and measures of additive interaction effects were estimated. The combinations of high psychosocial job demands and heavy physical work and strenuous postures, respectively, significantly increased the risks for sickness absence among nurses (HR 1.43; CI 1.09-1.88 and HR 1.42; CI 1.16-1.74, respectively), as well as among care assistants (HR 1.51; CI 1.36-1.67 and HR 1.49; CI 1.36-1.63, respectively). The combinations of low job control and both heavy physical work (HR 1.44; CI 1.30-1.60) and strenuous postures (HR 1.42; CI 1.30-1.56) were also associated with excess risk for sickness absence among care assistants. We also found interaction effects among care assistants but not among nurses. The results indicate that the high sickness absence rate among care workers in Sweden can be reduced if the simultaneous exposures of high psychosocial and high physical challenges are avoided. Management policies for reduced time pressure, improved lifting aids, and measures to avoid awkward work postures are recommended. For care assistants, increased influence over work arrangements is likely to lower their sickness absence risk.

Interaction effects of physical and psychosocial working conditions on the risk of disability pension among nursing professionals and care assistants in Sweden: A prospective study

BACKGROUND

Nursing professionals and care assistants are often subject to a combination of negative physical and psychosocial work environment factors, but most disability pension studies on such occupations have focused on one or the other of these factors. As they often coexist, there are reasons to assume that simultaneously being exposed to both types of exposures will increase the risk of disability more than being exposed to either.

OBJECTIVES

The study examined combinations of physical and psychosocial work conditions as predictors of future disability pension among nursing professionals and care assistants in Sweden.

PARTICIPANTS

The study was based on a random and representative sample of 79,004 participants in any of the Swedish Work Environment Surveys from 1993 to 2013. A total of 2576 nursing professionals, 10,175 care assistants, and 66,253 workers in other occupations were included.

METHODS

Information on background factors and disability pension was obtained from population registers. Cox proportional hazard regressions with 95% confidence intervals (CI) were performed to study if pairs of combinations of physical and psychosocial factors were related to an increased risk of disability pension. Additionally, measures of synergistic effects were estimated. The analyses were stratified on occupation group, with adjustment for selected confounders.

RESULTS

The results indicated increased hazard ratios (HR) for disability pension for most combinations of physical and psychosocial working conditions. The hazard ratios for joint exposure to high demands and heavy physical work were high among both nursing professionals (HR 1.91; CI 1.06-3.44) and care assistants (HR 2.09; CI 1.63-2.69). Also, the combination of high demands and strenuous postures resulted in significantly elevated risks of disability pension among nursing professionals (HR 1.95; CI 1.20-3.16) and care assistants (HR 2.18; CI 1.71-2.77). The HRs for joint exposure to low control and both heavy physical work and strenuous postures were significant among all other occupations (HR 2.30; CI 2.05-2.58 and HR 2.24; CI 2.01-2.51), and among care assistants (HR 1.52; CI 1.26-1.85 and HR 1.61; CI 1.34-1.93), but not significant among nursing professionals. The synergistic effects on disability pension from combined exposures were generally positive among all three occupational groups.

CONCLUSION

Nursing professionals and care assistants exposed to both negative physical and psychosocial conditions had an increased risk of disability pension. A synergistic effect with respect to disability pension was found among care assistants who reported low control and strenuous postures at work.

Workplace Factors Associated With Neck Pain Experienced by Computer Users: A Systematic Review

INTRODUCTION

The purpose of this systematic review was to examine literature on workplace factors associated with neck pain or symptoms in computer users performing clerical functions.

METHODS

A systematic search of the Cochrane, Medline, CINAHL, and EMBASE databases was conducted for observational and experimental studies published since 2000. This review applied the case definition of The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders.

RESULTS

Seven hundred twenty-nine studies were identified. Seven hundred and two studies were excluded. Twenty-seven studies fulfilled inclusion criteria and were assessed for risk of bias. Cross-sectional studies were commonly at risk from nonresponse bias and lack of adequate case definitions. Experimental studies were mostly at risk of bias due to confounding and participant recruitment methods.

CONCLUSIONS

Neck pain was not significantly associated with high job demands, low skill discretion, low decision authority, or low peer support. However, when these variables were combined with increased duration of computing tasks, or ergonomic demands, they reached significance. Supervisor support was found to be the only significant buffer capable of preventing these variables reaching significance in female office workers.

Prosthetists' and Orthotists' experience of their work and workspace - characterising the physical and organisational environment: Focus group findings

BACKGROUND

Little research has been undertaken into occupational health and safety in the Prosthetics and Orthotics profession.

OBJECTIVES

To identify physical, psychosocial and environmental workplace experiences of Prosthetists and Orthotists in organisational settings.

STUDY DESIGN

Qualitative methodology, cross-sectional design, using thematically analysed data collected from focus groups.

METHODS

Focus groups explored workplace and work experiences across varied Prosthetic and Orthotic settings. Data were thematically analysed to identify physical, psychosocial and environmental workplace experiences.

RESULTS

Three major themes, Demands of Work Practice, Impacts on the Individual and Job Design, were identified as problematic. A latent theme Perceptions of Others of P&O highlighted a lack of understanding of the Prosthetics and Orthotics job role outside the profession.

CONCLUSION

This first study of occupational health and safety in the Prosthetics and Orthotics profession identifies a number of important physical and psychosocial issues, including characteristics that have been previously identified as risk factors for work-related musculoskeletal disorders. Findings from the study indicate that some Australian organisations lack understanding of the Prosthetics and Orthotics job role, which results in inappropriate expectations of Prosthetics and Orthotics professionals. Preventing injuries and retaining experienced Prosthetists and Orthotists in the workplace is vital for the profession, and as a result, issues raised in this study require further exploration and then development of appropriate management strategies.

CLINICAL RELEVANCE

This is the first study characterising the experiences of work and risk of injuries in Prosthetists and Orthotists. Preventing injuries and retaining experienced Prosthetists and Orthotists in the workplace is vital for the international profession. Issues raised in this study require further exploration and then development of appropriate management strategies.

Cervical syndrome - the effectiveness of physical therapy interventions

Introduction:

The cervical syndrome refers to a set of disorders caused by the changes in the cervical spine and the soft-tissue surrounding it, with pain as the predominant symptom. Sore neck has been a common problem among a large section of today`s population. The factors contributing to this issue include the modern lifestyle, prolonged sitting and incorrect, fixed or constrained working postures. The root of these difficulties is found in the mechanical disorders of the cervical spine structures, poor body posture and jerky body movements. In the Scandinavian countries neck pain is considered to be a public health problem.

Methods:

The study evaluated 25 patients with an established diagnosis of cervical syndrome. The research was conducted at the PI Institute of Occupational and Sports Medicine of Zenica–Doboj Canton. Each patient received twenty physical therapy treatment sessions.

Results and conclusions:

The study included 25 patients suffering from the cervical syndrome. The statistical analysis of gender distribution indicated that 36% of the patients were male, while 64% were female. The mean age of study participants was 46.76±4,23. The patients ranged in age from 39 to 54 years, with no statistically significant difference in the mean age of male and female patients, p=0.691. Analysing the types of occupational activities performed by the patients, the study found a positive relation between neck pain and prolonged sitting at work. The patients who performed office work made up 76% of the total number. Each method of physical therapy applied in the treatment of neck pain patients proved useful. However, the combination of electrotherapy, kinesiotherapy and manual massage proved to be most effective.

Conclusion:

The cervical syndrome is a common medical condition primarily affecting adult population, with prevalence being higher among women and office workers. The condition places a considerable socioeconomic burden on the afflicted. Cervical pain ranges greatly in severity – from moderate to unbearable, thus leading to high levels of work absence as well as to a decrease in the quality of life. Proper physical therapy program can help the patients with neck pain return to their normal everyday activities, improve their quality of life, as well as reduce the absence from work.

Efficacy of a telerehabilitation intervention programme using biofeedback among computer operators

Computer operators spend long periods of time sitting in a static posture at computer workstations and therefore have an increased exposure to work-related musculoskeletal disorders (WRMSD). The present study is aimed at investigating the feasibility and effectiveness of a tele-biofeedback ergonomic intervention programme among computer operators suffering from WRMSD. Twelve subjects with WRMSD were assigned an ergonomic intervention accompanied by remote tele-biofeedback training, which was practised at their workstations. Evaluations of pain symptoms and locations, body posture and psychosocial characteristics were carried out before and after the intervention in the workplace. The hypothesis was partially verified as it showed improved body position at the workstation and decreased pain in some body parts. Tele-biofeedback, as part of an intervention, appears to be feasible and efficient for computer operators who suffer from WRMSD. This study encourages further research on tele-health within the scope of occupational therapy practice. Practitioner summary: Research concerning tele-health using biofeedback is scarce. The present study analyses the feasibility and partial effectiveness of a tele-biofeedback ergonomic intervention programme for computer operators suffering from WRMSD. The uniqueness and singularity of this study is the usage of remote communication between participants and practitioners through the Internet.

[Musculoskeletal pain and occupational vulnerability in municipal public sector workers in Belo Horizonte, Brazil]

This article seeks to describe the profile of workers in the municipal public sector in relation to the occurrence of self-reported musculoskeletal pain (MSP). In 2009, a cross-sectional study was conducted in Belo Horizonte that assessed sociodemographic characteristics, functional health status, habits and quality of life, through a self-applied questionnaire. We used the Grade of Membership method (GoM) to define the profiles and the degree of belonging to each particular profile. Three reference profiles were identified: worker with pain; worker without pain, non-respondents. Given the reference profiles, the typology of association between work and self-reported occurrence of MSP classified 89.9% of the sample. The typology was organized into five profiles: mixed (4.1%); sick worker (12.0%); worker more vulnerable to MSP (16.9%); worker less vulnerable to MSP (22.6%); healthy worker (34.3%). The analysis made it possible to clarify the connections between MSP and the physical and psychosocial factors at work in the municipal public service, indicating avenues for further reflection on the inequities in musculoskeletal health and occupational vulnerability.

Office workers' computer use patterns are associated with workplace stressors

This field study examined associations between workplace stressors and office workers' computer use patterns. We collected keyboard and mouse activities of 93 office workers (68F, 25M) for approximately two work weeks. Linear regression analyses examined the associations between self-reported effort, reward, overcommitment, and perceived stress and software-recorded computer use duration, number of short and long computer breaks, and pace of input device usage. Daily duration of computer use was, on average, 30 min longer for workers with high compared to low levels of overcommitment and perceived stress. The number of short computer breaks (30 s-5 min long) was approximately 20% lower for those with high compared to low effort and for those with low compared to high reward. These outcomes support the hypothesis that office workers' computer use patterns vary across individuals with different levels of workplace stressors.

Web-based office ergonomics intervention on work-related complaints: a field study

The aim of this study was a proof of concept to examine the effects of a Web-based office ergonomics intervention on subjects' individual workplace adjustments. An intervention study was conducted with 24 office workers lasting 6 weeks with three consecutive phases (before, 1 and 5 weeks after the intervention). Employees used a purpose-made website for adjusting their computer workplaces without any personal support of ergonomics experts. Workplace measurements were taken directly on site and by analysing photos taken of the employee. Self-reported complaints were assessed by filling in a questionnaire. It was found that 96% of the employees changed their workplaces on their own and retained them mostly unchanged after the intervention. Furthermore, self-reported musculoskeletal complaints and headache symptoms decreased significantly after the intervention. These findings suggest an improvement of workplace conditions so that cost-effective ergonomic Web-based interventions appear promising in further research and application.

Association between perceived union connection and upper body musculoskeletal pains among unionized construction apprentices

BACKGROUND

Several studies show varying associations between unionization and workers' health and well-being. This study investigated the association between individual worker's perceived union connection and musculoskeletal pains (MSPs).

METHODS

We conducted a cross-sectional survey of 1,757 unionized construction apprentices. Perceived union connection is a psychosocial scale measured by six questions that assessed individual worker's connection to their union (range 10-24) at unionized workplaces. We measured the prevalence of four MSPs (neck, shoulder, arm, and back pain) and difficulty in daily home activities, job activities, and sleeping caused by each of the four MSPs.

RESULTS

We found that a one score increase in perceived union connection was associated with 5% decreased odds of reporting neck pain (OR: 0.95, 95% CI: 0.91-1.00) and back pain (OR: 0.95, 95% CI: 0.91-0.99) after adjusting for confounders including self-reported ergonomic strain. We also found significant associations between perceived union connection and MSPs causing difficulty in daily activities. For a one score increase in perceived union connection, the odds of reporting back pain causing difficulty in home activities, job activities, and sleeping was 9% (95% CI: 0.87-0.96), 8% (95% CI: 0.88-0.96), and 7% (95% CI: 0.89-0.98) lower, respectively.

CONCLUSIONS

Although our findings are limited by the cross-sectional nature of the data, these results suggest that workers' perceived union connection can vary even within unionized workplaces, and it may be associated with the prevalence of MSPs and MSPs causing difficulty in daily activities.

Work-related upper quadrant musculoskeletal disorders in midwives, nurses and physicians: A systematic review of risk factors and functional consequences

BACKGROUND

Given a worldwide shortage of primary health care workers predicted to worsen, it is vital to address sources of attrition among these professionals. One such source may be work-related musculoskeletal disorders. We aimed to identify risk factors for and functional consequences of work-related upper quadrant musculoskeletal disorders in midwives, nurses and physicians.

METHODS

Eighteen of 87 studies identified from an electronic database search met the inclusion and quality criteria.

RESULTS

Job demands, demanding work schedules and physical exposures have the strongest associations with work-related upper quadrant musculoskeletal disorders. Functional consequences included widespread use of prescription and over-the-counter medications and major negative impact on activities of daily living. No studies of midwives were located.

CONCLUSION

High-quality studies of midwives as well as better-designed prospective studies of nurses and physicians are needed. Results of such studies could inform preventive strategies and reduce the contribution of work-related musculoskeletal disorders to attrition.

A survey study of musculoskeletal disorders among eye care physicians compared with family medicine physicians

PURPOSE

To evaluate the prevalence of musculoskeletal disorders among eye care physicians compared with family medicine physicians.

DESIGN

Case control study.

PARTICIPANTS AND CONTROLS

Ophthalmologists and optometrists at the University of Iowa and Mayo Clinic (participants) and family medicine physicians at the University of Iowa and Mayo Clinic (controls).

METHODS

An electronic survey was e-mailed to all subjects.

MAIN OUTCOME MEASURES

The prevalence of musculoskeletal symptoms between eye care providers and family medicine physicians (control group).

RESULTS

One hundred eight-six surveys were completed by 94 eye care physicians and 92 family medicine physicians with a response rate of 99% and 80%, respectively. There were no significant differences between the 2 groups with regard to mean age, gender, body mass index, years with current employer, or years in practice. Eye care providers, compared with their family medicine colleagues, reported a higher prevalence of neck (46% vs 21%; P<0.01), hand/wrist pain (17% vs 7%; P = 0.03), and lower back pain (26% vs 9%; P<0.01). A greater proportion of eye care physicians classified their job as a high-strain job (high demand, low control; 31% vs 20%) and a lower proportion classified their job as an active job (high demand, high control; 24% vs 47%; p = 0.01). Several job factors reported by eye care providers to contribute to musculoskeletal symptoms included performing the same task repeatedly, working in awkward/cramped positions, working in the same position for long periods, and bending/twisting the back (all P<0.01).

CONCLUSIONS

In this survey, the study group, composed of ophthalmologists and optometrists, had a higher prevalence of neck, hand/wrist, and lower back pain compared with family medicine physicians; repetitive tasks, prolonged or awkward/cramped positions, and bending/twisting were contributory factors. Given the ramifications of these findings, future efforts should concentrate on modifications to the eye care providers' work environment to prevent or alleviate musculoskeletal disorders and their personal and socioeconomic burden.

Psychosocial work characteristics, need for recovery and musculoskeletal problems predict psychological distress in a sample of British workers

From an original sample of 2454 participants free of self-reported psychological distress, 1463 workers completed a 15-month follow-up. Baseline measures included exposure to job demands, decision latitude, social support and need for recovery. Psychological distress was assessed using the General Health Questionnaire at baseline and at follow-up. The findings showed that medium and high exposure to job demands and social support increased the risk of reporting psychological distress at 15-months (relative risk (RR) = 1.65, 1.45). The highest adjusted RR was observed for workers reporting a high need for recovery after work (RR 2.12, 1.90) and this finding was independent of the effects of job demands, decision latitude and social support. Neither decision latitude, nor low back problems increased the risk of reporting future psychological distress, although neck problems (RR = 1.66) and hand/wrist problems (RR = 1.45) did. It was concluded that need for recovery appears to be an important indicator of individual workers who are at risk of developing psychological distress long term. STATEMENT OF RELEVANCE: This paper reports the findings of a longitudinal study showing that need for recovery from work was the strongest predictor, relative to psychosocial work characteristics (job demands, decision latitude and social support), and musculoskeletal problems, of psychological distress 15 months later in individuals initially free from distress.

Are there health effects of harassment in the workplace? A gender-sensitive study of the relationships between work and neck pain

The aim of this study was to identify workplace physical and psychosocial risk factors for neck pain among male and female workers and, in particular, to study the relationship between neck pain and intimidation and sexual harassment in the workplace in a representative sample of the Quebec working population. The study sample included 5405 men and 3987 women. In multiple logistic regression analyses, when taking into account individual and other workplace factors, neck pain was significantly associated with intimidation at work among both male (odds ratio (OR) 1.4 (1.01-1.8)) and female workers (OR 1.3 (1.01-1.8)). Among female workers, neck pain was alsosignificantly associated with unwanted sexual attention (OR 1.6 (1.1-2.4)). If confirmed in prospective studies, these results suggest that interventions to prevent harassment in the workplace may help reduce musculoskeletal disorders in the workplace and that workplace programmes to reduce harassment in the workplace should include prevention of sexual harassment.

PRACTITIONER SUMMARY

While taking into account relevant personal factors and previously identified workplace physical and psychosocial risk factors, this gender-based study identifies new work exposures associated with neck pain that have not previously been studied, including unwanted sexual attention, intimidation and difficult or tense situations with the public.

The prevalence and characteristics of back pain among school children in New Zealand

A cross-sectional survey among 245 children was conducted to establish the prevalence and characteristics of back pain in school children aged 11-14 years. A self-complete questionnaire was used to ascertain demographic details, pain prevalence, psychosocial parameters, school and leisure activities and family characteristics. In the last month, 58% of children had experienced spinal pain. In total, 31% of children reported that pain occurred in one part of the back, while 28% stated that pain presented in more than one spinal region. Pain in the last month was found to be equally prevalent in the low back (35%) and neck (36%) regions. Low back pain was associated with the most severe pain and pain lasting for the longest duration when compared with the upper back and neck regions. Further research should be directed towards investigating pain in the neck region and understanding the characteristics of symptom co-occurrence. STATEMENT OF RELEVANCE: A survey was conducted to establish the prevalence and characteristics of back pain in school children. The results provide additional evidence that back pain is a serious problem in children aged 11-14 years, whilst also indicating widespread co-occurrence of pain in the neck, upper back and lower back spinal regions.