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Ghafouri B, Rolander B, Gerdle B, Wåhlin C. Neck and shoulder pain and inflammatory biomarkers in plasma among forklift truck operators - A case-control study. Scand J Pain 2024; 24:sjpain-2023-0142. [PMID: 39215586 DOI: 10.1515/sjpain-2023-0142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 08/09/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVES The aim of this study was to investigate a panel of inflammatory biomarkers in plasma from forklift truck operators (FLTOs) and healthy controls, and their relation to neck pain characteristics. METHODS From employees in a warehouse, 26 FLTOs were recruited and 24 healthy age- and sex-matched controls (CONs) were recruited via advertisement. The inclusion criterion for FLTOs was that they should operate reach decker and/or counterbalanced tilting mast forklift trucks. All participants were asked to answer a questionnaire covering demographic data, pain intensity numeric rating scale (NRS), anatomical spread, psychological distress, and health aspects. Pain sensitivity was measured using a pressure algometer. Blood samples were collected and analyzed for inflammatory proteins in plasma using a panel of 71 cytokines and chemokines. Multivariate data analysis including orthogonal partial least square-discriminant analysis (OPLS-DA) was performed to identify significant biomarkers. RESULTS Thirty percent of FLTOs reported NRS > 3 in the neck. Shoulder pain was common in 26% of the FLTOs. Pain and discomfort that most often prevented completion of activities were in the neck (20%), lower back (32%), and hips (27%). The FLTOs reported significantly (p = 0.04) higher levels of anxiety than the CON group and they had significantly lower pressure pain thresholds in the trapezius muscle on both right (p < 0.001) and left sides (p = 0.003). A significant OPLS-DA model could discriminate FLTOs from CON based on nine inflammatory proteins where the expression levels of four proteins were upregulated and five proteins were downregulated in FLTOs compared to CONs. Twenty-nine proteins correlated multivariately with pain intensity. CONCLUSIONS The profile of self-reported health, pain intensity, sensitivity, and plasma biomarkers can discriminate FLTOs with pain from healthy subjects. A combination of both self-reported and objective biomarker measurements can be useful for better understanding the pathophysiological mechanisms underlying work-related neck and shoulder pain.
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Affiliation(s)
- Bijar Ghafouri
- Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, SE-581 85, Linköping, Sweden
| | - Bo Rolander
- Futurum, Academy for Health and Care, Jönköping County Council, Jönköping, Sweden
| | - Björn Gerdle
- Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, SE-581 85, Linköping, Sweden
| | - Charlotte Wåhlin
- Occupational and Environmental Medicine Center, and Department of Health, Medicine and Caring Sciences, Unit of Clinical Medicine, Linköping University, Linköping, Sweden
- Unit of Intervention and Implementation Research for Worker Health, Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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De Meulemeester K, Meeus M, De Pauw R, Cagnie B, Keppler H, Lenoir D. Suffering from chronic tinnitus, chronic neck pain, or both: Does it impact the presence of signs and symptoms of central sensitization? PLoS One 2023; 18:e0290116. [PMID: 37616265 PMCID: PMC10449148 DOI: 10.1371/journal.pone.0290116] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 07/24/2023] [Indexed: 08/26/2023] Open
Abstract
Chronic subjective tinnitus is a prevalent symptom, which has many similarities with chronic pain. Central sensitization is considered as a possible underlying mechanism of both symptoms. Central sensitization has already been investigated in chronic pain populations but not in patients with chronic subjective tinnitus. Therefore, the main objective of this cross-sectional study was to compare signs and symptoms, indicative for central sensitization, in tinnitus patients with and without chronic idiopathic neck pain, patients with chronic idiopathic neck pain only, and healthy controls. Also, differences in psychological and lifestyle factors, possibly influencing the association between central sensitization and tinnitus, were examined as well as correlations between signs and symptoms of central sensitization, and tinnitus, pain, psychological and lifestyle factors. Differences in signs and symptoms of central sensitization were examined using the self-report Central Sensitization Inventory and QST protocol (local and distant mechanical and heat hyperalgesia, conditioned pain modulation). Tinnitus, pain, psychological and lifestyle factors were evaluated using self-report questionnaires. Symptoms of central sensitization and local mechanical hyperalgesia were significantly more present in both tinnitus groups, compared to healthy controls, but were most extensive in the group with chronic tinnitus+chronic idiopathic neck pain. Distant mechanical hyperalgesia, indicative for central sensitization, was only observed in the group with both chronic tinnitus+chronic idiopathic neck pain. This group also displayed a significantly higher psychological burden and poorer sleep than patients with chronic tinnitus only and healthy controls. Signs and symptoms of central sensitization were also shown to be associated with tinnitus impact, pain-related disability, psychological burden and sleep disturbances. This study shows preliminary evidence for the presence of central sensitization in patients with chronic tinnitus+chronic idiopathic neck pain. This could be explained by the higher perceived tinnitus impact, psychological burden and sleep problems in this group. Trial registration: This study is registered as NCT05186259 (www.clinicaltrials.gov).
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Affiliation(s)
- Kayleigh De Meulemeester
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Pain in Motion International Research Group, The Netherlands
| | - Mira Meeus
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Pain in Motion International Research Group, The Netherlands
- MOVANT Research Group, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Robby De Pauw
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Lifestyle and Chronic Diseases, Department of Epidemiology and Public Health, Sciensano, Belgium
| | - Barbara Cagnie
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Hannah Keppler
- Audiology Research Group, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Department of Oto-Rhino-Laryngology, Ghent University Hospital, Ghent, Belgium
| | - Dorine Lenoir
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Pain in Motion International Research Group, The Netherlands
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Argus M, Pääsuke M. Musculoskeletal disorders and functional characteristics of the neck and shoulder: Comparison between office workers using a laptop or desktop computer. Work 2023; 75:1289-1299. [PMID: 36683484 DOI: 10.3233/wor-220080] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Using a laptop for work is gaining rapid popularity, but there is little evidence of how it influences musculoskeletal disorders (MSDs) and functional characteristics of the neck and shoulder area. OBJECTIVE This study aimed to compare the prevalence of upper body MSDs and functional characteristics of the neck between office workers using a laptop or desktop computer. METHODS A total of 110 office workers with a mean age of 41±10 years participated. 45 office workers (73% female) used a laptop and 65 office workers (86% female) used desktop computers. The prevalence of MSDs was recorded using the Nordic Musculoskeletal Questionnaire. Active range of motion (AROM), maximal voluntary isometric contraction (MVC) force, joint position error (JPE), and pain-pressure threshold (PPT) of the neck and shoulder area were measured. RESULTS Laptop users experienced significantly more MSDs in the right shoulder area on the day of participation (p < 0.001, OR = 4.47), during the previous 7 days (p < 0.01, OR = 3.74), and at 6 months (p < 0.01, OR = 3.57). Laptop users also experienced significantly more MSDs in the left shoulder during the previous 7 days (p < 0.05, OR = 2.44). There were no statistically significant differences in any of the functional characteristics of the neck and shoulder area between the groups. CONCLUSION Using the laptop computer for office work may pose a higher risk of developing MSDs in the right shoulder area, but might not have long-term effects on the functional characteristics of the neck and shoulder area.
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Affiliation(s)
- Martin Argus
- Institute of Sport Sciences and Physiotherapy, University of Tartu, Tartu, Estonia
| | - Mati Pääsuke
- Institute of Sport Sciences and Physiotherapy, University of Tartu, Tartu, Estonia
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Dong Y, Jiang P, Jin X, Jiang N, Huang W, Peng Y, Shen Y, He L, Forsman M, Yang L. Association between long-term static postures exposure and musculoskeletal disorders among university employees: A viewpoint of inflammatory pathways. Front Public Health 2022; 10:1055374. [PMID: 36530652 PMCID: PMC9752851 DOI: 10.3389/fpubh.2022.1055374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/16/2022] [Indexed: 12/02/2022] Open
Abstract
Background Musculoskeletal disorders (MSDs) are critical occupational and social problems. With the improvement of production mechanization and automation, and the widespread application of computers, more occupations are exposed to static postures and load. This study explored the role of inflammation in the association between static postures exposure and MSDs. Methods This study adopted a prospective nested case-control design in which 66 lower back MSDs cases and 66 healthy controls were selected from a cohort study of university employees. The personal information, postural load, musculoskeletal symptoms, pressure pain thresholds (PPTs), and inflammatory cytokines were collected. Logistic and linear regressions were used to investigate the association among postural load, inflammatory cytokines, and lower back MSDs. Mediation analysis was used to calculate the mediation effect. Results The results of logistic and linear regressions showed that postural load and inflammatory cytokines were positively associated with lower back MSDs (P < 0.05), and postural load was positively associated with inflammatory cytokines (P < 0.05). Further, mediation analysis showed that the mediation effect of postural load on the lower back MSDs through TNF-α was 0.073 (95%CI: 0.025-0.128), and the mediation effect of posture load on the lower back MSDs through IL-6 was 0.098 (95%CI: 0.041-0.179), respectively. Conclusion Static postures were associated with the occurrence of MSDs through inflammatory cytokines, and low-level inflammation may be a critical early event in the generation of MSDs. This study may help bridge the gap of potential mechanisms linking static postures to increased risks of MSDs, and provide new evidence for targeted protection against the global increasing MSDs.
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Affiliation(s)
- Yidan Dong
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing, China
| | - Ping Jiang
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing, China
| | - Xu Jin
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing, China
| | - Nanyu Jiang
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing, China
| | - Wenchu Huang
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing, China
| | - Yu Peng
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing, China
| | - Yuhong Shen
- Institute of Quartermaster Engineering & Technology, Beijing, China
| | - Lihua He
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing, China,*Correspondence: Lihua He
| | - Mikael Forsman
- Division of Ergonomics, School of Engineering Sciences in Chemistry, Biotechnology, and Health, Royal Institute of Technology, Huddinge, Sweden,Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Liyun Yang
- Division of Ergonomics, School of Engineering Sciences in Chemistry, Biotechnology, and Health, Royal Institute of Technology, Huddinge, Sweden,Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Social inequalities in multimorbidity patterns in Europe: A multilevel latent class analysis using the European Social Survey (ESS). SSM Popul Health 2022; 20:101268. [DOI: 10.1016/j.ssmph.2022.101268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/16/2022] [Accepted: 10/11/2022] [Indexed: 11/07/2022] Open
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Nunes A, Arendt-Nielsen L, Espanha M, Teles J, Moita J, Petersen KK. Bedside clinical tests to assess sensitization in office workers with chronic neck pain. Somatosens Mot Res 2021; 38:357-365. [PMID: 34635001 DOI: 10.1080/08990220.2021.1986379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This study aimed to assess pain sensitization in individual office workers with chronic neck pain through simple bedside quantitative sensory tests (QST) and to associate the findings with pain intensity and pain catastrophizing. METHODS One hundred-and-four office workers with chronic neck pain were assessed using pressure pain threshold (PPT) considering pain sensitive if PPTs were lower than 155 kPa in the upper trapezius and 245 kPa in the tibialis anterior. Pain sensitive to temporal summation of pain (TSP) was considered if there was a difference of two points in the visual analogue scale (VAS) comparing the first and last stimulus. Pain sensitive was considered to conditioned pain modulation (CPM) if the CPM-effect was less than -7.5%. Pain intensity and catastrophizing were measured using VAS and with the Pain Catastrophizing Scale. RESULTS There was at least one pain sensitive QST finding in 66 office workers (63.5%). TSP findings were the most common (48.1%), followed by PPT's (31.7%) and CPM (20.2%). Based on the QST findings, office workers were divided based on the number of individual QST findings, and higher pain intensity and pain catastrophizing scores were found in office workers with one (N = 38, P < 0.05) or two (N = 28, P < 0.05) compared with office workers with no QST findings (N = 38). CONCLUSION This study demonstrated that most office workers with chronic neck pain exhibit either widespread pressure hyperalgesia, facilitated TSP or impaired CPM, indicating pain sensitization within the central nervous system. This was associated with increased clinical pain and pain catastrophizing rumination scores.
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Affiliation(s)
- Alexandre Nunes
- Biomechanics and Functional Morphology Laboratory, CIPER, Faculdade de Motricidade Humana da Universidade de Lisboa, Cruz-Quebrada, Portugal.,Escola Superior de Saúde Jean Piaget do Algarve, Portugal
| | - Lars Arendt-Nielsen
- SMI, Faculty of Medicine, Department of Health and Technology, Aalborg University, Aalborg, Denmark.,Center for Neuroplasticity and Pain (CNAP), Department of Halth Science and Technology, School of Medicine, Aalborg University, Aalborg, Denmark
| | - Margarida Espanha
- Biomechanics and Functional Morphology Laboratory, CIPER, Faculdade de Motricidade Humana da Universidade de Lisboa, Cruz-Quebrada, Portugal
| | - Júlia Teles
- Biomechanics and Functional Morphology Laboratory, CIPER, Faculdade de Motricidade Humana da Universidade de Lisboa, Cruz-Quebrada, Portugal
| | - João Moita
- Escola Superior de Saúde Atlântica, Barcarena, Portugal
| | - Kristian Kjær Petersen
- SMI, Faculty of Medicine, Department of Health and Technology, Aalborg University, Aalborg, Denmark.,Center for Neuroplasticity and Pain (CNAP), Department of Halth Science and Technology, School of Medicine, Aalborg University, Aalborg, Denmark
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