Psychosocial work stress, leisure time physical exercise and the risk of chronic pain in the neck/shoulders: Longitudinal data from the Norwegian HUNT Study

Objectives: To prospectively investigate if the risk of chronic neck/shoulder pain is associated with work stress and job control, and to assess if physical exercise modifies these associations. Material and Methods: The study population comprised 29 496 vocationally active women and men in the Norwegian Nord-Trøndelag Health Study (HUNT Study) without chronic pain at baseline in 1984–1986. Chronic neck/shoulder pain was assessed during a follow-up in 1995–1997. A generalized linear model (Poisson regression) was used to calculate adjusted relative risks (RRs). Results: Work stress was dosedependently associated with the risk of neck/shoulder pain (ptrend < 0.001 in both sexes). The women and men who perceived their work as stressful “almost all the time” had multi-adjusted RRs = 1.27 (95% confidence interval (CI): 1.1–1.47) and 1.71 (95% CI: 1.46–2), respectively, referencing those with no stressful work. Work stress interacted with sex (p < 0.001). Poor job control was not associated with the risk of neck/shoulder pain among the women (RR = 1.04, 95% CI: 0.92–1.19) nor the men (RR = 1.09, 95% CI: 0.95–1.26). Combined analyses showed an inverse dose-dependent association between hours of physical exercise/week and the risk of neck/shoulder pain in the men with no stressful work (ptrend = 0.05) and among the men who perceived their work as “rarely stressful” (ptrend < 0.02). This effect was not statistically significant among the women or among men with more frequent exposure to work stress. Conclusions: Work stress is an independent predictor of chronic neck/shoulder pain and the effect is stronger in men than in women. Physical exercise does not substantially reduce the risk among the persons with frequent exposure to work stress

Association between work stress, physical exercise, and chronic shoulder/neck pain: the HUNT Study

Background: It is well documented that high work stress and low job control is associated with increased risk of shoulder/neck pain while regular physical exercise reduces this risk. However, there is limited knowledge about the combined effect of work stress and physical exercise on risk of chronic pain in shoulders/neck. The first objective of this study was to investigate the role of work stress and physical exercise as individual risk factors for chronic shoulder/neck pain in a large unselected population of women and men. A second objective was to investigate the combined effect of work stress and physical exercise on risk of chronic shoulder/neck pain. Methods: The Nord-Trøndelag health study (the HUNT Study) was conducted in 1984-1986 (HUNT 1), with follow-up in 1995-1997 (HUNT 2). All women and men who participated in both surveys were included in the present study. After exclusions, the study population consisted of 12,530 women and 16,896 men for the analysis of work stress and job control on risk of chronic shoulder/neck pain, and 8,057 women and 11,028 men for the analysis including physical exercise. Relative risk (RR) of chronic shoulder/neck pain in HUNT 2 associated with work stress, job control, and physical exercise at baseline (HUNT 1) was estimated by a general lineal model. Results: At follow-up, 4,357 (34,7%) women and 4,470 (26.5%) men reported chronic shoulder/neck pain. Work stress showed a strong dose-response association with risk of chronic shoulder/neck pain (P-trend <.001) for both women and men. Women and men who reported to be exposed to work stress almost all the time had RRs of 1.32 (95% confidence interval [95% CI] 1.11-1.58) and 1.68 (95% CI 1.41-2.00), respectively. The effect of job control on chronic shoulder/neck pain was weak, both among women and men. The different measures of physical exercise (i.e., frequency, duration, and intensity) all showed a moderate inverse dose-response effect on risk of chronic shoulder/neck pain in both women and men (10-20% reduced risk among the most active). The combined analysis showed that individuals who reported high stress levels and who exercised ≥2 sessions per week had a RR of 1.35 (95% CI 1.06-1.72) compared to a RR of 1.64 (95% CI 1.26-2.12) among inactive individuals with similar stress level. Conclusion: This prospective study indicates that women and men who perceive their work situation as stressful have an increased risk of chronic shoulder/neck pain. There was a moderate inverse relation between physical exercise and risk of chronic shoulder/neck pain for both women and men. Regular physical exercise can, to some extent, compensate for the adverse effect of work stress on risk of chronic shoulder/neck pain

Psychosocial work stress, leisure time physical exercise and the risk of chronic pain in the neck/shoulders: Longitudinal data from the Norwegian HUNT Study

Objectives: To prospectively investigate if the risk of chronic neck/shoulder pain is associated with work stress and job control, and to assess if physical exercise modifies these associations. Material and Methods: The study population comprised 29 496 vocationally active women and men in the Norwegian Nord-Trøndelag Health Study (HUNT Study) without chronic pain at baseline in 1984–1986. Chronic neck/shoulder pain was assessed during a follow-up in 1995–1997. A generalized linear model (Poisson regression) was used to calculate adjusted relative risks (RRs). Results: Work stress was dosedependently associated with the risk of neck/shoulder pain (ptrend < 0.001 in both sexes). The women and men who perceived their work as stressful “almost all the time” had multi-adjusted RRs = 1.27 (95% confidence interval (CI): 1.1–1.47) and 1.71 (95% CI: 1.46–2), respectively, referencing those with no stressful work. Work stress interacted with sex (p < 0.001). Poor job control was not associated with the risk of neck/shoulder pain among the women (RR = 1.04, 95% CI: 0.92–1.19) nor the men (RR = 1.09, 95% CI: 0.95–1.26). Combined analyses showed an inverse dose-dependent association between hours of physical exercise/week and the risk of neck/shoulder pain in the men with no stressful work (ptrend = 0.05) and among the men who perceived their work as “rarely stressful” (ptrend < 0.02). This effect was not statistically significant among the women or among men with more frequent exposure to work stress. Conclusions: Work stress is an independent predictor of chronic neck/shoulder pain and the effect is stronger in men than in women. Physical exercise does not substantially reduce the risk among the persons with frequent exposure to work stress