Musculoskeletal disorders (MSDs) are a significant health concern among medical students, potentially impacting their academic performance and future professional careers. Understanding the prevalence, distribution, and risk factors of MSDs in this population is crucial for developing effective prevention and rehabilitation strategies.
Objective
This study aimed to investigate the prevalence, distribution, and risk factors of MSDs among medical students, focusing on comorbidity patterns and pain localization.
Methods
A cross-sectional study was conducted among 3809 medical students in Hubei, China. The Nordic Musculoskeletal Symptom Self-Assessment Scale was used to assess MSD prevalence. Risk factors were analyzed using logistic regression, and pain patterns and comorbidity associations were examined using the Apriori algorithm.
Results
MSD prevalence was 21.2% in the past week and 21.6% in the past year, with neck and shoulders most affected. Significant risk factors included older age, prolonged screen time, physical inactivity, and obesity, while sufficient sleep reduced risk. Female students had higher prevalence (61.4% vs. 38.6% in males). Single-site pain was reported by 7.2% of participants, while 6.9% experienced two-site pain. A strong comorbidity association was observed between neck/shoulder pain and upper back pain.
Conclusions
MSDs among medical students are influenced by gender, age, screen time, sleep duration, and physical activity levels, often presenting as multi-site pain. These findings highlight the need for medical students to improve MSD awareness and implement preventive strategies to mitigate future work-related health risks.
GillTKMittintyMMMarchLM, et al.Global, regional, and national burden of other musculoskeletal disorders, 1990–2020, and projections to 2050: a systematic analysis of the global burden of disease study 2021. The Lancet Rheumatology2023; 5: e670–e682.
2.
SafiriSKolahiAACrossM, et al.Global, regional, and national burden of other musculoskeletal disorders 1990–2017: results from the global burden of disease study 2017. Rheumatology2021; 60: 855–865.
3.
JinZWangDZhangH, et al.Incidence trend of five common musculoskeletal disorders from 1990 to 2017 at the global, regional and national level: results from the global burden of disease study 2017. Ann Rheum Dis2020; 79: 1014–1022.
4.
HuiyiWUQinYYangZ, et al.Disease burden of musculoskeletal disorders in China from 1990 to 2019. zhjbkzzz2023; 27: 655–661.
5.
LiuSWangBFanS, et al.Global burden of musculoskeletal disorders and attributable factors in 204 countries and territories: a secondary analysis of the global burden of disease 2019 study. BMJ Open2022; 12: e062183.
6.
WuDWongPGuoC, et al.Pattern and trend of five major musculoskeletal disorders in China from 1990 to 2017: findings from the global burden of disease study 2017. BMC Med2021; 19: 34.
7.
WoolfADErwinJMarchL. The need to address the burden of musculoskeletal conditions. Best Practice & Research Clinical Rheumatology2012; 26: 183–224.
8.
SafiriSKolahiACrossM, et al.Prevalence, deaths, and disability-adjusted life years due to musculoskeletal disorders for 195 countries and territories 1990–2017. Arthritis & Rheumatology2021; 73: 702–714.
9.
CiezaACauseyKKamenovK, et al.Global estimates of the need for rehabilitation based on the global burden of disease study 2019: a systematic analysis for the global burden of disease study 2019. Lancet2020; 396: 2006–2017.
10.
SebbagEFeltenRSagezF, et al.The world-wide burden of musculoskeletal diseases: a systematic analysis of the world health organization burden of diseases database. Ann Rheum Dis2019; 78: 844–848.
11.
GuanS-YZhengJ-XSamNB, et al.Global burden and risk factors of musculoskeletal disorders among adolescents and young adults in 204 countries and territories, 1990–2019. Autoimmun Rev2023; 22: 103361.
12.
KhanomSMcDonaghJEBriggsM, et al.Adolescents’ experiences of fluctuating pain in musculoskeletal disorders: a qualitative systematic review and thematic synthesis. BMC Musculoskelet Disord2020; 21: 45.
13.
AyedHBYaichSTriguiM, et al.Prevalence, risk factors and outcomes of neck, shoulders and low-back pain in secondary-school children. J Res Health Sci2019; 19: e440.
14.
AlSahiemJAlghamdiSAlQahtaniR, et al.Musculoskeletal disorders among dental students: a survey from Saudi Arabia. BMC Oral Health2023; 23: 95.
15.
MasondoSSKhozaTE. Musculoskeletal disorders among undergraduate radiography students during work integrated learning in Kwazulu-Natal, South Africa. J Med Imaging Radiat Sci2023; 54: 153–161.
16.
PartoDNWongAYMacedoL. Prevalence of musculoskeletal disorders and associated risk factors in Canadian university students. BMC Musculoskelet Disord2023; 24: 01.
17.
HendiOAlturkistaniLBajaberA, et al.Prevalence of musculoskeletal disorder and its relation to stress among medical student at taif university, Saudi Arabia. Int J Prev Med2021; 12: 98.
18.
NochianMAMousaviSKhosraviH, et al.Association between internet addiction and musculoskeletal disorders in Iranian medical sciences students. BMC Musculoskelet Disord2024; 25: 62.
19.
Jacquier-BretJGorceP. Prevalence of body area work-related musculoskeletal disorders among healthcare professionals: a systematic review. IJERPH2023; 20: 41.
20.
YangSLiLWangL, et al.Effectiveness of a multidimensional intervention program in improving occupational musculoskeletal disorders among intensive care unit nurses: a cluster-controlled trial with follow-up at 3 and 6 months. BMC Nurs2021; 20: 46.
21.
ChangFYChiangCCHuangCL. Factors related to musculoskeletal disorders among hospital nurses. Hu Li Za Zhi2024; 71: 36–46.
22.
HafnerNDMilekDMFikfakMD. Hospital staff’s risk of developing musculoskeletal disorders, especially low back pain. Slovenian Journal of Public Health2018; 57: 133–139.
23.
TianJWeipingHNanZ, et al.Current status of work-related musculoskeletal pain among medical workers: a survey. Chinese Journal of Rehabilitation Medicine2024; 39: 708–711.
24.
WatsonNFBadrMSBelenkyG, et al.Recommended amount of sleep for a healthy adult: a joint consensus statement of the American academy of sleep medicine and sleep research society. SLEEP2015; 38: 843–844.
25.
LearSAHuWRangarajanS, et al.The effect of physical activity on mortality and cardiovascular disease in 130 000 people from 17 high-income, middle-income, and low-income countries: the PURE study. Lancet2017; 390: 2643–2654.
26.
KuorinkaIAnderssonG. Standardised nordic questionnaires for the analysis. Appl Ergon1987; 18: 233–237.
27.
WangJZengJGuoH, et al.Association of internet addiction disorder with musculoskeletal disorders in medical college students. Chinese Journal of School Health2010; 31: 315–316.
28.
XuXLiDSunY, et al.Analysis of chronic diseases comorbidity among the elderly in China based on association rules. Chinese Journal of Chronic Disease Prevention and Control2021; 29: 808–812.
29.
AlshehriMMAlqhtaniAMGharawiSH, et al.Prevalence of lower back pain and its associations with lifestyle behaviors among college students in Saudi Arabia. BMC Musculoskelet Disord2023; 24: 46.
30.
AlsaadiSM. Musculoskeletal pain in undergraduate students is significantly associated with psychological distress and poor sleep quality. IJERPH2022; 19: 13929.
31.
HarithasanDSinghDKAAbd RazakNAB, et al.Personal, academic stressors and environmental factors contributing to musculoskeletal pain among undergraduates due to online learning: a mixed method study with data integration. IJERPH2022; 19: 14513.
32.
SamarahOQMadenHASanwarBO, et al.Musculoskeletal pain among medical students at two Jordanian universities. BMR2023; 36: 429–436.
33.
Zhang L Gan, X E L, L C. The prevalence and influence factors of work-related musculoskeletal disorders of dental nurse. Chinese J Ind Hyg Occup Diseases2022; 40: 756–760.
34.
AlsulaihebiHSAlsulaihebiASAlsaediZK, et al.Musculoskeletal disorder prevalence and its correlation with stress in medical students: a cross sectional survey. J Family Med Prim Care2024; 13: 1524–1529.
35.
BoussaidSDaldoulCRekikS, et al.Low back pain among students of medical university of Tunis. CRR2023; 19: 205–213.
36.
LinYZhangXLiH, et al.Musculoskeletal pain is prevalent in Chinese medical and dental students: a cross-sectional study. Front Public Health2022; 10: 1046466.
37.
SrirugPJongjitKMuansriO, et al.Prevalence and factor associated work-related musculoskeletal disorders of students in virtual classroom. Heliyon2023; 9: e18461.
38.
ZhaoLWangYZhangZ. Playing-related musculoskeletal disorders among Chinese conservatoire piano students: prevalence, risk factors and preventive interventions. Front Psychol2024; 15: 1386661.
39.
Zerbo ŠporinDKozincŽPrijonT, et al.Incidence and duration of sick leave due to work-related musculoskeletal disorders in the accommodation and food services activities sector in Slovenia: a nationwide 5-year observational study. IJERPH2023; 20: 3133.
40.
MaithaKANasserMAFarhaAA, et al.Prevalence, patterns, and risk factors of work-related musculoskeletal diseases among teachers in the eastern province, Saudi Arabia: a community-based retrospective cross-sectional survey. Cureus2022; 14: e32178.
41.
TanMLHengMKerPTS, et al.Work-Related musculoskeletal disorders among podiatrists in Singapore. JAPMA2025; 115: e1–e26.
42.
BasagerA. Musculoskeletal disorders and discomfort for female surgeons or surgeons with small hand size when using hand-held surgical instruments: a systematic review. Syst Rev2024; 13: 57.
43.
KrishnanKSRajuGShawkatalyO. Prevalence of work-related musculoskeletal disorders: psychological and physical risk factors. IJERPH2021; 18: 9361.
44.
ZaheerDMunawarAAliS. Relation of sleep and musculoskeletal disorders among workers: a systematic review. J Pak Med Assoc2023; 73: 1468–1474.
45.
HaackMSimpsonNSethnaN, et al.Sleep deficiency and chronic pain: potential underlying mechanisms and clinical implications. Neuropsychopharmacol2020; 45: 205–216.
46.
HämmigO. Work- and stress-related musculoskeletal and sleep disorders among health professionals: a cross-sectional study in a hospital setting in Switzerland. BMC Musculoskelet Disord2020; 21: 19.
47.
De SouzaJMPintoRZTebarWR, et al.Association of musculoskeletal pain with poor sleep quality in public school teachers. WOR2020; 65: 599–606.
48.
PirnesKPKallioJHakonenH, et al.Physical activity, screen time and the incidence of neck and shoulder pain in school-aged children. Sci Rep2022; 12: 10635.
49.
PriftisNPanagiotakosD. Screen time and its health consequences in children and adolescents. Children2023; 10: 1665.
50.
WuFBaDSuolangL, et al.Analysis of musculoskeletal disorders among Tibetan college students in a university in Tibet. J Occup Health2020; 38: 115–117.
51.
StincelO-ROravitanMPanteaC, et al.Assessment of forward head posture and ergonomics in young IT professionals – reasons to worry?Med Lav2023; 114: e2023006.
52.
AlmutairiHAlhammadLAldossariB, et al.Prevalence and interrelationships of screen time, visual disorders, and neck pain among university students: a cross-sectional study at majmaah university. Healthcare2024; 12: 2067.
53.
AdachiGOshikawaTAkuzawaH, et al.Differences in the activity of the shoulder girdle and lower back muscles owing to postural alteration while using a smartphone. J Med Invest2020; 67: 274–279.
54.
RhimHCTenfordeAMohrL, et al.Association between physical activity and musculoskeletal pain: an analysis of international data from the ASAP survey. BMJ Open2022; 12: e059525.
55.
RorenADasteCColemanM, et al.Physical activity and low back pain: a critical narrative review. Ann Phys Rehabil Med2023; 66: 101650.
56.
ThorudH-MSMudvariPRFalkenbergHK. Academic performance and musculoskeletal pain in adolescents with uncorrected vision problems. BMC Pediatr2024; 24: 02.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
