Risk factors for neck pain in office workers: a prospective study A workplace exercise versus health promotion intervention to prevent and reduce the economic and personal burden of non-specific neck pain in office personnel: protocol of a cluster-randomised controlled trial. Work and neck pain: A prospective study of psychological, social, and mechanical risk factors High Quantitative Job Demands and Low Coworker Support As Risk Factors for Neck Pain: Results of a Prospective Cohort Study Work Related Risk Factors for Neck, Shoulder and Arms Complaints: A Cohort Study Among Dutch Computer Office Workers The burden and determinants of neck pain in workers: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Individual, physical and psychological risk factors for neck pain in Australian office workers: a 1-year longitudinal study The influence of working conditions and individual factors on the incidence of neck and upper limb symptoms among professional computer users Participatory ergonomics to reduce exposure to psychosocial and physical risk factors for low back pain and neck pain: results of a cluster randomised controlled trial High physical and psychosocial load at work and sickness absence due to neck pain. Prevalence and occupational associations of neck pain in the British population. Tension neck and evaluation of a physical training course among office workers in a bank corporation. The impact of psychosocial factors on neck pain and disability outcomes among primary care patients: Results from the UCLA Neck Pain Study Symptoms of Neck, Shoulder, Forearms, and Hands: A Cohort Study Among Computer Office Workers in Sudan Effect of two contrasting types of physical exercise on chronic neck muscle pain. Predictors for chronic neck and low back pain in office workers: a 1-year prospective cohort study. Risk factors in the onset of neck/shoulder pain in a prospective study of workers in industrial and service companies
Background Persisting neck pain is common in society . It has been reported that the prevalence of neck pain in office workers is much higher than in the general population . The costs to the worker , employer and society associated with work-related neck pain are known to be considerable and are escalating . The factors that place office workers at greater risk of developing neck pain are not understood . The aim of this study is to investigate the incidence and risk factors of work-related neck pain in Australian office workers . Methods / design We will conduct a prospect i ve cohort study . A cohort of office workers without neck pain will be followed over a 12 month period , after baseline measurement of potential risk factors . The categories of risk factors being evaluated are physical ( cervical spine posture , range of movement , muscle endurance and exercise frequency ) , demographic ( age , sex ) , work environment ( sitting duration , frequency of breaks ) and psychosocial ( psychological distress and psychosocial work factors ) . Cox regression analysis will be used to identify risk factors associated with work-related neck pain , and will be expressed as hazard ratios with 95 % confidence intervals . The data will also enable the incidence of neck pain in this population to be estimated . Discussion In addition to clarifying the magnitude of this occupational health problem these data could inform policy in workplaces and provide the basis for primary prevention of neck pain in office workers , targeting the identified risk factors INTRODUCTION Non-specific neck pain is a major burden to industry , yet the impact of introducing a workplace ergonomics and exercise intervention on work productivity and severity of neck pain  in a population of office personnel is unknown . RESEARCH QUESTION Does a combined workplace-based best practice ergonomic and neck exercise program reduce productivity losses and risk of developing neck pain in asymptomatic workers , or decrease severity of neck pain  in symptomatic workers , compared to a best practice ergonomic and general health promotion program ? DESIGN Prospect i ve cluster r and omised controlled trial . PARTICIPANTS AND SETTING Office personnel aged over 18 years , and who work>30 hours/week .  INTERVENTION Individualised best practice ergonomic intervention plus 3 × 20 minute weekly , progressive neck/shoulder girdle exercise group sessions for 12 weeks . CONTROL Individualised best practice ergonomic intervention plus 1-hour weekly health information sessions for 12 weeks . MEASUREMENTS Primary ( productivity loss ) and secondary ( neck pain and disability , muscle performance , and quality of life ) outcome measures will be collected using vali date d scales at baseline , immediate post-intervention and 12 months after commencement . PROCEDURE 640 volunteering office personnel will be r and omly allocated to either an intervention or control arm in work group clusters . ANALYSIS Analysis will be on an ' intent-to-treat ' basis and per protocol . Multilevel , generalised linear models will be used to examine the effect of the intervention on reducing the productivity loss in dollar units ( AUD ) , and severity of neck pain and disability . DISCUSSION The findings of this study will have a direct impact on policies that underpin the prevention and management of neck pain in office personnel & NA ; To determine the impact of occupational psychological/social and mechanical factors on  neck pain , a prospect i ve cohort study with a follow‐up period of 2 years was conducted with a sample of Norwegian employees . The following design s were tested : ( i ) cross‐sectional analyses at baseline ( n = 4569 ) and follow‐up ( n = 4122 ) , ( ii ) prospect i ve analyses with baseline predictors , ( iii ) prospect i ve analyses with average exposure over time [ ( T1 + T2)/2 ] as predictor , and ( iv ) prospect i ve analyses with measures of change in exposure from T1 to T2 as predictors . A total of 2419 employees responded to both the baseline and follow‐up question naire . Data were analyzed using ordinal logistic regression . After adjustment for age , sex , neck pain at T1 , and other exposure factors that had been estimated to be confounders , the most consistent risk factors were role conflict ( highest OR 2.97 , 99 % CI : 1.29–6.74 ) and working with arms raised to or above shoulder level ( highest OR 1.37 , 99 % CI : 1.05–1.78 ) . The most consistent protective factors were empowering leadership ( lowest OR 0.53 , 99 % CI : 0.35–0.81 ) and decision control ( lowest OR 0.60 , 99 % CI : 0.36–1.00 ) . Hence , psychological and social factors are important precursors of neck pain , along with mechanical factors . Although traditional factors such as quantitative dem and s and decision control play a part in the etiology of neck pain at work , in this study several new factors emerged as more important Study Design . A 3-year prospect i ve cohort study among 1334 workers was conducted . Objective . To determine whether the work-related psychosocial factors of quantitative job dem and s , conflicting job dem and s , skill discretion , decision authority , supervisor support , coworker support , and job security are risk factors for neck pain . Summary of Background Data . Among the various risk factors for neck pain , work-related psychosocial factors play a major role . Previous studies on risk factors for neck pain often had a cross-sectional design , and did not take both physical and psychosocial factors into account . Methods . At baseline , data on work-related psychosocial factors were collected by means of a question naire . During the 3-year follow-up period , data on the occurrence of neck pain were collected by means of postal question naires . Individuals without neck pain at baseline were selected for the analyses . Cox regression analysis was applied to examine the relation between the work-related psychosocial factors and the cumulative incidence of neck pain . Adjustments were made for various physical factors and individual characteristics . Results . The analysis included 977 patients . Altogether , 141 workers ( 14.4 % ) reported that they had experienced neck pain at least once during the 3-year follow-up period . The relation of neck pain to high quantitative job dem and s ( relative risk [ RR ] , 2.14 ; 95 % confidence interval [ CI ] , 1.28–3.58 ) and low coworker support ( RR , 2.43 ; 95 % CI , 1.11–5.29 ) was statistically significant . An increased risk was found for low decision authority in relation to neck pain ( RR , 1.60 ; 95 % CI , 0.74–3.45 ) , but this relation was not statistically significant . Conclusions . High quantitative job dem and s and low coworker support are independent risk factors for neck pain . There are indications that another risk factor for neck pain is low decision authority Introduction This study aims to investigate the relationship between work-related physical and psychosocial characteristics and complaints of the neck , shoulder and forearm/h and s. Methods Data were used from a prospect i ve Dutch cohort study among computer office workers with a follow-up period of 2 years . The study was conducted among 264 computer users . Physical and psychosocial risk factors were tested to predict the occurrence of neck , shoulder and forearm/h and s complaints . Bivariate and multivariable logistic regression was used to identify the association between risk factors and outcome variables . Results The 2 year follow-up prevalence rates with 95 % CI for neck complaints were 0.31 ( 0.28–0.37 ) , for shoulder complaints 0.33 ( 0.27–0.39 ) and for forearm/h and s complaints 0.21 ( 0.14–0.28 ) . Four main predictors for the occurrence of neck and shoulder complaints were identified : ( 1 ) Irregular head and body posture [ OR : 1.1 ( 1.0–1.2 ) P = 0.04 ] ; ( 2 ) task difficulty ( job dem and s ) [ OR : 1.2 ( 1.0–1.5 ) P = 0.01 ] ; ( 3 ) number of working hours/day with the computer [ OR : 1.20 ( 1.0–1.4 ) P = 0.03 ] ; and ( 4 ) having had a previous history of complaints [ OR : 7.2 ( 3.8–13.2 ) P = 0.01 ] . Two predictors were identified for forearm/h and s complaints : time pressure ( job dem and s ) [ OR : 1.20 ( 1.0–1.4 ) P = 0.03 ] and having had a previous history of complaints [ OR : 7.1 ( 3.5–14.1 ) P = 0.06 ] . Conclusion This longitudinal study suggests that risk factors of upper musculoskeletal complaints in computer workers consist of a mixture of physical and psychosocial characteristics STUDY DESIGN Systematic review and best evidence synthesis . OBJECTIVES To describe the prevalence and incidence of  neck pain and disability in workers ; to identify risk factors for neck pain in workers ; to propose an etiological diagram ; and to make recommendations for future research . SUMMARY OF BACKGROUND DATA Previous review s of the etiology of neck pain in workers relied on cross-sectional evidence . Recently published cohorts and r and omized trials warrant a re- analysis of this body of research . METHODS We systematic ally search ed Medline for literature published from 1980 - 2006 . Retrieved articles were review ed for relevance . Relevant articles were critically appraised . Articles judged to have adequate internal validity were included in our best evidence synthesis . RESULTS One hundred and nine papers on the burden and determinants of neck pain in workers were scientifically admissible . The annual prevalence of neck pain varied from 27.1 % in Norway to 47.8 % in Québec , Canada . Each year , between 11 % and 14.1 % of workers were limited in their activities because of neck pain . Risk factors associated with neck pain in workers include age , previous musculoskeletal pain , high quantitative job dem and s , low social support at work , job insecurity , low physical capacity , poor computer workstation design and work posture , sedentary work position , repetitive work and precision work . We found preliminary evidence that gender , occupation , headaches , emotional problems , smoking , poor job satisfaction , awkward work postures , poor physical work environment , and workers ' ethnicity may be associated with neck pain . There is evidence that interventions aim ed at modifying workstations and worker posture are not effective in reducing the incidence of neck pain in workers . CONCLUSION Neck disorders are a significant source of pain and activity limitations in workers . Most neck pain results from complex relationships between individual and workplace risk factors . No prevention strategies have been shown to reduce the incidence of neck pain in workers Neck pain is more prevalent in office workers than in the general community . To date , findings from prospect i ve studies that investigated causal relationships between putative risk factors and the onset of neck pain in this population have been limited by high loss to follow-up . The aim of this research was to prospect ively evaluate a range of risk factors for neck pain in office workers , using vali date d and reliable objective measures as well as attain an estimate of 1-year incidence . We assembled a cohort of 53 office workers without neck pain and  measured individual , physical , workplace and psychological factors at  baseline . We followed participants for 1 year to measure the incidence of neck pain . We achieved 100 % participant follow-up . Cox regression analysis was applied to examine the relationship between the putative risk factors and the cumulative incidence of neck pain . The 1-year incidence proportion of  neck pain in Australian office workers was estimated in this study to be 0.49 ( 95 % CI 0.36–0.62 ) . Predictors of neck pain with moderate to large effect sizes were female gender ( HR : 3.07 ; 95 % CI : 1.18–7.99 ) and high psychological stress ( HR : 1.64 ; 95 % CI : 0.66–4.07 ) . Protective factors included increased mobility of the cervical spine ( HR : 0.44 ; 95 % CI : 0.19–1.05 ) and frequent exercise ( HR : 0.64 ; 95 % CI : 0.27–1.51 ) . These results reveal that neck pain is common in Australian office workers and that there are risk factors that are potentially modifiable Objectives To assess the influence of working conditions and individual factors on the incidence of neck and upper limb symptoms among professional computer users . Methods The study is a prospect i ve cohort study with an observation period of 10 months . A baseline question naire about symptoms in the neck , shoulder and arm/h and during previous month , individual factors , work content , physical and psychosocial work-related exposures was answered by 1,283 computer operators ( response rate 84 % ) . Incidence data were collected by ten monthly question naires regarding the occurrence of symptoms categorized into three gross body regions : neck , shoulders and arms/h and s. A case , in the specific gross body region , was defined as a subject who was classified as non-symptomatic in that region at baseline or during minimum one follow-up period and later reported symptoms ( ≥3 days ) . Univariable and multivariable incidence rate ratios with 95 % confidence intervals for first occurrence of neck , shoulder and arm/h and cases , respectively , were calculated with Cox regression analysis . Results The incidence rate was 67 , 41 and 47 cases per 100 person years for neck , shoulder and arm/h and symptoms , respectively . In the multivariable analyses , comfort of the computer work environment and gender were related to the incidence of symptoms in all body regions ( RR = 1.5–1.9 for low comfort and 1.8–2.1 for females , respectively ) . Duration of mouse use predicted arm/h and symptoms ( RR = 1.7 for ≥3 h/day ) and job strain ( high dem and s and low decision latitude ) predicted neck symptoms ( RR = 1.6 and 2.2 for medium and high strain , respectively ) . Additionally , age was related to neck and shoulder symptoms . Conclusion Preventive strategies to reduce neck and upper limb symptoms among computer users should include measures to reduce mouse use  , to increase the comfort of the work environment and to reduce job strain . Although the effect estimates were relatively weak to moderate , preventive measures may have a marked impact on the incidence of neck and upper limb symptoms in the general population because of the widespread use of computers in working life as well as at home Objectives This study investigated the effectiveness of the Stay@Work participatory ergonomics programme to reduce workers′ exposure to psychosocial and physical risk factors . Methods 37 departments ( n=3047 workers ) from four Dutch companies participated in this cluster r and omised controlled trial ; 19 ( n=1472 workers ) were r and omised to an intervention group ( participatory ergonomics ) and 18 ( n=1575 workers ) to a  control group ( no participatory ergonomics ) . During a 6 h meeting guided by an ergonomist , working groups devised ergonomic measures to reduce psychosocial and physical workload and implemented them within 3 months in their departments . Data on psychosocial and physical risk factors for low back pain and neck pain were collected at baseline and after 6 months . Psychosocial risk factors were measured using the Job Content Question naire and physical risk factors using the Dutch Musculoskeletal Question naire . Intervention effects were studied using multilevel analysis . Results Intervention group workers significantly increased on decision latitude ( 0.29 points ; 95 % CI 0.07 to 0.52 ) and decision authority ( 0.16 points ; 95 % CI 0.04 to 0.28 ) compared to control workers . However , exposure to awkward trunk working postures significantly increased in the intervention group ( OR 1.86 ; 95 % CI 1.15 to 3.01 ) compared to the control group . No significant differences between the intervention and control group were found for the remaining risk factors . After 6 months , loss to follow-up was 35 % in the intervention group and 29 % in the control group . Conclusion Participatory ergonomics was not effective in reducing exposure to psychosocial and physical risk factors for low back pain and neck pain among a large group of workers . Trial registration IS RCT N27472278 OBJECTIVES This study investigates the relationship between physical and psychosocial load at work and sickness absence due to  neck pain . METHODS A prospect i ve cohort study with a follow-up period of 3 years ( 1994 - 1998 ) was performed among a working population . At the beginning of the study , physical load at work was quantified by means of video recordings .  Work-related psychosocial variables were measured by means of the Job Content Question naire . The frequency of sickness absence due to neck pain with a minimal duration of 3 days was assessed on the basis of company registration s during the follow-up period . Altogether 758 workers were included in the analyses . Possible confounding by individual characteristics , physical load , and psychosocial load was studied . RESULTS Work-related neck flexion and neck rotation , low decision authority , and medium skill discretion showed statistically significant increased risks for sickness absence due to neck pain ( adjusted rate ratios ranging from 1.6 to 4.2 ) . High quantitative job dem and s , low skill discretion , and low job security showed nonsignificant increased risks for sickness absence due to neck pain ( adjusted rate ratios of 2.0 , 1.6 and 1.7 , respectively ) . Work-related sitting , conflicting job dem and s , supervisor support , and co-worker support did not increase sickness absence due to neck pain . CONCLUSION Work-related neck flexion , neck rotation , low decision authority , and medium skill discretion are risk factors for sickness absence due to neck pain . There are indications that high job dem and s , low skill discretion , and low job security are also risk factors for sickness absence due to neck pain OBJECTIVES This study determined the prevalence of neck pain and its relation to occupation and occupational activities in the general population . METHODS A question naire was mailed to 21 201 subjects aged 16 - 64 years , r and omly selected from the patient registers of general practice s in Engl and , Scotl and , and Wales , and to 993 subjects r and omly selected from pay records of the armed services . Information was collected on occupation , workplace physical activities , neck pain in the past week and year , headaches , and feelings of tiredness or stress . Associations were explored by logistic regression , the result ant odds ratios being converted to prevalence ratios ( PR ) . RESULTS Among 12907 respondents , 4348 and 2528 reported neck pain  in past year ( 1421 with pain interfering with normal activities ) and week , respectively . Symptoms were the most prevalent among male construction workers [ past week and year 24 % and 38 % ( pain interfering with activities 11 % ) , respectively ] , followed by nurses , armed services members , and the unemployed . Generally the age-st and ardized prevalence of neck pain varied little by occupation . Work with arms above the shoulders for > 1 hours/day was associated with a significant excess of symptoms [ PR 1.3 - 1.7 ( women ) and 1.2 - 1.4 ( men ) ] , but no associations existed for typing , lifting , vibratory tool use , or professional driving . Stronger neck-pain associations were found with frequent headaches ( PR 2.3 - 2.8 ) and frequent tiredness or stress ( PR 2.2 - 2.5 ) than with occupational activities . CONCLUSIONS The data provide evidence against a strong association between neck pain and the examined occupational physical activities . They suggest that psychosocial factors may be more important The purpose of this study was to investigate the effects of a physical training course in a group of patients ( n = 74 ) suffering from chronic tension neck . All participants in the course were employed by a bank corporation in Helsinki , Finl and . A comparable control group ( n = 77 ) consisted of office workers with tension neck from the same bank corporation who did not attend any training course . The outcome was analysed 6 months after the course . Pain and disability in the neck and shoulder region did not vary significantly between the group which participated in the training course and the control group . The experimental group had increased the amount of physical workout  compared to the control group ( 83.7 % vs 69.0 % , P = 0.0448 ) . Also , regarding the frequency of relaxation and stretching exercises the two groups differed significantly : the experimental group had continued to perform exercises more often ( P = 0.0434 ) . The frequency of sick leave days did not significantly differ between the groups , but the office workers in the experimental group had more periods of extended sick leave ( > 10 days ) and the controls had more frequent short sick leaves . The experimental group did increase their physical workout significantly compared with the controls , but no differences were detected regarding pain and disability . In order to gain more benefit more attention should be paid to the educational part of the training courses in order to enhance the patients ' self-care abilities . Also , strategies to alleviate psychosocial problems and organized relaxation exercises could decrease muscle tension in the neck in office workers Purpose . The purpose of this study is to estimate the associations of psychosocial factors with pain and disability outcomes among neck-pain patients enrolled in a r and omized clinical trial of chiropractic treatments .  Methods . Neck-pain patients were r and omized to one of 8 modes of chiropractic treatment .  Health status and psychosocial variables were measured at baseline . Changes in neck pain severity and disability from baseline to 6 months were the primary outcome variables . Multivariable regression models were used to estimate effects of psychosocial variables adjusted for potential confounders . Results . Of 960 eligible patients , 336 were enrolled and 80 % were followed up through 6 months . Coping strategies involving self-assurance result ed in better disability outcomes , whereas getting angry or frustrated result ed in worse pain and disability outcomes . Participants with high levels of social support from individuals were more likely to experience clinical ly meaningful reductions in pain and disability . No consistent relations of internal health locus of control , and physical and psychological job dem and s with improvements in pain and disability were detected . Conclusions . We found some evidence that certain coping strategies and types of social support are associated with pain and disability outcomes in this population of largely subacute and chronic neck-pain patients Objectives Complaints of the arms , neck , and shoulders in general and computer-related disorders in particular affect many office workers in economically developed countries . However , with the increased use of computer systems in developing countries , the associated musculoskeletal symptoms and risk factors are yet to be investigated . The study investigates the relationship between work-related physical and psychosocial characteristics and symptoms of the arms , neck , and shoulders in an African economically developed worksite . Methods A prospect i ve cohort study with 1-year follow-up was conducted . Data were used from 250 computer office workers in Khartoum , Sudan . Data were collected using the Arabic version of the Maastricht Upper Extremity Question naire . Prevalence rates for symptoms were calculated and the categories of risk factors being evaluated consisted of physical , psychological , and individual risk factors . Multivariable logistic regression analysis was used to identify risk factors associated with complaints that were expressed as odds ratios ( ORs ) with 95 % confidence intervals ( CIs ) . Results The 1-year follow-up prevalence rate was 0.63 ( 95 % CI : 0.58 - 0.70 ) for neck symptoms , 0.56 ( 95 % CI : 0.45 - 0.66 ) for shoulder symptoms , and 0.46 ( 95 % CI : 0.42 - 0.59 ) for symptoms of the forearms/h and s. Three main risk factors were significantly associated with the presence of symptoms : ( 1 ) time pressure [ OR : 1.31 ( 1.00 to 1.90 ) P=0.05 ] , ( 2 ) task difficulty [ OR : 1.85 ( 1.73 to 1.99 ) P=0.03 ] , and ( 3 ) previous history of symptoms [ OR : 4.62 ( 2.20 to 9.35 ) P=0.01 ] . Conclusions The targeted office workers in Sudan are reporting symptoms in the neck , shoulders , and forearms . Work-related psychological factors predicted more significantly the presence of symptoms in the targeted population OBJECTIVE The prevalence of neck muscle pain has steadily increased and especially pain from the descending part of the trapezius muscle has been associated with monotonous work tasks such as computer work . Physical exercise is generally recommended as treatment , but it is unclear which type of training is most effective . Our objective was to determine the effectiveness of specific strength training of the painful muscle versus general fitness training without direct involvement of the painful muscle ( leg bicycling ) on work-related neck muscle pain . METHODS We conducted a r and omized controlled trial and recruited subjects from 7 workplaces characterized by monotonous jobs ( e.g. , computer-intensive work ) . Forty-eight employed women with chronic neck muscle pain ( defined as a clinical diagnosis of trapezius myalgia ) were r and omly assigned to 10 weeks of specific strength training locally for the affected muscle , general fitness training performed as leg bicycling with relaxed shoulders , or a reference intervention without physical activity . The main outcome measure was an acute and prolonged change in intensity of neck muscle pain ( 100-mm visual analog scale [ VAS ] ) . RESULTS A decrease of 35 mm ( approximately 79 % ; P<0.001 ) in the worst VAS pain score over a 10-week period was seen with specific strength training , whereas an acute and transient decrease in pain ( 5 mm ; P<0.05 ) was found with general fitness training . CONCLUSION Specific strength training had high clinical relevance and led to marked prolonged relief in neck muscle pain .  General fitness training showed only a small yet statistically significant acute pain reduction OBJECTIVE All occupations expose workers to varied and unique conditions . The nature of work has been recognized as influencing the health of workers . Whether predictors for chronic neck and low back pain would be occupation-specific is unknown . This study aim ed to identify predictors for chronic neck and low back pain in a cohort of office workers . METHODS A prospect i ve study was carried out among 669 healthy office workers . At baseline , risk factors were assessed using a question naire and st and ardized physical examination . A symptomatic case was defined as an individual who reported pain greater than 30 mm on a 100-mm VAS , and chronic pain was defined as experiencing ongoing neck or low back pain for greater than 3 months over the past 6 months . Two regression models were built to analyze the risk factors for developing chronic neck and low back pain . RESULTS Of the sample , 17 and 27 % of office workers who reported a new onset of neck or low back pain developed chronicity , respectively . Predictors for chronic neck pain were high body mass index , frequent neck extension during the work day , high initial pain intensity , and high psychological job dem and s. The development of chronic low back pain was associated with history of low back pain and high initial pain intensity . CONCLUSIONS The findings suggest that predictors for chronic musculoskeletal pain in a sub population may be a subset of predictors identified in a general population or occupation specific . Successful management to prevent chronic musculoskeletal pain may also need to consider the patient 's occupation Aims : To quantify the relative contribution of work related physical factors , psychosocial workplace factors , and individual factors and aspects of somatisation to the onset of neck/shoulder pain .  Methods : Four year prospect i ve cohort study of workers from industrial and service companies in Denmark . Participants were 3123 workers , previously enrolled in a cross sectional study , where objective measurement of physical workplace factors was used . Eligible participants were followed on three subsequent occasions with approximately one year intervals . Outcomes of interest were : new onset of neck/shoulder pain ( symptom cases ) ; and neck/shoulder pain with pressure tenderness in the muscles of the neck/shoulder region ( clinical cases ) . Results : During follow up , 636 ( 14.1 % ) participants reported neck/shoulder pain of new onset ; among these , 82 ( 1.7 % ) also had clinical signs of substantial muscle tenderness . High shoulder repetition was related to being a future symptom case , and a future clinical case . Repetition was strongly intercorrelated with other physical measures . High job dem and s were associated with future status as a symptom case , and as a clinical case . A high level of distress predicted subsequent neck/shoulder pain , and neck/shoulder pain with pressure tenderness . Conclusions : High levels of distress , and physical and psychosocial workplace factors are predictors of onset of pain in the neck and /or shoulders , particularly pain with pressure tenderness in the muscles
Conclusions : Neck pain was not significantly associated with high job dem and s , low skill discretion , low decision authority , or low peer support .
However , when these variables were combined with increased duration of computing tasks , or ergonomic dem and s , they reached significance .
Supervisor support was found to be the only significant buffer capable of preventing these variables reaching significance in female office workers
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 .