Biopsychosocial factors and chronic upper limb pain

Pain in the upper limb is frequent among employees with repetitive and forceful job tasks. A recent study showed a prevalence of pain in the shoulder, elbow and hand/ wrist of 60, 40 and 52%, respectively, among 645 Danish slaughterhouse workers. 38% of the workers reported work disability due to upper limb pain. Chronic pain is a combination of complex biopsychosocial factors, such as fear avoidance. Therefore, functional capacity assessments should assess biological, psychological and social factors.

82 male slaughterhouse workers participated in the study: 49 with chronic upper limb pain and 33 pain-free controls.

In the chronic pain group, maximum muscle strength and neuromuscular activity were reduced by 28% and 24–34%, respectively. The ability to rapidly exert force was reduced by 58–78 % as compared with the pain-free controls.. 

Pressure pain threshold testing of non-painful muscles in the leg showed evidence of hyperalgesia among the chronic pain participants. This may be due to central sensitisation processes. 

The participants in the chronic pain group twere active on the labour market working fulltime, therefore they were not absent but working with reduced productivity.

Chronic upper limb pain was associated with reduced upper limb neuromuscular function, impaired work ability, work disability and general health. The biopsychosocial nature of pain must be taken into consideration when designing and implementing preventative strategies.

> From: Sundstrup et al., BMC Musculoskelet Disord 17 (2016) 104. All rights reserved to The Author(s). Click here for the Pubmed summary.