Neck and shoulder pain among elementary school students: Prevalence and its risk factors

Abstract

Background: Neck and shoulder pain is relatively common among children and teenagers and has a negative impact on their physical and psychological health. This study was carried out to assess the prevalence of neck and shoulder pain among elementary school students, and to investigate the relationship between this pain and its risk factors. Methods: In this cross-sectional study, 693 elementary school students aged 7 to 12 years from Hamadan city, located in western Iran, were selected through the multistage cluster random sampling method. Data were collected through interviews and questionnaires. For the social and psychological variables, the parent version of the Strengths and Difficulties Questionnaire (SDQ) was used. For assessing each student's posture, an observational checklist, the Rapid Upper Limbs Assessment (RULA), was used. The data was analyzed using the unadjusted (univariate) and adjusted (multivariate) logistic regression. Results: The prevalence of the neck pain was slightly higher than that of shoulder pain. The prevalence reported over a month was 35.8 and 30.9% for neck and shoulder pain, respectively. The logistic regression analyses showed that, very high desk height (odds ratio (OR) =1.96, 95% confidence interval CI: 1.02-3.74), backward seat pan inclination (OR = 2.10, 95% CI: 1.37-3.24), forward seat pan inclination (OR = 3.12, 95% CI:1.46-6.68), difficulty in viewing the board (OR = 2.54, 95% CI: 1.10-5.84), too much homework (OR = 2.59, 95% CI: 1.49-4.51), RULA score at level III (OR = 2.88, 95% CI:1.64-5.05), and RULA score at level IV (OR = 3.12, 95% CI: 1.72-5.63) increased the risk of neck pain independently. On the other hand, sitting on desk and seat (OR = 0.59, 95% CI: 0.39-0.91) and laying position for doing homework (OR = 0.53, 95% CI: 0.34-0.81) reduced the related risk. Very short desk height (OR = 2.41, 95% CI: 1.26-4.61) and too much homework (OR = 1.94, 95% CI: 1.10-3.42) increased the risk of shoulder pain. Conclusion: The elementary school students reported a high prevalence of shoulder and neck pain. This study found that improper sitting positions, as well as physical factors such as the school furniture, too much homework, and difficulty in viewing the classroom board, were associated with pain. Proper interventions considering the risk factors assessed in this study, are suggested.