Coping with Musculoskeletal Pain at Work and the Effects on Work Performance.

Musculoskeletal disorders (MSDs) describe a wide range of degenerative and inflammatory disorders of the musculoskeletal system. They result in pain and disability and threaten the future of many workers and the effectiveness of many organisations. The literature shows that MSDs follow a pathological process that may lead to disability and during this process workers may be present at work despite experiencing symptoms. To date, workers’ experiences of musculoskeletal pain in the work context have received little attention. The present research aimed to gain insight into the musculoskeletal pain experiences of office workers while at work. The study explored the range of coping strategies that office workers use in order to deal with musculoskeletal pain at work and the factors that have an effect on their decision making in using particular coping strategies. It also assessed the effects of musculoskeletal pain on work performance. A mixed methods approach was taken that used both a questionnaire survey and qualitative interviews. A number of sampling methods were used for the questionnaire survey including convenience sampling, and distribution to local companies. In this way the survey was administered to a group of 720 office workers. After checking for eligibility against the criteria for entry to the study, 120 useful responses were entered into the SPSS (version 13.0) for statistical analysis. Factor analysis was applied to the questionnaire coping items that led to an eight factor solution. The extracted factors, pacing, ignoring pain, self-talk, social support, stretching, distraction/relaxation, resting, and exercise explained 69.8% of the variance in coping. Most of the variance was explained by the factors, pacing (21.8%), ignoring pain (10.8%), and self-talk (9.1%); whereas resting (4.7%) and exercise (4.7%) explained the least variance in coping. Ignoring pain (99.2%), stretching (69.7%), and pacing (60.5%) were found to be the most common ways of dealing with musculoskeletal pain at work. Seeking social support (30.3%) and distraction/relaxation (24.4%) were the least frequently used strategies. 33% of the participants reported that musculoskeletal pain reduced their productivity on average, by 16%, where work pace, time spent working on tasks, and the amount of work done were the main factors affecting productivity. Quality of work done and time spent on work that had to be redone were reported as the least affected productivity areas. The survey results were used to inform the interview sampling process. A purposive sample of 18 participants was recruited based on their gender, age, musculoskeletal symptoms, and organisation. Semi-structured, individual and tape recorded interviews were performed with these participants at their convenience. Tapes were transcribed verbatim and transferred to the qualitative data analysis software NUD*IST (N6) for analysis. The pre-specified themes, coping strategies, decision making, and work performance, were used as key themes for the analysis. A conceptual framework was developed based on these themes and data collection was continued until no new information was uncovered. As a result, the interviews revealed that the office workers used a range of both cognitive and behavioural strategies in order to deal with pain while at work. These strategies were confirmed by the questionnaire survey. The use of coping strategies was affected by job characteristics, as well as personal and pain characteristics. Some of the office workers reported, during the interviews, that they kept their pain hidden due to lack of trust, fear and feelings of job insecurity. A number of them developed poor coping strategies (e.g. cutting down from rest breaks) in order to keep up with their productivity requirements. The results demonstrate the importance of creating an atmosphere of trust that will allow workers to discuss their musculoskeletal health issues, and not hide them using poor coping methods. If pain remains hidden the future outcomes may be more serious health problems or progress to disability