Craniocervical Pain, Sleep Quality, Depressive Symptoms, and Physical Activity in Healthcare Workers During COVID-19 Pandemic.

BACKGROUND: An increase in the workload and use of personal protective equipment by healthcare workers was observed during the COVID-19 pandemic. Due to the connections between craniocervical structures, symptoms such as neck pain and temporomandibular symptoms could be influenced by the use of PPE. AIMS: To assess the prevalence of craniocervical pain, sleep quality, physical activity, and depressive symptoms and relationship among craniocervical symptoms in healthcare workers before and during the COVID-19 pandemic in Brazil. DESIGN: Cross-sectional study. PARTICIPANTS: Healthcare workers. SETTINGS: An online questionnaire included a self-report of craniocervical pain intensity [orofacial pain, neck pain, and headache (Numerical Rating Scale)], sleep quality (Pittsburgh Sleep Quality Index), depressive symptoms (Patient Health Questionnaire two items) and physical activity (self-report). METHODS: The sample analysis was performed by descriptive statistics, the paired t-test was used to compare symptoms intensity before and during the pandemic. The relationship between dependent and independent samples was assessed through McNemar test, Pearson's chi-squared test, and Student's independent t-test. A value of p < .05 was adopted as statistical significance. RESULTS: Overall, 147 participants replied the questionnaires. Headache, neck pain, and orofacial pain complaints increased during the pandemic in healthcare workers (p < 0.001). Craniocervical pain was correlated with poor sleep quality, probable depression, and physical activity during the pandemic (p < 0.05). CONCLUSION: Healthcare workers self-reported more craniocervical pain during the COVID-19 pandemic compared to before the pandemic. In addition, poor sleep quality, depressive symptoms, and physical inactivity were associated with craniocervical symptoms during this period.

Pain, smartphone overuse and stress in physiotherapy university students: An observational cross-sectional study.

BACKGROUND: There is a high prevalence of musculoskeletal pain and stress levels in university students in the health area. The current study aimed to evaluate the prevalence of pain in the cervical region, lumbar spine, and upper and lower limbs in university students in the final year of physiotherapy; and to determine the correlation between smartphone overuse, stress level, and musculoskeletal pain. METHODS: This is observational cross-sectional study. Students completed an online questionnaire containing sociodemographic information, the Neck Disability Index (NDI), Nordic Musculoskeletal Questionnaire (NMQ), Smartphone Addiction Scale Short-version (SAS-SV), Job Stress Scale, and Oswestry Disability Questionnaire (ODI). The Biserial-point correlation test and Spearman correlationvtest was performed. RESULTS: In total, 42 university students participated in the study. The results indicate a high prevalence of students with cervical pain (83.3%), lumbar pain (76.2%), shoulder (57.1%) and wrist (52.4%). Correlations were found in the comparison of the SAS-SV versus NDI (p < 0.001, R = 0.517) and neck pain (p = 0.020, R = 0.378). The stress scale versus pain in the upper back (p = 0.008, R = 0.348), elbow (p = 0.047, R = 0.347), wrist (p = 0.021, R = 0.406), and knee (p = 0.028, R = 0.323), pain in the wrist versus high scores in the SAS-SV (p = 0.021, R = 0.367), and also hours spent using the smartphone versus pain in the hip (total time: p = 0.003, R = 446; work: p = 0.041, R = 0.345; recreation: p = 0.045, R = 0.308). CONCLUSION: There is a high prevalence of pain in the cervical and lumbar regions in university students in the final year of Physiotherapy. A correlation was found between neck disability, neck and upper back pain and overuse of the smartphone and stress.

Reliability of quantitative sensory testing on myofascial trigger points in the upper trapezius muscle of individuals with chronic neck pain.

OBJECTIVE: The objective of this study was to measure the intra- and inter-rater reliability of the quantitative sensory testing for measuring the thermal pain threshold on myofascial trigger points in the upper trapezius muscle of individuals with chronic neck pain. METHODS: Thirty female participants were included, aged between 18 and 45 years and with bilateral myofascial trigger points, active and centrally located in the upper trapezius muscle. Two measurements with quantitative sensory testing were performed by each examiner at an interval of 1 week between them. RESULTS: We observed substantial reliability for the intra-rater analysis (intraclass correlation coefficient ranging between 0.876 and 0.896) and excellent reliability for the inter-rater analysis (intraclass correlation coefficient ranging between 0.917 and 0.954). CONCLUSION: The measurement of the thermal pain threshold on myofascial trigger points in individuals with chronic neck pain has acceptable reliability values, supporting the use of the quantitative sensory testing in the research setting and the clinical environment.

Reliability of quantitative sensory testing on myofascial trigger points in the upper trapezius muscle of individuals with chronic neck pain

SUMMARY OBJECTIVE: The objective of this study was to measure the intra- and inter-rater reliability of the quantitative sensory testing for measuring the thermal pain threshold on myofascial trigger points in the upper trapezius muscle of individuals with chronic neck pain. METHODS: Thirty female participants were included, aged between 18 and 45 years and with bilateral myofascial trigger points, active and centrally located in the upper trapezius muscle. Two measurements with quantitative sensory testing were performed by each examiner at an interval of 1 week between them. RESULTS: We observed substantial reliability for the intra-rater analysis (intraclass correlation coefficient ranging between 0.876 and 0.896) and excellent reliability for the inter-rater analysis (intraclass correlation coefficient ranging between 0.917 and 0.954). CONCLUSION: The measurement of the thermal pain threshold on myofascial trigger points in individuals with chronic neck pain has acceptable reliability values, supporting the use of the quantitative sensory testing in the research setting and the clinical environment.

Painful and non-painful comorbidities associated with short- and long-term painful temporomandibular disorders: A cross-sectional study among adolescents from Brazil, Canada and France.

BACKGROUND: Temporomandibular disorder (TMD) pain is common among adolescents. The association between painful TMD and other comorbidities has been demonstrated. However, the difference between short-term (<6 months) and long-term (≥ 6 months) painful TMD is not yet clear. OBJECTIVE: The aim of this study was to assess the association between comorbidities and short- and long-term painful TMD among adolescents. METHODS: In this cross-sectional study, adolescents were recruited from Montreal (Canada), Nice (France) and Arceburgo (Brazil). Self-reported painful TMD, comorbidities, school absence and analgesic intake were assessed using reliable instruments. Multivariable logistic regression analyses were conducted to assess the study aims. RESULTS: The prevalence of short- and long-term painful TMD was estimated at 22.29% and 9.93% respectively. The number of comorbidities was associated with short- (OR = 1.71, 95%CI = 1.53-1.90) and long-term painful TMD (OR = 1.79, 95%CI = 1.55-2.08) compared to controls. Frequent headaches (ORshort-term  = 4.39, 95%CI = 3.23-5.98, ORlong-term  = 3.69, 95%CI = 2.45-5.57) and back pain (ORshort-term  = 1.46, 95%CI = 1.06-2.03, ORlong-term  = 1.69, 95%CI = 1.11-2.59) were associated with both painful TMD groups. Frequent neck pain (OR = 2.23, 95%CI = 1.53-3.26) and allergies were only associated with short-term painful TMD (OR = 1.54, 95%CI = 1.13-2.10). Frequent stomach pain was related to long-term (OR = 2.01, 95%CI = 1.35-3.26), and it was the only comorbidity significantly more frequent among the long than short-term TMD (OR = 1.82, 95%CI: 1.14-2.90). These analyses were adjusted by sex, age and city. CONCLUSION: In this multi-centre study, both short- and long-term painful TMD are associated with frequent headaches and back pain, whereas frequent neck pain and allergies are related to only short-term and frequent stomach pain with long-term painful TMD.

[Pain and cervical disability among public workers who use data visualization display terminals]. / Dolor y discapacidad cervical de los trabajadores públicos usuarios de pantallas de visualización de datos.

Work-related neck/shoulder disorders are considered an important health issue. This study is aimed at establishing the pain and cervical disability patterns of workers with visual display terminals, as well as at determining the factors that mostly affect the onset of a new episode of back pain. A descriptive, correlational study was carried out on a sample of 88 workers who use visual display terminals, of the Ministry of Health (Xunta de Galicia). The workers completed the following questionnaires: "Neck Disability Index Scale," "Visual Analog Scale," "12-item Short Form Health Survey," and an individual postural analysis was conducted. For the comparative analysis, the Student's t-test, and the Mann-Whitney U test were performed. A binary logistic regression analysis was used to extract a predictive model of a cervical pain episode, and 58% reported cervical pain. There were no differences between men and women. The variables that best predict the onset of a new episode of pain are the level of disability, and the quality of physical life. Study results indicate that a worker who uses visual display terminals, with high levels of cervical disability and low values of physical quality of life, is more likely to suffer an episode of back pain.

Los trastornos del cuello-hombro relacionados con el trabajo son un importante problema de salud. El objetivo de este estudio es establecer el patrón de dolor y discapacidad cervical de trabajadores con pantallas de visualización de datos, así como determinar los factores que predominan en la aparición de un nuevo episodio de dolor de espalda. Se realizó un estudio descriptivo-correlacional, en una muestra de 88 trabajadores usuarios de ordenadores de la Consellería de Sanidade (Xunta de Galicia). Los trabajadores respondieron los cuestionarios: "Neck Disability Index", "Escala analógica visual", "12-item Short Form Health Survey" y se realizó un análisis postural. Para el análisis comparativo se realizaron las pruebas T Student y U de Mann-Whitney. Un análisis de regresión logística binaria se utilizó para la extracción de un modelo predictivo de episodio de dolor cervical. El 58% refirieron dolor cervical. No existieron diferencias significativas entre hombres y mujeres. Las variables que mejor predicen la aparición de un nuevo episodio de dolor son el nivel de discapacidad y la calidad de vida física. Los resultados indican que un trabajador con altos niveles de discapacidad cervical y bajos valores de calidad de vida física, tiene mayor probabilidad de sufrir un episodio de dolor.

The burden of neck pain in Brazil: estimates from the global burden of disease study 2019.

BACKGROUND: This study analyzed neck pain estimates in Brazil and its states between 2000 and 2019, in view of the country's lacking epidemiological data. METHODS: An analysis was performed of the GBD 2019 estimates by location, sex, and age, per 100,000 population, with uncertainty intervals (95% UI). Brazilian estimates were compared to global, Mexican, English, and American rates. RESULTS: Global, Brazilian, and Mexican prevalence numbers were statistically homogeneous and stable in the period. Throughout the period analyzed in the study, Brazilian neck pain prevalence (2241.9; 95%UI 1770.5-2870.6) did not show statistical differences when compared to global (2696.5; 95%UI 2177.0-3375.2) or Mexican (1595.9; 95%UI 1258.9-2058.8) estimates. Estimates observed in the USA (5123.29; 95%UI 4268.35-6170.35) and England (4612.5; 95%UI 3668.8-5830.3) were significantly higher. In 2019, when compared to the USA and England, age-standardized prevalences were lower globally, in Brazil, and in Mexico. Prevalences in Brazilian states were similar, being that Roraima (1915.9; 95%UI 1506.5-2443.1) and the Federal District (1932.05; 95%UI 1515.1-2462.7) presented the lowest and highest values respectively. The exception was the state of São Paulo (3326.5; 95%UI 2609.6-4275.5). There was no statistical difference by sex, but the prevalence tended to increase with aging. In 2019, the Brazilian prevalence was 2478.6 (95% UI 1791.0-3503.8), 5017.2 (95%UI 3257.26-7483.8), and 4293.4 (95% UI 2898,8-6343.9), for those aged 15 to 49, 50 to 69, and 70+ years. There was no statistical difference among the YLDs in all locations and times. CONCLUSIONS: Brazil is going through a fast-paced process of populational aging; a higher prevalence of neck pain in middle-aged individuals and the elderly highlights the need for lifelong prevention initiatives. The higher rates observed among higher-income populations and the homogeneity of the Brazilian estimates suggest a lack of robust epidemiological data in lower-income countries.

Relationship between Neuromuscular Mechanosensitivity and Chronic Neck Pain in Guitarists: A Cross-Sectional Study.

Musicians frequently complain of musculoskeletal pain due to high mechanical demands, with the cervical spine being the most affected. Increased neuromuscular mechanosensitivity due to repetitive mechanical stress over time has been described in neck pain patients. Nevertheless, the association between musculoskeletal pain and neuromuscular mechanosensitivity in musicians is unknown. Therefore, the aim of this study was to analyze the relationship between neuromuscular tissue mechanosensitivity and neck pain in guitarists. Guitarists with chronic neck pain (n = 70) and without pain (n = 70) were enrolled. Pain and disability were measured by the visual analogue scale and the Neck Disability Index, respectively. The pressure pain threshold (PPT) was bilaterally measured for the upper trapezius and median nerve. Finally, the Upper limb neural test one (ULNT1) was bilaterally measured. The analyses included a 2-by-2 mixed analysis of variance, pairwise comparisons with Bonferroni correction, linear regression model, and multiple linear regression. Our data showed that chronic neck pain guitarists have a lower PPT at all locations compared to healthy guitarists. They also showed a bilateral main effect for pain for ULNT1 compared to healthy guitarists. These results were not affected by the mediator variables. Finally, a relationship between upper trapezius PPT and median nerve PPT was found.

Neck pain and associated factors in a sample of high school students in the city of Bauru, São Paulo, Brazil: cross-sectional study.

BACKGROUND: Neck pain is a major public health problem. OBJECTIVE: The aim of the present study was to determine the prevalence of neck pain among high school students and to analyze associations with sociodemographic variables, use of electronic devices, habitual physical activity practices and mental health problems. DESIGN AND SETTING: Cross-sectional epidemiological study on a sample of high school students in the city of Bauru, São Paulo, Brazil. METHOD: Participants were selected through cluster sampling in two stages and data were collected via face-to-face interviews. Data collection comprised the following steps: 1. sociodemographic characteristics; 2. use of electronic devices; 3. habitual physical activity levels; 3. mental health; and 4. neck pain. RESULTS: A total of 1,628 participants were interviewed. The prevalence of neck pain was 49.1% (95% confidence interval, CI 46.7 to 51.5), with 40.4% (95% CI 37.0 to 43.7) in men and 57.5% (95% CI 54.2 to 60.9) in women. The variables associated with in neck pain were: female (prevalence ratio, PR = 2.04), use of cell phone in standing posture (PR = 1.47), use of tablet in sitting posture (PR = 1.72), length of computer use greater than 3 hours/day (PR = 1.54), length of cell phone use greater than 3 hours/day (PR = 1.54), length of tablet use greater than 3 hours/ day (PR = 1.34) and mental health problems (PR = 1.56). CONCLUSION: There is high prevalence of neck pain among students and striking associations with female sex, use of electronic devices and mental health problems.

Are There Gender Differences in Neck Pain and Musculoskeletal Disorders of the Cervical Spine Associated with Migraine?

OBJECTIVE: To evaluate gender differences in clinical characteristics of migraine by examining presence and severity of cutaneous allodynia, migraine-related disability, neck pain and its associated disability, passive mobility of the upper cervical spine, and performance of the deep neck flexor muscles. DESIGN: Cross-sectional study. SUBJECTS: 30 men and 30 women with migraine. METHODS: Participants responded to the questionnaires Migraine Disability Assessment questionnaire, 12-item Allodynia Symptom Checklist, and Neck Disability Index. The mobility of the upper cervical spine was assessed by using the Flexion-Rotation Test. Performance of the deep neck flexor muscles was evaluated by applying the Craniocervical Flexion Test. Comparison of the groups was carried out by using the Student's t-test or the χ2 test. The prevalence ratio was also calculated. RESULTS: Women showed a higher prevalence of cutaneous allodynia (P = .001) and a 4 times greater risk of having severe cutaneous allodynia than to men (P = 0.007). No gender differences were observed in migraine-related disability (P = .08). Women showed higher prevalence of self-reported neck pain (P = .03) and increased risk of having this symptom in comparison to men (Prevalence Ratio = 1.69; P = 0.025). However, there were no gender differences in neck pain-related disability (P = .25), mobility of the upper cervical spine (P = .92), or performance of the deep neck flexor muscles (P = .52). CONCLUSION: Women with migraine had a higher frequency of self-reported neck pain and higher prevalence and severity of cutaneous allodynia when compared to men. However, the two groups did not differ regarding neck pain-related disability and performance in the physical tests.

Neck pain and associated factors in a sample of high school students in the city of Bauru, São Paulo, Brazil: cross-sectional study

ABSTRACT BACKGROUND: Neck pain is a major public health problem. OBJECTIVE: The aim of the present study was to determine the prevalence of neck pain among high school students and to analyze associations with sociodemographic variables, use of electronic devices, habitual physical activity practices and mental health problems. DESIGN AND SETTING: Cross-sectional epidemiological study on a sample of high school students in the city of Bauru, São Paulo, Brazil. METHOD: Participants were selected through cluster sampling in two stages and data were collected via face-to-face interviews. Data collection comprised the following steps: 1. sociodemographic characteristics; 2. use of electronic devices; 3. habitual physical activity levels; 3. mental health; and 4. neck pain. RESULTS: A total of 1,628 participants were interviewed. The prevalence of neck pain was 49.1% (95% confidence interval, CI 46.7 to 51.5), with 40.4% (95% CI 37.0 to 43.7) in men and 57.5% (95% CI 54.2 to 60.9) in women. The variables associated with in neck pain were: female (prevalence ratio, PR = 2.04), use of cell phone in standing posture (PR = 1.47), use of tablet in sitting posture (PR = 1.72), length of computer use greater than 3 hours/day (PR = 1.54), length of cell phone use greater than 3 hours/day (PR = 1.54), length of tablet use greater than 3 hours/ day (PR = 1.34) and mental health problems (PR = 1.56). CONCLUSION: There is high prevalence of neck pain among students and striking associations with female sex, use of electronic devices and mental health problems.

The contemporary management of neck pain in adults.

Neck pain is a common condition with a high prevalence worldwide. Neck pain is associated with significant levels of disability and is widely considered an important public health problem. Neck pain is defined as pain perceived between the superior nuchal line and the spinous process of the first thoracic vertebra. In some types of neck conditions, the pain can be referred to the head, trunk and upper limbs. This article aims to provide an overview of the available evidence on prevalence, costs, diagnosis, prognosis, risk factors, prevention and management of patients with neck pain.

[Neck pain among tobacco farm workers in Southern Brazil]. / Dolor cervical entre agricultores que producen tabaco en el sur de Brasil.

This study aims to assess neck pain prevalence and associated factors among tobacco farm workers. This is a cross-sectional study of 2,469 tobacco farm workers in southern Brazil. An adapted version of the Nordic Questionnaire of Musculoskeletal Symptoms was used to characterize neck pain. Multivariate analysis was performed using Poisson regression, following a hierarchical theoretical model. Neck pain prevalence in the last year among the population studied was 7.4%. Worker age, tobacco smoking, tobacco bundling, use of heavy chainsaws, working at an intense or accelerated pace and green tobacco sickness were variables associated with neck pain in females. Among males, age, use of heavy chainsaws, working in a sitting position on the ground, pesticide poisoning, and green tobacco sickness were associated with the outcome. The study reinforces the importance of ergonomic and physiological workloads in the determination of neck pain. Future studies are needed to understand the role of pesticides and nicotine exposures on musculoskeletal problems. The mechanization of tobacco harvesting could reduce ergonomic and chemical exposure, thereby improving farmers' health.

Este estudio tiene como objetivo evaluar la prevalencia del dolor cervical y los factores asociados entre agricultores que producen tabaco. Se realizó un estudio transversal en el que participaron 2.469 agricultores que producen tabaco en el sur de Brasil. Para la caracterización del dolor cervical se utilizó una adaptación del cuestionario nórdico para síntomas musculoesqueléticos. El análisis multivariante se realizó mediante la regresión de Poisson, siguiendo un modelo teórico jerárquico. La prevalencia del dolor cervical en el año previo entre la población estudiada fue del 7,4%. Las variables que se asociaron con el dolor cervical entre las mujeres trabajadoras fueron la edad, el consumo de tabaco, el enfardado del tabaco, el uso de motosierras pesadas, trabajar en un ritmo intenso o acelerado y la enfermedad del tabaco verde, mientras que, entre los varones, fueron la edad, el uso de motosierras pesadas, el trabajo sentado en el suelo, la intoxicación por plaguicidas y la enfermedad del tabaco verde. El estudio refuerza la importancia de las cargas de trabajo ergonómicas y fisiológicas en la determinación del dolor cervical. Se necesitan estudios futuros para comprender el papel de la exposición a los plaguicidas y a la nicotina en los problemas musculoesqueléticos. La mecanización de la cosecha del tabaco podría reducir la exposición ergonómica y química, mejorando así la salud de los agricultores.

Photobiomodulation therapy and transcutaneous electrical nerve stimulation on chronic neck pain patients: Study protocol clinical trial (SPIRIT Compliant).

INTRODUCTION: Chronic neck pain is a common musculoskeletal disorder that is associated with functional disability and decreased of quality of life. Electrophysical agents are commonly used to relieve pain, however the effects of combined use of these agents are little studied. The objective is to investigate the efficacy of photobiomodulation and electrical stimulation to relieve pain, both in isolation and combined. MATERIALS AND METHODS: This a 4-arm randomized placebo-controlled trial with patient and evaluator blinded. This study will be performed in Department of Physical Therapy at Federal University of São Carlos, São Carlos/SP, Brazil. One hundred and forty-four patients with chronic neck pain will be randomized into 4 groups: active photobiomodulation therapy with active electrical stimulation, active photobiomodulation therapy, active electrical stimulation, or placebo treatment. They will receive 10 sessions of treatment. PRIMARY OUTCOME: pain intensity (measured by pain numerical rating scale) posttreatment. SECONDARY OUTCOMES: pain during movement, neck disability, range of motion, pressure pain threshold, temporal summation, conditioned pain modulation, depressive symptoms, pain catastrophizing, quality of life, analgesic intake, and global perceived effect at posttreatment (10 sessions). Pain intensity and global perceived effect will also be measured after 6 weeks randomization. DISCUSSION: The findings of this study might clarify the importance of using the photobiomodulation therapy and transcutaneous electrical nerve stimulation for patients with chronic neck pain. TRIAL REGISTRATION: NCT04020861. https://clinicaltrials.gov/ct2/show/NCT04020861?term=NCT04020861&draw=2&rank=1.

Are Outcomes of Anterior Cervical Discectomy and Fusion Influenced by Presurgical Depression Symptoms on the Mental Component Score of the Short Form-12 Survey?

STUDY DESIGN: Retrospective comparative study. OBJECTIVE: The purpose of this study was to investigate whether preoperative depressive symptoms, measured by mental component score of the Short Form-12 survey (MCS-12), influence patient-reported outcome measurements (PROMs) following an anterior cervical discectomy and fusion (ACDF) surgery for cervical degeneration. SUMMARY OF BACKGROUND DATA: There is a paucity of literature regarding preoperative depression and PROMs following ACDF surgery for cervical degenerative disease. METHODS: Patients who underwent an ACDF for degenerative cervical pathology were identified. A score of 45.6 on the MCS-12 was used as the threshold for depression symptoms, and patients were divided into two groups based on this value: depression (MCS-12 ≤45.6) and nondepression (MCS-12 >45.6) groups. Outcomes including Neck Disability Index (NDI), physical component score of the Short Form-12 survey (PCS-12), and Visual Analogue Scale Neck (VAS Neck), and Arm (VAS Arm) pain scores were evaluated using independent sample t test, recovery ratios, percentage of patients reaching the minimum clinically important difference, and multiple linear regression - controlling for factors such as age, sex, and BMI. RESULTS: The depression group was found to have significantly worse baseline pain and disability than the nondepression group in NDI (P < 0.001), VAS Neck pain (P < 0.001), and VAS Arm pain (P < 0.001) scores. Postoperatively, both groups improved to a similar amount with surgery based on the recovery ratio analysis. The depression group continued to have worse scores than the nondepression group in NDI (P = 0.010), PCS-12 (P = 0.026), and VAS Arm pain (P = 0.001) scores. Depression was not a significant predictor of change in any PROMs based on regression analysis. CONCLUSION: Patients who presented with preoperative depression reported more pain and disability symptoms preoperatively and postoperatively; however, both groups achieved similar degrees of improvement. LEVEL OF EVIDENCE: 3.

Continuity of physical activity practice from childhood to adolescence is associated with lower neck pain in both sexes and lower back pain in girls.

BACKGROUND: The literature on physical activity practice through sports as a protective factor for back pain in adolescents is conflicting. However, few studies have aimed to verify if continuity of the practice of physical activity from childhood to adolescence may be related to lower chances of back pain in adolescents. OBJECTIVES: The objective of this study was to analyze the association between physical activity practice from childhood to adolescence and back pain in adolescents. METHODS: The random sample was composed of 870 adolescents with a mean age of 13.7 ± 2.0 years. The continuity of physical activity practice was assessed through the continuity of sports practice from childhood to adolescence. Pain in the neck and low back were evaluated through a questionnaire. RESULTS: The prevalence of neck pain and low back pain in boys was 17.5% and in girls was 20.9% for neck pain and 21.9% for low back pain. Physical activity practice during childhood to adolescence was a protective factor for neck pain (OR = 0.57 [CI = 0.35-0.94]) and low back pain (OR = 0.53 [CI = 0.33-0.86]) in girls and neck pain in boys (OR = 0.52 [CI = 0.30-0.90]), even after adjusting for confounding factors. CONCLUSION: Girls with physical activity practice during childhood to adolescence were less likely to develop neck pain and back pain when compared to girls who did not maintain practice of physical activity. Similar results were observed in boys considering neck pain.

Dolor cervical entre agricultores que producen tabaco en el sur de Brasil / Neck pain among tobacco farm workers in Southern Brazil

RESUMEN Este estudio tiene como objetivo evaluar la prevalencia del dolor cervical y los factores asociados entre agricultores que producen tabaco. Se realizó un estudio transversal en el que participaron 2.469 agricultores que producen tabaco en el sur de Brasil. Para la caracterización del dolor cervical se utilizó una adaptación del cuestionario nórdico para síntomas musculoesqueléticos. El análisis multivariante se realizó mediante la regresión de Poisson, siguiendo un modelo teórico jerárquico. La prevalencia del dolor cervical en el año previo entre la población estudiada fue del 7,4%. Las variables que se asociaron con el dolor cervical entre las mujeres trabajadoras fueron la edad, el consumo de tabaco, el enfardado del tabaco, el uso de motosierras pesadas, trabajar en un ritmo intenso o acelerado y la enfermedad del tabaco verde, mientras que, entre los varones, fueron la edad, el uso de motosierras pesadas, el trabajo sentado en el suelo, la intoxicación por plaguicidas y la enfermedad del tabaco verde. El estudio refuerza la importancia de las cargas de trabajo ergonómicas y fisiológicas en la determinación del dolor cervical. Se necesitan estudios futuros para comprender el papel de la exposición a los plaguicidas y a la nicotina en los problemas musculoesqueléticos. La mecanización de la cosecha del tabaco podría reducir la exposición ergonómica y química, mejorando así la salud de los agricultores.

ABSTRACT This study aims to assess neck pain prevalence and associated factors among tobacco farm workers. This is a cross-sectional study of 2,469 tobacco farm workers in southern Brazil. An adapted version of the Nordic Questionnaire of Musculoskeletal Symptoms was used to characterize neck pain. Multivariate analysis was performed using Poisson regression, following a hierarchical theoretical model. Neck pain prevalence in the last year among the population studied was 7.4%. Worker age, tobacco smoking, tobacco bundling, use of heavy chainsaws, working at an intense or accelerated pace and green tobacco sickness were variables associated with neck pain in females. Among males, age, use of heavy chainsaws, working in a sitting position on the ground, pesticide poisoning, and green tobacco sickness were associated with the outcome. The study reinforces the importance of ergonomic and physiological workloads in the determination of neck pain. Future studies are needed to understand the role of pesticides and nicotine exposures on musculoskeletal problems. The mechanization of tobacco harvesting could reduce ergonomic and chemical exposure, thereby improving farmers' health.

Is the presence of neck pain associated with more severe clinical presentation in patients with migraine? A cross-sectional study.

OBJECTIVE: To investigate the association between the presence of self-reported neck pain in patients with migraine and clinical features, upper cervical mobility, and neck muscle performance. METHODS: A total of 142 patients with migraine were recruited and stratified by the presence (n = 99) or absence of self-reported neck pain (n = 43). The clinical examination included the Migraine Disability Assessment, the 12-item Allodynia Symptom Checklist, a flexion rotation test, and the Craniocervical Flexion Test. RESULTS: Migraine-related disability was reported by more than 80% in both groups (p = 0.82). However, there was a greater prevalence and severity of cutaneous allodynia observed in the group with neck pain (p < 0.001). Reduced upper cervical mobility was verified in 67% of the patients with neck pain and in 41% of those without neck pain (p = 0.005). In addition, 67% of the patients with neck pain and 40% without neck pain were not able to maintain the third stage of the Craniocervical Flexion Test without compensation (p = 0.003). CONCLUSIONS: The presence of self-reported neck pain in patients with migraine was associated with a poor clinical presentation regarding cutaneous allodynia, neck mobility, and muscle function. However, there were no differences in migraine-related disability.

Systemic diseases and other painful conditions in patients with temporomandibular disorders and migraine.

Temporomandibular disorders (TMD) are a highly prevalent, painful musculoskeletal condition affecting the masticatory system, and are frequently associated with migraines (M) and other diseases. This study aimed to investigate the association between painful TMD and M with other painful conditions and systemic diseases, such as cervicalgia, body pain (BP), ear-nose-throat disorders, musculoskeletal disorders, diabetes, cardiopulmonary diseases and gastritis/peptic ulcer. METHODS: This was a cross-sectional study conducted in a sample of 352 individuals. Participants were stratified into three groups according to the presence of painful TMD and M: controls [individuals free of TMD and any headache (HA)]; TMD only (presence of painful TMD, but free of any HA); and TMD+M (presence of painful TMD and M). TMD was classified according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) - Axis I. Nonspecific physical symptoms (NSPS) were assessed by RDC/TMD - Axis II. The International Classification of Headache Disorders - II criteria, second edition, were applied to identify and classify primary HA. Other painful conditions and systemic diseases were assessed by volunteers' self-report. The prevalence of all assessed conditions was higher in the TMD+M group. Multiple regression models showed that cervicalgia was associated with the TMD only group (p<0.05), whereas gender (p<0.05), cervicalgia (p<0.05), BP (p<0.05) and NSPS (p<0.05) were significantly associated with the TMD+M group. Our results suggest that individuals with a comorbidity (TMD associated with M) have a more severe condition than those presenting only painful TMD.

[Musculoskeletal pain among bus drivers and fare collectors in the Metropolitan Region of Belo Horizonte, Brazil]. / Dor musculoesquelética em motoristas e cobradores de ônibus da Região Metropolitana de Belo Horizonte, Brasil.

Musculoskeletal pain among professionals in the transport sector has been linked to working conditions. The scope of this study was to assess the prevalence of cervical musculoskeletal pain and its relation to pain in other areas (arms, hands and shoulders). The association between neck pain, related to pain in other areas or otherwise, was checked against occupational factors. A cross-sectional, descriptive and analytical study was conducted with 799 bus drivers and 708 fare collectors of the Metropolitan Region of Belo Horizonte, Brazil. The outcome was characterized according to the positive answer to the question about musculoskeletal pain in the anatomical areas studied. The prevalence of neck pain in the sample was highest at 16.3%, followed by pain in the shoulders 15.4%, arms 13.3% and hands 6.3%. The factors associated with musculoskeletal pain in the sample were being female, complaints of disability, perception of threat to safety, vibration, excessive or unbearable noise and sitting in an uncomfortable posture. The results provide clues to transformation of the workplace, thereby contributing to the enhancement of occupational health.

A dor musculoesquelética em profissionais do setor de transporte tem sido relacionada às condições de trabalho. Objetivou-se estimar a prevalência de dor cervical e sua relação com a dor em outros sítios (braços, mãos e ombros). Verificou-se a associação entre dor no pescoço, relacionada ou não à dor nos outros sítios, com os fatores ocupacionais. Estudo transversal, descritivo e analítico. Foram entrevistados 799 motoristas e 708 cobradores de ônibus da Região Metropolitana de Belo Horizonte, Brasil. Para o desfecho foi considerada a resposta sobre a existência de dor por sítio anatômico. A prevalência de dor musculoesquelética no pescoço foi de 16,3%. Para ombros, braços e mãos foram 15,4%, 13,3% e 6,3%, respectivamente. Aqueles com dor no pescoço apresentaram maiores prevalências de dores nas demais áreas estudadas. Os fatores associados à dor musculoesquelética foram sexo feminino, relato de incapacidade, percepção de ameaça a segurança, vibração, ruído elevado ou insuportável e adoção de postura desconfortável. Os resultados indicaram a elaboração de pistas para transformação do ambiente de trabalho, de maneira a contribuir para a promoção da saúde dos trabalhadores.