Document Type : Original Article


Department of Physiotherapy, Federal Medical Centre, Owo, Ondo - State, Nigeria


Objective: Musculoskeletal disorders (MSDs) are one of the major complaints in the work place. This study investigated the prevalence and pattern of work-related MSDs, risk factors and the strategies of management among nurses working in various specialty areas in a tertiary health institution in Nigeria.
Methods: This cross-sectional survey recruited 150 nurses working in various specialty areas of a government own tertiary institution in South-west, Nigeria. Data were obtained on demographic characteristics, occupational profile, work-related musculoskeletal symptoms, perceptions on job risk factors and management strategies. Data were presented using descriptive statistics of percentages and frequency tables.
Results: The most common MSD among the respondents was low back pain (LBP) (60.0%), followed by neck pain (48.0%), while elbow pain was the lowest work-related musculoskeletal pain (5.3%). Findings indicated that respondents working in Intensive Care Unit (100.0%), Dental Unit (100.0%), Accident and Emergency (77.8%), Orthopaedics (75.0%), Ear Nose and Throat (75.0%) and Medicine (72.7%) suffered from LBP more than other respondents in other specialty areas. Results also revealed that frequent bending (64.0%), prolonged standing (49.3%) and frequent lifting of patients (48.0%) were major factors that contributed to LBP among the respondents. Rest (56.0%), pain killer drugs (50.7%), and exercise (36.0 %) were the most preferred pain management strategies among the respondents, while only 12.0% preferred physiotherapy management.
Conclusion: A great percentage of Nigerian nurses suffer from work-related MSDs in their professions with the low back being the most injured body part. Nurses working in Intensive Care Unit, Dental, Accident and Emergency and Orthopedics are more prone to work-related LBP. Education programs on back care and workplace ergonomics are recommended for reduction and prevention of occupational hazards among nurses.


Main Subjects

1. Punnett L, Wegman DH. Work-related musculoskeletal disorders: the epidemiologic evidence and the debate. J Electromyogr Kinesiol 2004; 14(1): 13-23. doi: 10.1016/j. jelekin.2003.09.015.
2. Smith DR, Leggat PA. Musculoskeletal disorders in nursing. Aust Nurs J 2003; 11(1): 19-21.
3. Gopal K, Thomas M, Sreedharan J. Work-related musculoskeletal disorders (WMSD) in hospital nurses: Prevalence and coping strategies. Gulf Medical Journal 2012;1(S1):S159-63.
4. Salik Y, Ozcan A. Work-related musculoskeletal disorders: a survey of physical therapists in Izmir-Turkey. BMC
Musculoskelet Disord 2004; 5: 27. doi: 10.1186/1471-2474- 5-27.
5. Arvidsson I, Gremark Simonsen J, Dahlqvist C, Axmon A, Karlson B, Bjork J, et al. Cross-sectional associations between occupational factors and musculoskeletal pain in women teachers, nurses and sonographers. BMC Musculoskelet Disord 2016; 17: 35. doi: 10.1186/s12891-016-0883-4.
6. Menzel NN, Brooks SM, Bernard TE, Nelson A. The physical workload of nursing personnel: association with musculoskeletal discomfort. Int J Nurs Stud 2004; 41(8): 859-67. doi: 10.1016/j.ijnurstu.2004.03.012.
7. Josephson M, Lagerstrom M, Hagberg M, Wigaeus Hjelm E. Musculoskeletal symptoms and job strain among nursing
personnel: a study over a three year period. Occup Environ Med 1997; 54(9): 681-5. doi: 10.1136/oem.54.9.681.
8. Smedley J, Egger P, Cooper C, Coggon D. Manual handling activities and risk of low back pain in nurses. Occup Environ
Med 1995; 52(3): 160-3. doi: 10.1136/oem.52.3.160.
9. Yip Y. A study of work stress, patient handling activities and the risk of low back pain among nurses in Hong Kong. J
Adv Nurs 2001; 36(6): 794-804.
10. Smith DR, Leggat PA, Smyth W, Wang RS. Musculoskeletal disorders among female Australian nurses working in a
unique tropical environment: results from a pilot study. Ergon Aust 2003; 17 (3): 14-7.
11. Lagerstrom M, Wenemark M, Hagberg M, Hjelm EW. Occupational and individual factors related to musculoskeletal symptoms in five body regions among Swedish nursing personnel. Int Arch Occup Environ Health 1995; 68(1): 27-35.
12. Bongers PM, Kremer AM, ter Laak J. Are psychosocial factors, risk factors for symptoms and signs of the shoulder, elbow, or hand/wrist?: A review of the epidemiological literature. Am J Ind Med 2002; 41(5): 315-42. doi:10.1002/ajim.10050.
13. Smith DR, Wei N, Zhao L, Wang RS. Musculoskeletal complaints and psychosocial risk factors among Chinese hospital nurses.Occup Med (Lond) 2004; 54(8): 579-82. doi: 10.1093/occmed/kqh117.
14. Holder NL, Clark HA, DiBlasio JM, Hughes CL, Scherpf JW, Harding L, et al. Cause, prevalence, and response to
occupational musculoskeletal injuries reported by physical therapists and physical therapist assistants. Phys Ther 1999;
79(7): 642-52. doi: 10.1093/ptj/79.7.642.
15. Badley EM, Rasooly I, Webster GK. Relative importance of musculoskeletal disorders as a cause of chronic health
problems, disability, and health care utilization: findings from the 1990 Ontario Health Survey. J Rheumatol 1994; 21(3): 505-14.
16. Riihimaki H. Hands up or back to work--future challenges in epidemiologic research on musculoskeletal diseases. Scand J Work Environ Health 1995; 21(6): 401-3.
17. Kemmlert K. Prevention of occupational musculo-skeletal injuries. Labour Inspectorate investigation. Scand J Rehabil
Med Suppl 1996; 35: 1-34.
18. Ando S, Ono Y, Shimaoka M, Hiruta S, Hattori Y, Hori F, et al. Associations of self estimated workloads with
musculoskeletal symptoms among hospital nurses. Occup Environ Med 2000; 57(3): 211-6. doi: 10.1136/oem.57.3.211.
19. Kim YO, Koo JW. Musculoskeletal symptoms and related factors on the nurses in several general hospitals’. Korean J
Occup Health Nurs 2002; 41(3): 131-41.
20. Daynard D, Yassi A, Cooper JE, Tate R, Norman R, Wells R. Biomechanical analysis of peak and cumulative spinal loads during simulated patient-handling activities: a substudy of a randomized controlled trial to prevent lift and transfer
injury of health care workers. Appl Ergon 2001; 32(3): 199-214.
21. Wilkinson WE, Salazar MK, Uhl JE, Koepsell TD, DeRoos RL, Long RJ. Occupational injuries: a study of health care workers at a northwestern health science center and teaching hospital. AAOHN J 1992; 40(6): 287-93.
22. Harber P, Billet E, Gutowski M, SooHoo K, Lew M, Roman A. Occupational low-back pain in hospital nurses. J Occup
Med 1985; 27(7): 518-24.
23. Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering- Sorensen F, Andersson G, et al. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon 1987; 18(3): 233-7.
24. Al-samawi MAG, Abdallah Awad HAM. Why do women have back pain more than men? A representative prevalence
study in the federal republic of Germany. Clin J Pain 2006; 22(8): 738-47. doi: 10.1097/01.ajp.0000210920.03289.93.
25. Al-samawi MAG, Abdallah Awad HAM. Prevalence of low back pain among nurses working In Elmak Nimer
university hospital. IInternational Journal of Research -Granthaalayah 2015; 3(9): 108-21.
26. Sikiru L, Shmaila H. Prevalence and risk factors of low back pain among nurses in Africa: Nigerian and Ethiopian
specialized hospitals survey study. East Afr J Public Health 2009; 6(1): 22-5.
27. Lela M, Frantz JM. Physical activity among nurses in Kanombe military hospital. African Journal of Physiotherapy and Rehabilitation Sciences 2012; 4(1-2): 63-6. doi: 10.4314/ajprs.v4i1-2.10.
28. Aljeesh Y, Al Nawajha S. Determinants of low back pain among operating room nurses in Gaza governmental hospitals. J Al Azhar Univ (Nat Sci) 2011; 13: 41-54.
29. Roupa Z, Vassilopoulos A, Sotiropoulou P, Makrinika E, Noula M, Faros E, et al. The problem of lower back pain in
nursing staff and its effect on human activity. Health Sci J 2008; 2(4): 219-25.
30. Karahan A, Kav S, Abbasoglu A, Dogan N. Low back pain: prevalence and associated risk factors among hospital
staff. J Adv Nurs 2009; 65(3): 516-24. doi: 10.1111/j.1365-2648.2008.04905.x.
31. Sikiru L, Hanifa S. Prevalence and risk factors of low back pain among nurses in a typical Nigerian hospital. Afr Health Sci 2010; 10(1): 26-30.
32. Bejia I, Younes M, Jamila HB, Khalfallah T, Ben Salem K, Touzi M, et al. Prevalence and factors associated to low back
pain among hospital staff. Joint Bone Spine 2005; 72(3): 254-9. doi: 10.1016/j.jbspin.2004.06.001.
33. Charlotte ER, Stuart GP. Molecular genetics and age‐related disease. Age Ageing 2001; 30: 449-54.
34. Abou El-Soud AM, El-Najjar AR, El-Fattah NA, Hassan AA. Prevalence of low back pain in working nurses in Zagazig University Hospitals: an epidemiological study. Egyptian Rheumatology and Rehabilitation 2014; 41(3):
109-15. doi: 10.4103/1110-161x.140525.
35. Wong TW, Teo N, Kyaw MO. Prevalence and risk factors associated with low back among health care providers in a
District Hospital. Malays Orthop J 2010; 4(2): 23-8.
36. Reid MC, Williams CS, Gill TM. Back pain and decline in lower extremity physical function among communitydwelling
older persons. J Gerontol A Biol Sci Med Sci 2005;60(6): 793-7. doi: 10.1093/gerona/60.6.793
37. Leveille SG, Zhang Y, McMullen W, Kelly-Hayes M, Felson DT. Sex differences in musculoskeletal pain in older adults.
Pain 2005; 116(3): 332-8. doi: 10.1016/j.pain.2005.05.002.
38. Cilliers L, Maart S. Attitudes, knowledge and treatment of low back pain amongst nurses in the Eastern Cape, South
Africa. Afr J Prim Health Care Fam Med 2013; 5(1): 535.doi: 10.4102/phcfm.v5i1.535.