Objective: To establish whether review articles provide consistent conclusions on associations between work-place psychosocial factors and musculoskeletal pain and, if differences exist, to explore whether this is related to the methods employed.
Methods: Reviews, reported up to February 2007, which included consideration of work-place psychosocial factors and either upper limb, back or knee pain were identified through searches of multiple databases. The specific work-related psychosocial factors considered were job demands, support, job autonomy and job satisfaction. The conclusions of each review for one or more of the psychosocial/musculoskeletal pain were extracted.
Results: 15 review articles were identified which considered one or more of the regional pain syndromes included in the study. For back pain the most consistent conclusions (4 reviews positive from 6) were with high job demands and low job satisfaction. The studies of upper limb pain were exclusively related to shoulder and/or neck pain and the most consistent positive conclusions were with high and low job demands (4 reviews positive out of 6; 2 reviews positive out of 3, respectively). For knee pain only a single review was identified. For individual reviews of back and upper limb pain there were marked differences in the number of associations concluded to be positive between reviews.
Conclusion: The reasons for reviews coming to different conclusions included that they were often evaluating different bodies of evidence (according to their search criteria, the year when the review was conducted, the role that quality assessment played in whether studies contributed to evidence, and the combination of risk factors addressed in individual studies), but more important was whether the review specified explicit criteria for making conclusions on strength of evidence. These conclusions emphasise the importance of developing standardised methods for conducting such evaluations of existing evidence, and the importance of new longitudinal studies to clarify the temporal relationship between psychosocial factors and musculoskeletal pain in the workplace.
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