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New Emirates Medical Journal

Volume 1, 2 Issues, 2020
ISSN: 0250-6882 (Online)
This journal supports open access

Open Access Article

Frequency of Neck Pain Among Female Medical Students in a Medical University of Karachi



Saba Aijaz2, Ambreen Shahzad1, Muhammad Faisal Fahim1, *, Aisha Ahmed2, Urooj Asghar2, Muntaha Mukhtar2
1 Department of Physical Therapy, Bahria University Medical & Dental College, Karachi, Pakistan
2 Department of Physical Therapy, Dow University of Health Sciences, Karachi, Pakistan

Abstract

Background:

Among all the Musculoskeletal Pain (MSP), the most commonly reported MSP among the undergraduate medical students is the neck pain. As the students study for long hours sitting in front of the computers, use incorrect postures while using the computers, mobile phones, reading, etc. The females face neck problems due to increase stress in their daily life. Our study aims to find out how prevalent is the neck pain among female medical students in a Medical University of Karachi.

Methodology:

The study conducted was a cross-sectional survey with a study duration of 4 months i.e. from January, 2018 till April, 2018. A non-probability purposive sampling, conducted among the female undergraduate students of Doctor of Physiotherapy (DPT), Bachelor of Dental Surgery (BDS), Bachelor of Medicine and Bachelor of Surgery (MBBS) and Doctor of Pharmacy (Pharm-D) studying in DOW University of Health Science, Ojha campus Karachi. The estimated sample size was 400 including female undergraduate medical students of MBBS, BDS, Pharm-D and DPT of DOW University, Ojha campus. Male medical students and students other than DOW University, Ojha campus were not included in this study. Data was analyzed through SPSS version 16.0. Pearson Chi-Square test was used to see the association between neck pain and different physical parameters of the Neck Disability Index. P-value less than 0.05 was considered significant.

Results:

The results showed that out of 400 female medical students 301 students were having neck pain among which 24.8% of students reported no disability, 36.5% reported mild disability, 9.5% reported severe disability, and 4.5% reported complete disability.

Conclusion:

It was concluded that the majority of the female medical students were having neck pain with mild disability due to the presence of neck pain.

Keywords: Disability, Female medical students, Musculoskeletal disorders, Neck pain, Neck Disability Index (NDI), Inflammatory.


Article Information


Identifiers and Pagination:

Year: 2020
Volume: 1
Issue: 1
First Page: 11
Last Page: 16
Publisher Id: nemj-1-11
DOI: 10.2174/0250688202002021102

Article History:

Received Date: 30/10/2019
Revision Received Date: 01/1/2019
Acceptance Date: 09/1/2020
Electronic publication date: 11/03/2020
Collection year: 2020

© 2020 Aijaz et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


* Address correspondence to this author at the Department of Physical Therapy, Bahria University Medical & Dental College, Karachi, Pakistan;
E-mail:faisalfahim88@hotmail.com





1. INTRODUCTION

A group of inflammatory and deteriorating conditions that affect the musculoskeletal anatomy of the body like affecting the muscles, tendons, and supporting structures are defined as musculoskeletal disorders (MSDs). They are one of the commonest causes that lead to disability and persistent pain. Some common forms of MSDs are neck, knee, back, shoulder pain, etc [1].


One of the most common musculoskeletal disorders is the neck pain in majority of the adult population. Its frequency ranges from 16.7% to 75.1% around the world [2]. In recent societies, neck pain is regarded as the major community health problem. The origination of neck pain can occur from any of the structures like; intervertebral discs, muscles, fascia, joints, ligaments, nerve roots, etc [3].

There are multiple causes of neck pain, the possible causes can include any infection, congenital disorders, tumors, or any inflammatory condition [3]. Many factors can contribute to the onset of neck pain that might include psychological, physical factors. Similarly, in a systematic literature review by Côté et al age, any history of previous musculoskeletal pain, poor work posture, increase workload, continuous work, and poor workplace designs are associated risk factors causing neck pain [4].

The symptoms of neck pain include dull aching pain that might get worse by the twisting or turning of the head. It can be associated with stiff neck, headaches, tenderness, tingling in the arms, muscle pain and weakness [5]. Neck pain has been ranked 4th by the World Health Organization (WHO) and other MSDs it ranked 10th. In the widespread community, the one-year prevalence of neck pain is said to be recorded as high as 40% [3]. A number of studies in recent years, suggest that the occurrence of neck pain is increasing among the adolescents, in which the girls tend to be affected more in the population [6].

A study conducted in Canada reported that about 54% of the general population in the past six months had experienced neck pain, and the population that was grossly disabled by the neck pain approximated to be 5% [7]. The study conducted in the Netherlands has ranked neck pain as the third most frequently occurring self-reported MSK pain. Neck pain also has a great impact on the activities of daily livings and may affect the individuals’ participation and lead to work disabilities [8]. About 19-37% of patients complaining of neck pain usually develop chronic pain [4]. Its prevalence reported in Finland is 5% in men and 7% in women [7]. Another study in Finland reported that about 26% of the population aged 14 to 18 years had neck pain once in a week [6].

Neck pain commonly occurs in the individuals who spend working in standing or sitting with their neck bend for long hours or with people who perform tasks requiring overhead activities, as conducted by a study in China [2]. The increased incidence of neck pain is reported among the office workers and the individuals who spend their time using computers with the estimated 1-year prevalence range of neck pain is between 10.4% and 21.3% [9].

As it is suggested that increased strain over a long period of time may cause minor trauma to the tissues and similarly stress may also aggravate the muscular tension [7]. Today, many people spend their time working in a constant position for long hours that fatigues the neck and shoulder muscles and ultimately causing pain [10]. The knowledge about the causes and risk factors of neck pain and the frequency of its occurrence would help to assist the progress of the need for proper medical aid and proper facilitation of the resources [11].

Evidence shows that musculoskeletal pain is relatively high among medical students [12]. The prevalence of neck pain increases with the passage of time and evidence shows that women generally experience additional neck pain than men [13]. Studies revealed that the universities’ authorities should take steps in preventing the risk factors related to medical universities, so as to decrease the prevalence of neck pain [12]. Due to increase in the neck pain we can evaluate the factors causing it and can take preventive measures to avoid them. The students can also modify their way of living by improving the sitting posture and reducing their working hours by taking rests in between, these measures can help reduce the onset and prevalence of neck pain.

Neck pain is among the common musculoskeletal disorders caused by a number of factors including poor posture, stress, physical activity, lifestyle, etc. The students enduring study stress, sitting for long hours and prolong use of computers usually experience neck pain. This study aims to focus on how prevalent is the neck pain among female medical students that might help us to know the common causes and factors causing the neck pain. Our aim was to find out the frequency of neck pain among female medical students at DOW University, Ojha campus.

2. METHODOLOGY

The non-probability purposive sampling technique was used. 400 female students were randomly selected for the study from each year of the departments. There were four departments in total as per the inclusion criteria i.e. MBBS, DPT, BDS and Pharm-D and excluding the male medical students, as the ratio of female students was more than male students and universities other than DOW University of Health Sciences, Ojha Campus Karachi. The data collection started from the month of January, 2018 till April, 2018. The questionnaires were distributed among the students who filled out the consent form and then the questionnaire was explained to the students.

The consent form was signed by each student before filling out the form. The questionnaire was divided into two parts; the first part of the questionnaire included some demographic details that included the name, age, gender, department, year of study and the e-mail id (optional). The second part was the standard Neck Disability Index (NDI) questionnaire that is a reliable and valid disability questionnaire that is further divided into ten sections each of which has 6 options scoring from 0 to 5. These sections included the impairments of the body that is the pain intensity, personal care, lifting and reading as well as the physical limitations such as headache, difficulty in concentration, driving, work, sleeping and recreational activities were also included. After taking the consent from the female medical students, the printed questionnaire was distributed among them which was then, filled up by using a pen.

The results were analyzed using SPSS version 16.0 with the confidence interval of 95%. The P-value less than 0.05 was considered significant. The frequency percentages were reported for the department, pain, levels of disability and the ten sections of the questionnaire. Pearson Chi-square test was used to see the association of pain with the department and the association between pain and disability level with different sections of the questionnaire.

3. RESULTS

In this study, 400 female students participated from the department of DPT, BDS, MBBS and Pharm-D. The results showed that out of 400 students 301 students were having neck pain (75.2%) and 99 students had no neck pain (24.8%) (Table 1).

Among the 301 students, 24.8% reported no disability, 36.5% reported mild disability, 24.8% reported moderate disability, 9.5% reported severe disability, and 4.5% reported complete disability (Table 2).

Table 1
Frequency table showing the percentage of neck pain.

Table 2
Frequency table showing the percentage of the levels of disability.


3.1. Neck Pain in Association with Reading and Concentration

According to the obtained results, it is concluded that out of 301 students who were having pain 185 students (46.2%) reported that they were experiencing slight neck pain while reading or studying (Table 3).

Similarly, the results showed that out of 301 students, 211 students (52.8%) were having no difficulty while concentrating, whereas, 126 students (31.5%) were having slight difficulty while concentrating due to neck pain (Table 4).

3.2. Neck Pain in Association with Headache

There were majority of students i.e. 194 students (48.5%) out of 301 who were having slight headaches which were infrequent. There was a vast significant association between the neck pain and headaches as demonstrated in Fig. (1).

3.3. Neck Pain in Association with Work

117 students (29.2%) out of 301 students who were having neck pain reported that they were able to do their work with mild difficulty due to neck pain. But 235 students among them (58.8%) were able to do their work without any pain. The Chi-Square showed association between neck pain and the amount of work done shown in Fig. (2). A significant value was less than 0.05 i.e. <0.001 which isgraphically presented in Fig. (2).


Table 3
Frequency of neck pain while reading.


Table 4
Frequency of neck pain in relation with concentration.


Fig. (1)
Graphical representation of neck pain in association with headaches.

Fig. (2)
Graphical representation of neck pain in association with work.

4. DISCUSSION

A study reported that musculoskeletal pain is more common among females than males, suggesting the different physiological mechanisms of pain perception [13]. The results of this study concluded that out of 400 female students 301 female students (75.2%) were having neck pain (Table 1). In support of this study, there was a prevalence study conducted which reported that out of 30 studies conducted in 25 of the studies (83%) women reported more neck pain than men [13]. Similarly, in a Norwegian study, it was found out that females reported more neck pain than males i.e. 15% were males and 25% were females [11].

Another results of our study reported some physical limitations occurring due to neck pain. About 46.2% students were having slight pain while reading and 31.5% students were having slight difficulty concentrating due to neck pain for long periods of time (Table 3 and 4). To support the results of the present study it was found in a past study analyzing 3,016 questionnaires among high school students in Shanghai that the prevalence of neck-shoulder pain was 40.8% due to the higher academic pressures placed on them [6].

The next calculated results of our study showed that about 48.5% students were having infrequent headaches (Fig. 1). In a study showing the clinical occurrence of neck pain in migraine reported that 70% of the patients who were having migraine headaches had neck pain during the migraine phase [14]. In another study, it was reported that the headache that is associated with the structures of the neck is called cervicogenic headaches. The prevalence of this type of headache was as high as 20% of the patients experiencing a chronic headache which was four times more common among females than males [15].

According to our study, there was a small percentage of students i.e. 29.2% who were having difficulty in doing work while the majority of the students i.e. 58.8% were having no difficulty in doing their work (Fig. 2). Contrary to this, in one of the studies, it was analyzed that the neck pain has a significant relationship with the amount of workload i.e. there is 7% risk of neck pain occurrence for every one-year increase in workload [16]. One more study showed that there is a high percentage of neck pain occurrence in those students who were in their clinical practice due to some external factors as poor posture; prolong working hours and lack of resting time in between [17].

It was concluded that neck pain frequency is high among female students and it was associated with the physical limitations. A strong association was seen between the neck pain and headache and an increase in work demands. This study was limited to four medical departments and only female students were selected for the study, further research can be done including the males as well to see the ratio of neck pain among both genders. Furthermore, more medical departments can also be included in the future study so that more risk factors can be assessed which are causing the neck pain and the physical limitations or disability occurring due to neck pain.

CONCLUSION

The study revealed the presence of neck pain among the female medical students and also the relationship among different parameters as difficulty in reading and concentration, difficulty in doing their work. Also, it has been found that headaches can be associated with neck pain. The outcomes of this study may help the students to use preventive measures to avoid the neck pain like improving their posture, taking breaks in between study so it may not fatigue the neck muscles. The study will help to increase the awareness of correct posture and ergonomics regarding the work environment.

ETHICS APPROVAL AND CONSENT TO PARTICIPATE

The data collection was approved by the Institute of Physical Medicine and Rehabilitation, OJHA Campus Dow University of Health Sciences, Karachi, Pakistan.

HUMAN AND ANIMAL RIGHTS

Not applicable.

CONSENT FOR PUBLICATION

The consent form was signed by each student.

AVAILABILITY OF DATA AND MATERIALS

The authors confirms that the data supporting the findings of this study are available within the article.

FUNDING

None.

CONFLICT OF INTEREST

The author declares no conflict of interest, financial or otherwise.

ACKNOWLEDGEMENTS

The researchers would like to thank their research supervisor for the guidance throughout the research, special thanks to the statistician who helped us in the data analysis.

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Editor-in-Chief

Abdullah Shehab
Emirates Cardiac Society
Emirates Medical Association
Dubai
(UAE)

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