The association between postural alignment and psychosocial factors to upper quadrant pain in high school students: A prospective study

Prolonged sitting and psychosocial factors have been associated with musculoskeletal symptoms among adolescents. However, the impact of prolonged static sitting on musculoskeletal pain among South African high school students is uncertain. A prospective observational study was performed to determine whether sitting postural alignment and psychosocial factors contribute to the development of upper quadrant musculoskeletal pain (UQMP) in grade ten high school students working on desktop computers. The sitting postural alignment, depression, anxiety and computer use of 104 asymptomatic students were measured at baseline. At three and six months post baseline, the prevalence of UQMP was determined. Twenty-seven students developed UQMP due to seated or computer-related activities. An extreme cervical angle (<34.75° or >43.95°; OR 2.8; 95% CI: 1.1–7.3) and a combination of extreme cervical and thoracic angles (<63.1° or >71.1°; OR 2.2; 95% CI: 1.1–5.6) were significant postural risk factors for the development of UQMP. Boys with any extreme angle were more likely to suffer pain compared with boys with all middle range angles (OR 4.9; 95% CI: 1.0–24.5). No similar effect was found for girls. There was no strong relationship between depression, anxiety, computer exposure and UQMP among South African high school students.