¹Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
²Institute for Occupational Safety and Health of the German Social Accident Insurance (IFA), Sankt Augustin, Germany
³German Social Accident Insurance Institution for the woodworking and metalworking industries (BGHM), Düsseldorf, Germany
⁴German Social Accident Insurance Institution for the administrative sector (VBG), Hamburg, Germany

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Introduction: The shift in work practices, changes in physical activity, and additionally increased mental strain during the SARS-CoV-2 pandemic may have influenced musculoskeletal pain (MSP) among computer workers. This cross-sectional study aimed to investigate the prevalence of MSP among computer workers in German companies and to explore if working from home (WFH) and different working conditions are associated with the occurrence or worsening of MSP.

Methods: Computer workers were invited to participate in the online survey conducted between September 2023 and April 2024. Current pain and pain experienced before the pandemic in early 2020 (assessed retrospectively) were evaluated using the Brief Pain Inventory, on a scale from 0 (no pain) to 10 (the worst imaginable pain), for various localizations (low back, upper back, neck, shoulder, forearm/elbow, wrist/hand). The Patient Health Questionnaire-4 was used to assess symptoms of anxiety and depression. A score for the ergonomic remote workstation equipment (WFH score) was established based on information about seating, table, and electronic workplace equipment (computer screen, keyboard, and mouse). The relationship between WFH and newly developed MSP and worsening of MSP since the pandemic was modeled using logistic regression analyses, adjusted for age, sex, body mass index (BMI)/weight change, physical activity, of anxiety and depression symptoms, eye problems, headaches, analgesic use, and occupational health screening, and described with odds ratios (OR) and 95% confidence intervals (95% CI).

Results: Data from 1,064 employees with at least four hours of daily computer work were included in the analysis. A total of 968 participants had worked remotely at some point (WFH employees), with a higher percentage at the time of the survey compared to before the pandemic (87% vs. 39%). According to the ergonomic WFH score, 74% of WFH employees had workstations that were ergonomically well-equipped. The highest prevalence of MSP has been observed for the lower back and neck (42% and 40% at the time of the survey, respectively). WFH employees had a slightly higher risk than office workers for worsening of existing MSP, but this difference failed to reach the formal level of statistical significance (e.g., neck pain OR 1.62; 95% CI 0.83-3.19). Poorer workstation setups, longer daily screen time, or lack of regular participation in occupational health screenings were also risk factors for MSP. Additionally, more severe symptoms of anxiety or depression were associated with a higher risk of MSP (e.g., worsening low back pain OR 1.20; 95% CI 1.11-1.29).

Discussion: Our findings confirm that the pandemic led to an increase in WFH among office workers in Germany, which continues to be a frequent model among the new forms of working. Consistent with other surveys, we found an association between MSP, working conditions, and the ergonomics of remote workstations.

Conclusion: To prevent MSP, employers should ensure that employees are able to set up and adjust their workstations correctly according to ergonomic recommendations, as well as encourage regular participation in appropriate occupational health screenings.