The etiology of nonspecific neck pain is widely considered to be multifactorial. Each risk factor has not only direct effects on neck pain but may also exert effects indirectly through other risk factors. This study sought to test this hypothesized model in office workers. A one-year prospective cohort study of 559 healthy office workers was conducted. At baseline, a self-administered questionnaire and standardized physical examination were employed to gather biopsychosocial data. Follow-up data were collected every month for the incidence of neck pain. A regression model was built to analyze factors predicting the onset of neck pain. Path analysis was performed to examine direct and indirect associations between identified risk factors and neck pain. The onset of neck pain was predicted by female gender, having a history of neck pain, monitor position not being level with the eyes, and frequent perception of muscular tension, of which perceived muscular tension was the strongest effector on the onset of neck pain. Gender, history of neck pain, and monitor height had indirect effects on neck pain that were mediated through perceived muscular tension. History of neck pain was the most influential contributor in perceived muscular tension.
The results of this study support the hypothesis that each risk factors may contribute to the development of neck pain both directly and indirectly. The combination of risk factors required to result in neck pain is likely occupation specific. Perceived muscular tension is hypothesized to be an early sign of musculoskeletal symptoms