The most uncomfortable chronic pain in primary school teachers: differential between different body regions

Gabani, Flávia Lopes; González, Alberto Durán; Mesas, Arthur Eumann; Andrade, Selma Maffei de

doi:10.5935/2595-0118.20180029

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ORIGINAL ARTICLE • BrJP 1 (2) • Apr-Jun 2018 • https://doi.org/10.5935/2595-0118.20180029 copy

The most uncomfortable chronic pain in primary school teachers: differential between different body regions

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

BACKGROUND AND OBJECTIVES:

Chronic pain is a complex and multifactorial event. Very few research compare chronic pain according to the body region in teachers, a population with demanding workloads. The objective was to characterize the most uncomfortable chronic pain, reported by teachers, according to the body region.

METHODS:

A cross-sectional study conducted from 2012 to 2013 with K-12 teachers from the 20 largest state schools in Londrina (PR). Chronic pain (≥6-month duration) and the one that bothered the most were investigated. The Chi-square test (Yates) was used to compare the proportions of teachers with and without chronic pain, with a significance score of 5%.

RESULTS:

Among the 958 teachers, 408 (42.6%) reported chronic pain, and the most disturbing pain were located mainly in the upper limbs, head, lower limbs and lower back (n=321). Pain in the head region stood out for its longer duration, being classified as intense/unbearable and for strongly interfering with teachers’ leisure and work. Pain in the upper and lower limbs frequently made it difficult for teachers to sleep. Teachers with low back pain had a greater proportion of leave of absence above 30 days compared to those with pain in other body sites.

CONCLUSION:

We observed differences in the most uncomfortable pain according to the regions of the body. Pain in the head region stood out for its duration, intense/unbearable intensity and for interfering in teachers’ leisure/work in greater proportion.

Keywords:
Chronic pain; Occupational health; Teachers

Demographic characteristics and life habits^* * Records excluded with unreported information.	Population without pain (n=550)		Regions (n=321)
	Population without pain (n=550)		Upper limbs (n=94)		Head (n=91)		Lower limbs (n=72)		Lumbar spine (n=64)
	n	%	n	%	n	%	n	%	n	%
Gender
Male	206	37.5	17	18.1	11	12.1	24	33.3	28	43.7^ p<0.05;
Female	344	62.5	77	81.9^† † p<0.001 (Chi-square test with Yates correction comparing pain in each body region with the population without pain).	80	87.9^† † p<0.001 (Chi-square test with Yates correction comparing pain in each body region with the population without pain).	48	66.7	36	56.3
Age group (years)
≤ 30	101	18.4	11	11.7	13	14.3	11	15.3	9	14.1
31 to 40	175	31.8	23	24.5	29	31.9	13	18.0	15	23.4
41 to 50	176	32.0	38	40.4	36	39.5	26	36.1	29	45.3
≥ 51	98	17.8	22	23.4	13	14.3	22	30.6^ p<0.05;	11	17.2
Body mass index
Malnutrition/eutrophic	269	49.2	45	47.3	53	58.2	20	28.2	23	35.9
Overweight/obesity	278	50.8	49	52.1	38	41.8	51	71.8^† † p<0.001 (Chi-square test with Yates correction comparing pain in each body region with the population without pain).	41	64.1
Physical activity
Sufficiently active	174	31.6	19	20.2	17	18.7	25	34.7	13	20.3
Insufficiently active	90	16.4	13	13.8	15	16.5	11	15.3	10	15.6
Inactive	286	52.0	62	66.0	59	64.8	36	50.0	41	64.1

Characteristics and consequences of pain ^* * Records excluded with unreported information.	Regions (n=321)
	Upper limbs (n=94)		Head (n=91)		Lower limbs (n=72)		Lumbar spine (n=64)
	n	%	n	%	n	%	n	%
Time with pain
6 months to 2 years	31	33.0	9	9.8	30	41.7	20	31.3
More than 2 years up to 5 Years	36	38.3	15	16.5	22	30.6	13	20.3
More than 5 years up to 10 years	17	18.1	25	27.5	14	19.4	13	20.3
More than 10 years	10	10.6	42	46.2	6	8.3	18	28.1
Pain frequency
Daily	51	54.3	12	13.3	44	65.7	26	40.6
Weekly	32	34.0	46	51.1	17	25.3	29	45.3
Sporadic	11	11.7	32	35.6	6	9.0	9	14.1
Pain intensity
Mild	8	8.5	8	8.8	13	18.4	13	20.3
Moderate	42	44.7	23	25.3	29	40.8	28	43.8
Intense/Unbearable	44	46.8	60	65.9	29	40.8	23	35.9
Interference of pain in leisure
None	8	8.6	2	2.2	6	8.4	5	7.8
Little/moderately	48	51.6	41	45.1	33	45.8	38	59.4
Much/completely	37	39.8	48	52.7	33	45.8	21	32.8
Interference of pain in work
None	5	5.3	3	3.3	7	9.7	5	8.0
Little/moderately	43	45.8	41	45.1	50	69.5	46	73.0
Much/completely	46	48.9	47	51.6	15	20.8	12	19.0
Difficulty to sleep due to pain
No	42	44.7	48	52.7	31	43.1	31	48.4
Yes	52	55.3	43	47.3	41	56.9	33	51.6

Absenteeism and capacity to work^* * Records excluded with unreported information.	Population without pain (n=550)		Regions (n=321)
	Population without pain (n=550)		Upper limbs (n=94)		Head (n=91)		Lower limbs (n=72)		Lumbar spine (n=64)
	n	%	n	%	n	%	n	%	n	%
Leave of absence due to health problems
No	294	53.5	37	39.4	37	40.7	29	40.3	26	40.6
Yes	256	46.5	57	60.6^† † p<0.05 (Chi-square test with Yates	54	59.3^† † p<0.05 (Chi-square test with Yates	43	59.7^† † p<0.05 (Chi-square test with Yates	37	58.7
Leave of absence duration due to health problems (days) ^ Percentage calculated considering the teachers who missed work due to health problems.
1 to 7	195	76.2	40	70.2	43	81.1	31	72.1	25	67.6
8 to 30	45	17.6	10	17.5	7	13.2	9	20.9	5	13.5
> 30	16	6.2	7	12.3	3	5.7	3	7.0	7	18.9^† † p<0.05 (Chi-square test with Yates
Capacity to work regarding the physical demands
Very good/good	383	69.6	31	33.0	52	57.1	39	54.2	32	50.0
Moderate	141	25.6	49	52.1	33	36.3	25	34.7	25	39.1
Low/very low	26	4.8	14	14.9^† † p<0.05 (Chi-square test with Yates	6	6.6	8	11.1	7	10.9
Capacity to work regarding the mental demands
Very good/good	396	72.0	67	71.3	58	63.7	58	80.6	45	70.3
Moderate	126	22.9	21	22.3	23	25.3	10	13.9	16	25.0
Low/very low	28	5.1	6	6.4	10	11.0	4	5.5	3	4.7

Pain treatment^* * Records excluded with unreported information;	Regions (n=321)								Total
	Upper limbs (n=94)		Head (n=91)		Lower limbs (n=72)		Lumbar spine (n=64)		Total
	n	%	n	%	n	%	n	%	n	%
Medical consultation to treat this pain in last the 12 months
No	34	36.2	41	45.6	32	44.4	31	48.4	138	43.1
Yes	60	63.8	49	54.4	40	55.6	33	51.6	182	56.9
Recommendation of medical treatment ^ Percentage calculated considering the number of teachers who sought medical care.
No	4	6.7	5	10.2	4	10.0	4	12.1	17	9.3
Yes	56	93.3	44	89.8	36	90.0	29	87.9	165	90.7
Medical treatment that provided pain relief^* ***** Percentage calculated considering the number of teachers who had treatment recommended by a physician.
Pharmacological	21	37.5	31	70.5	11	30.6	7	24.1	70	42.4
Non-pharmacological	14	25.0	3	6.8	12	33.3	9	31.1	38	23.0
Both	18	32.1	2	4.5	9	25.0	11	37.9	40	24.2
None	3	5.4	8	18.2	4	11.1	2	6.9	17	10.4
Intensity of pain relief after medical treatment ^* ***** Percentage calculated considering the number of teachers who had treatment recommended by a physician.
None	4	7.2	7	15.9	5	13.9	1	3.5	17	10.3
Little/moderately	26	46.4	18	40.9	17	47.2	11	37.9	72	43.6
Much/completely	26	46.4	19	43.2	14	38.9	17	58.6	76	46.1
Treatment without medical indication
No	57	60.6	40	44.0	44	61.1	40	62.5	181	56.4
Yes	37	39.4	51	56.0	28	38.9	24	37.5	140	43.6

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[1] Correspondence to: Av Roberto Koch, 60 86038-350 Londrina, PR, Brasil. E-mail: lopesgabani@gmail.com