Factors associated with musculoskeletal pain among teachers working remotely during the COVID-19 pandemic

Silva, Jéssica Silva da; Sousa, Camila Carvalho de; Pinho, Paloma de Sousa; Araújo, Tânia Maria de

doi:10.1590/2317-6369/02824pt2025v50e10

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Research article • Rev. bras. saúde ocup. 50 • 2025 • https://doi.org/10.1590/2317-6369/02824en2025v50e10 linkcopy

Factors associated with musculoskeletal pain among teachers working remotely during the COVID-19 pandemic

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective To evaluate the factors associated with musculoskeletal pain (MSP) among teachers in the private education system working remotely during the COVID-19 pandemic.

Methods Cross-sectional study, carried out with teachers from all levels of education in the private education system, in Bahia. Data were collected using an electronic form. Crude and adjusted analyses were performed, stratified by sex.

Results 1,144 teachers participated, 76.5% of whom were female. The prevalence of pain in the upper limbs was 70.6%, and in the spine or back, 69.9%, being higher in females (74.0% upper limbs and 74.1% spine or back). There were differences between the sexes regarding the associated factors. In females, there was an association between MSP in both body segments and increased time dedicated to work; pain in the spine or back was associated with unpreparedness for the new demands and domestic overload. In males, upper limb pain was associated with difficulties with students and a weekly workload greater than 20 hours; while back or spine pain was associated with noise and difficulty organizing the schedule.

Conclusion The prevalence of MSP was high among teachers during remote activities. The accumulation of tasks and an inadequate home environment may have been potential factors for MSP.

Teacher; Remote Work; Pandemic; COVID-19; Musculoskeletal Pain; Occupational Health

Variable	n	(%)	Female (1,099)		Male (338)
Variable	n	(%)	n	(%)	n	(%)
Age group (1,444)
Under 40	830	57.5	643	58.5	184	54.4
40 years or older	614	42.5	456	41.5	154	45.6
Marital status (1,444)
With a partner	870	60.2	659	60.0	207	61.2
No partner	574	39.8	440	40.0	131	38.8
Race/color (1,440)*
White	402	27.9	297	27.0	100	29.9
Black	1,038	72.1	801	73.0	235	70.1
Time in the profession (1,437)*
Up to 10 years	620	43.1	480	43.9	140	41.5
More than 10 years	817	56.9	613	56.1	197	58.5
Weekly workload (1,444)
< 20 hours	605	41.9	488	44.4	116	34.3
21-40 hours	716	49.6	538	49.0	173	51.2
> 40 hours	123	8.5	73	6.6	49	14.5
Has another job (1,444)
No	726	50.3	618	56.2	104	30.8
Yes	718	49.7	481	43.8	234	69.2
Does remote work (1,444)
No	23	1.6	21	1.9	2	0.6
Yes	1,421	98.4	1078	98.1	336	99.4
How the choice of tool was made (1,444)
Joint decision	216	15.2	158	14.7	55	16.4
Decided alone	44	3.0	39	3.6	5	1.5
The institution indicated	1,161	81.7	881	81.7	276	82.1
They felt prepared to use the chosen tool (1,421)*
Yes	151	10.6	90	8.3	61	18.2
Partially	718	50.5	545	50.6	169	50.3
No	552	38.8	443	41.1	106	31.5
Training in the use of digital tools (1,416)*
Yes	806	56.9	602	56.1	201	60.0
No	610	43.1	472	43.9	134	40.0
Internet (1,410)*
Suitable	1,225	86.9	926	86.7	292	87.2
Inadequate	185	13.1	142	13.3	43	12.8
Computer (1,407)*
Suitable	1,221	86.8	913	85.6	301	90.1
Inadequate	186	13.2	153	14.4	33	9.9
Headset and microphone (1.393)*
Suitable	1,084	77.8	804	76.2	275	83.1
Inadequate	309	22.2	251	23.8	56	16.9
Furniture (1,398)*
Suitable	876	62.7	657	62.1	215	64.6
Inadequate	522	37.3	401	37.9	118	35.4
Physical space for work (1,410)*
Suitable	798	56.6	598	55.9	195	58.6
Inadequate	612	43.4	472	44.1	138	41.4
Noise level (1.411)*
Suitable	933	66.1	686	64.2	242	72.2
Inadequate	478	33.9	383	35.8	93	27.8
Interruptions (1,405)*
Suitable	998	71.0	735	69.1	257	76.7
Inadequate	407	29.0	328	30.9	78	23.3
Change in weekly time spent at work (1,418)*
None	132	9.3	97	9.0	34	10.1
Reduced	197	13.9	141	13.1	55	16.4
Increased	1,089	75.4	838	77.9	246	73.4
How do you feel about the new demands of remote activity (1,419)*
Prepared	189	13.3	105	9.8	82	24.4
Partially prepared	797	56.2	612	56.9	183	54.5
Unprepared	433	30.5	359	33.4	71	21.1
New work demands invading time devoted to other jobs (1,420)*
No	202	14.2	134	12.4	67	19.9
Yes	707	49.8	496	46.1	208	61.9
Only works one job	511	36.0	447	41.5	61	18.2
The new demands of work invade the time dedicated to daily activities, such as:
Rest or relaxation (1,405)*
No	277	19.7	204	19.2	72	21.5
Yes	1,128	80.3	859	80.8	263	78.5
Sleep (1,345)*
No	479	35.6	346	33.9	132	41.8
Yes	866	64.4	676	66.1	184	58.2
Food (1,307)*
No	688	52.6	500	50.6	185	59.1
Yes	620	47.4	488	49.4	128	40.9
Looking after yourself (1,373)*
No	409	29.8	289	27.7	119	37.0
Yes	964	70.2	755	72.3	203	63.0
Level of difficulty in carrying out teaching activities in the context of social distancing:
Communication with students (1,444)
Has no difficulty	381	26.4	280	25.5	99	29.3
Has difficulty	1,063	73.6	819	74.5	239	70.7
Planning and execution of distance activities (1,444)
Has no difficulty	378	26.2	269	24.5	108	32.0
Has difficulty	1,066	73.8	830	75.5	230	68.0
Use of the tools required to carry out the work (1,444)
Has no difficulty	434	30.1	301	27.4	132	39.1
Has difficulty	1,010	69.9	798	72.6	206	60.9
Organizing a schedule of activities in the home environment (1,444)
Has no difficulty	335	23.2	245	22.3	90	26.6
Has difficulty	1,109	76.8	854	77.7	248	73.4
Physical activity
Yes	589	40.8	419	38.1	167	49.4
No	855	59.2	680	61.9	171	50.6
Leisure activities
Yes	571	39.5	381	34.7	185	54.7
No	873	60.5	718	65.3	153	45.3
Smokes (1,444)
No	1,384	95.8	1066	97.0	314	92.9
Yes	60	4.2	33	3.0	24	7.1
Consume alcoholic beverages (1,444)
No	667	46.2	556	50.6	110	32.5
Yes	777	53.8	543	49.4	228	67.5
Domestic overload (1,444)
Low	919	63.6	634	57.7	279	82.5
High	525	36.4	465	42.3	59	17.5
Satisfaction with ability to work (1,444)
Satisfied	590	40.9	427	38.9	160	47.3
Dissatisfied	854	59.1	672	61.1	178	52.7
Satisfaction with interpersonal relationships (1,444)
Satisfied	598	41.4	462	42.0	134	39.6
Dissatisfied	846	58.6	637	58.0	204	60.4
Satisfaction with oneself (1,444)
Satisfied	623	43.1	465	42.3	155	45.9
Dissatisfied	821	56.9	634	57.7	183	54.1

Variable	Upper limb pain				Back pain
Variable	n	P(%)	PR	95%CI	n	P(%)	PR	95%CI
Gender
Male	201	59.5	1.00	-	190	56.2	1.00	-
Female	813	74.0	1.24	1.13;1.36	814	74.1	1.32	1.19;1.46
Age group
Under 40	576	69.4	1.00	-	625	75.3	1.00	-
40 years or older	444	72.3	1.04	0.97;1.11	384	62.5	0.83	0.77;0.89
Marital status
With a partner	613	70.5	1.00	-	610	70.1	1.00	-
No partner	407	70.9	1.01	0.94;1.07	399	69.5	0.99	0.92;1,06
Race/color
White	274	68.2	1.00	-	282	70.1	1.00	-
Black	742	71.5	1.06	0.98;1.14	725	69.8	0.99	0.92;1,07
Time in the profession
Up to 10 years	430	69.4	1.00	-	456	73.5	1.00	-
More than 10 years	584	71,5	1.03	0.96;1.10	547	67,0	0.91	0.85;0.97
Weekly workload
< 20 hours	425	70.2	1.00	-	425	70.2	1.00	-
21-40 hours	516	72.1	1.03	0.96;1.09	505	70.5	1.01	0.94;1.07
> 40 hours	79	64.2	0.91	0.79;1.05	79	64.2	0.91	0.79;1.05
Has another job
No	503	69.3	1.00	-	517	71.2	1.00	-
Yes	517	72.0	1.04	0.97;1.11	492	68.5	0.96	0.89;1.03
Does remote work
No	16	69.6	1.00	-	12	52.2	1.00	-
Yes	1,004	70.7	1.02	0.77;1.33	997	70.2	1.35	0.91;1.99
How the choice of tool was made
Joint decision	150	69.4	1.00	-	133	61.6	1.00	-
Decided alone	33	75.0	1.08	0.89;1.31	34	77.3	1.25	1.04;1.52
The institution indicated	821	70.7	1.02	0.93;1.12	830	71.5	1.16	1.04;1.29
I felt prepared to use the tool
Yes	99	65.6	1.00	-	87	57.6	1.00	-
Partially	496	69.1	1.05	0.93;1.19	488	68.0	1.18	1.02;1.36
No	409	74.1	1.13	0.99;1.28	422	76.4	1.33	1.15;1.53
Training in the use of tools
Yes	545	67.6	1.00	-	531	65.9	1.00	-
No	456	74.8	1.11	1.04;1.18	436	75.9	1.15	1.08;1.23
Internet
Suitable	851	69.5	1.00	-	841	68.7	1.00	-
Inadequate	146	78.9	1.14	1.06;1.24	149	80.5	1.17	1.08;1.27
Computer
Suitable	856	70.1	1.00	-	839	68.7	1.00	-
Inadequate	139	74.7	1.06	0.97;1.17	149	80.1	1.16	1.75;1.26
Headset and microphone
Suitable	747	68.9	1.00	-	722	66.6	1.00	-
Inadequate	240	77.7	1.13	1.05;1.21	258	83.5	1.25	1.18;1.34
Furniture
Suitable	587	67,0	1.00	-	562	64.2	1.00	-
Inadequate	400	76.6	1.14	1.07;1.22	419	80.3	1.25	1.17;1.34
Physical space for work
Suitable	542	67.9	1.00	-	509	63.8	1.00	-
Inadequate	453	70.6	1.09	1.02;1.16	480	78.4	1.23	1.15;1.31
Noise level
Suitable	630	67.5	1.00	-	597	64.0	1.00	-
Inadequate	367	76.8	1.14	1.06;1.22	394	82.4	1.28	1.21;1.37
Interruptions
Suitable	688	68.9	1.00	-	657	65.8	1.00	-
Inadequate	308	70.9	1.09	1.02;1.18	332	81.6	1.24	1.16;1,32

Variable	Upper limb pain				Back pain
Variable	n	P (%)	PR	95%CI	n	P (%)	PR	95%CI
Change in the amount of time spent at each week
None	81	61.4	1.00	-	67	50.0	1.00	-
Decreased	111	56.3	0.92	0.76;1.10	110	55.8	1.10	0.89;1.35
Increased	810	74.4	1.21	1.05;1.39	819	75.2	1.48	1.25;1.76
How do you feel about the new demands of remote activity?
Prepared	107	56.6	1.00	-	88	46.6	1.00	-
Partially prepared	554	69.5	1.23	1.07;1.40	552	69.3	1.48	1.27;1.75
Unprepared	341	78.8	1.39	1.22;1.59	355	82.0	1.76	1.50;2.06
New work demands invading time devoted to other jobs
No	114	56.4	1.00	-	98	48.5	1.00	-
Yes	524	74.1	1.31	1.15;1.49	530	75.0	1.54	1.33;1.79
New work demands invade the time dedicated to daily activities, such as:
Rest or relaxation
No	154	55.6	1.00	-	141	49.1	1.00	-
Yes	838	74.3	1.34	1.19;1.49	852	75.5	1.54	1.36;1.74
Sleep
No	278	58.0	1.00	-	264	55.1	1.00	-
Yes	675	77.9	1.34	1.23;1.46	693	80.0	1.45	1.33;1.58
Food
No	436	63.4	1.00	-	418	60.8	1.00	-
Yes	496	80.0	1.26	1.18;1.35	513	82.7	1.36	1.27;1.46
Self-care
No	243	75.8	1.00	-	223	54.5	1.00	-
Yes	731	59.4	1.28	1.17;1.39	748	77.6	1.42	1.29;1.56
Level of difficulty in carrying out teaching activities in the context of social distancing:
Communication with students
Has no difficulty	244	64.0	1.00	-	221	58.0	1.00	-
Has difficulty	776	73.0	1.14	1.05;1.24	788	74.1	1.28	1.16;1.40
Planning and execution of activities
Has no difficulty	245	64.8	1.00	-	221	58.5	1.00	-
Has difficulty	775	72.7	1.12	1.03;1.22	788	73.9	1.26	1.15;1.38
Use of the tools required to carry out the work
Has no difficulty	280	64.5	1.00	-	275	63.4	1.00	-
Has difficulty	740	73.3	1.14	1.01;1,23	734	72.7	1.14	1.06;1.24
Organizing a schedule of activities in the home environment
Has no difficulty	198	59.1	1.00	-	176	52.5	1.00	-
Has difficulty	822	74.1	1.25	1.14;1.38	833	75.1	1.43	1.28;1.59

Variable	Upper limb pain				Back pain
Variable	n	P (%)	PR	95%CI	n	P (%)	PR	95%CI
Physical activity
Yes	647	63.3	1.00	-	649	61.1	1.00	-
No	373	75.7	1.19	1.11;1.28	360	75.9	1.24	1.15;1.34
Leisure activities
Yes	678	59.9	1.00	-	664	60.4	1.00	-
No	342	77.7	1.29	1.20;1.39	345	76.1	1.26	1.17;1.36
Smokes
No	974	70.4	1.00	-	969	70.0	1.00	-
Yes	46	76.7	1.09	0.94;1.26	40	66.7	0.95	0.79;1.14
Consume alcoholic beverages
No	465	69.7	1.00	-	478	71.7	1.00	-
Yes	555	71.4	1.03	0.96;1.09	531	68.3	0.95	0.89;1.02
Domestic overload
Low	622	67.7	1.00	-	608	66.2	1.00	-
High	398	75.8	1.12	1.05;1.19	401	76.4	1.15	1.08;1.23
Satisfaction with ability to work
Satisfied	378	64.1	1.00	-	363	61.5	1.00	-
Dissatisfied	642	75.2	1.17	1.09;1.26	646	75.6	1.23	1.14;1.32
Satisfaction with interpersonal relationships
Satisfied	396	73.8	1.00	-	376	62.9	1.00	-
Dissatisfied	624	66.2	1.11	1.04;1.19	633	74.8	1.19	1.11;1.28
Satisfaction with oneself
Satisfied	393	63.1	1.00	-	378	60.7	1.00	-
Dissatisfied	627	76.4	1.21	1.13;1.30	631	76.9	1.27	1.18;1.37

Variable	Female		Male
	Upper limb pain
	RP*	95%CI	PR	95%CI
Increased time dedicated to work	1.19	1.08-1.32
Difficulty organizing the schedule	1.14	1.03;1.26
Works in more than one school	1.08	1.02;1.16
Leisure activities	0.85	0.78;0.92	0.72	0.60;0.86
Difficulty with students			1.33	1.06;1.67
Weekly workload greater than 20 hours			1.28	1.05;1.56
	Back pain
	PR	95%CI	PR	95%CI
Difficulty organizing the schedule	1.20	1.07;1.35	1.68	1.27;2.22
Noise			1.27	1.05;1.54
Interruption in remote work			0.78	0.65;0.94
Leisure activities			0.81	0.66;0.99
Age > 40 years	0.90	0.84;0.97	0.71	0.57;0.85
Feel unprepared for the new demands	1.07	1.02;1.14
Domestic overload	1.10	1.03;1.17
Difficulty with students	1.12	1.02;1.22
Increased time dedicated to work	1.28	1.15;1.43

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[TFN1001] *Response rates varied due to loss of information for the variables analyzed. Lost data was excluded from the analysis.