Efficacy of Ergonomic Interventions on Work-Related Musculoskeletal Pain: A Systematic Review and Meta-Analysis

Abstract

Background: Among the leading causes of work-related disability, musculoskeletal diseases (MSDs) profoundly affect productivity and quality of life. Workplace changes, equipment adjustments, and training courses, among other ergonomic interventions, seek to lower the frequency and degree of MSDs. This systematic review and meta-analysis evaluated whether ergonomic interventions help prevent and control MSDs in various workplace environments. Methods: A systematic search was conducted in PubMed, Scopus, Embase, Web of Science, and Cochrane Library to identify relevant studies. Inclusion criteria included randomized controlled trials (RCTs) that evaluated ergonomic interventions against conventional conditions. Effect sizes were computed using mean differences and pooled using a random-effects model in case of heterogeneity. A uniform Excel sheet was used for data extraction. Revman software (Cochrane Collaboration, Copenhagen, Denmark) was used for statistical analysis. Results: This meta-analysis included 24 RCTs with 4086 workers with different occupations. A meta-analysis of 10 included studies demonstrated lower pain intensity with a mean difference in VAS score between ergonomic interventions and the control group of -0.28 (95%CI: -0.43, -0.14, p = 0.0001). Also, there was a significant reduction in reported MSD-related pain in the lower back with ergonomic interventions with an OR 0.53 (95%CI: 0.40-0.70, p < 0.00001). Moreover, there were statistically significant results for ergonomic interventions in the upper back, ankles, wrists, and neck. In contrast, there were no significant improvements in the thighs, arms, knees, shoulders, and elbows. Conclusions: Our findings support implementing ergonomic strategies as a practical approach to reducing work-related MSDs. However, further research is needed to improve intervention design and long-term effectiveness.

Keywords: ergonomics; pain; work-related musculoskeletal disorders.

Figure 1

Study selection flow diagram. * Number of studies found in each database and total number in databases.

Figure 2

Risk of bias assessment of included studies [9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33].

Figure 3

Graph showing reported pain reduction in the lower back at the last follow-up [11,12,15,17,21,23,24,25,27].

Figure 4

Graph showing reported pain reduction in the upper back at the last follow-up [12,15,21,23,24,27].

Figure 5

Graph showing reported pain reduction in the neck at the last follow-up [12,15,17,21,22,23,24,25,26,27].

Figure 6

Graph showing a subgrouping analysis for neck pain reduction outcome based on population workplace to investigate heterogeneity among included studies [12,15,17,21,22,23,24,25,26,27].

Figure 7

Graph showing reported pain reduction in shoulders at the last follow-up [12,15,17,21,22,23,24,25,26,27].

Figure 8

Graph showing reported pain reduction in the elbow at the last follow-up [12,21,22,23,25,27].

Figure 9

Graph showing reported pain reduction in the arms at the last follow-up [15,22,27].

Figure 10

Graph showing reported pain reduction in wrists at the last follow-up [12,15,17,21,22,23,25].

Figure 11

Graph showing reported pain reduction in thighs at the last follow-up [12,15,21,23,27].

Figure 12

Graph showing reported pain reduction in knees at the last follow-up [12,15,21,23,27].

Figure 13

Graph showing reported pain reduction in ankles at the last follow-up [12,15,21,23,27].

Figure 14

Graph showing the mean difference in pain intensity scores between ergonomic interventions and the control group at the last follow-up [9,13,18,19,28,29,30,31,32,33].

Figure 15

Graph showing the mean difference in disability scores between ergonomic interventions and the control group at the last follow-up [11,13,29,30,31].

Figure 16

Funnel plot evaluating publication bias regarding pain intensity and disability scores.