Association between Musculoskeletal Pain and Gastrointestinal Symptoms among Medical Students in Peshawar: A Cross-Sectional Study
DOI:
https://doi.org/10.65761/pjcr.2025.2.2.26Keywords:
Musculoskeletal Pain, Gastrointestinal Diseases, Medical Students, Low Back Pain, Sedentary Behavior, PakistanAbstract
Background: Musculoskeletal pain (MSP) is a leading cause of disability worldwide and is increasingly recognized among medical students. Prolonged sitting, intensive study hours, and poor posture place students at heightened risk of lower back, neck, and shoulder pain. Emerging evidence also suggests a link between sedentary behavior and gastrointestinal (GI) symptoms, yet data from Peshawar, Pakistan, remain scarce. This study aimed to estimate the prevalence and severity of MSP and GI symptoms among medical students and examine their association.
Methods: Research was a multi-center cross-sectional study on 346 undergraduate students in three medical colleges in Peshawar. A structured questionnaire was administered to participants, and it included the Visual Analog Scale (VAS) of back pain, The Modified Nordic Musculoskeletal Questionnaire of musculoskeletal fatigue, and self-report GI symptom scale. Cronbach alpha was used to verify reliability by adjusting it to 0.70 or above. Means and standard deviations (means) or frequencies (percentages) were used to explain descriptive statistics and chi-square, t-tests, and binary logistic regression tests were used to determine associations. Any value that was below 0.05 was counted as significant.
Findings: Mean age was 22.5 ± 2.1 years; 56.1% were female. Based on VAS, 39.9% (95% CI: 34.7–45.2) reported mild, 45.1% (95% CI: 39.8–50.4) moderate, and 15.0% (95% CI: 11.3–18.7) severe back pain. Musculoskeletal fatigue was most frequent in the lower back (67.9%; 95% CI: 62.9–72.9), shoulders (41.9%; 95% CI: 36.7–47.2), and legs (35.0%; 95% CI: 30.0–40.0). Overall, 45.1% (95% CI: 39.8–50.4) reported at least one GI symptom, most commonly bloating (30.1%; 95% CI: 25.3–35.0), constipation (25.1%; 95% CI: 20.6–29.6), and indigestion (22.0%; 95% CI: 17.6–26.4). Students with severe back pain (VAS 7–10) had higher odds of reporting GI symptoms than those with mild/moderate pain (OR = 2.1; 95% CI: 1.4–3.1; p = 0.002).
Conclusion: Medical students in Peshawar exhibit a high burden of MSP and GI symptoms, particularly in the lower back, shoulders, and legs. Severe back pain is significantly associated with digestive complaints, suggesting that prolonged sitting and sedentary behaviors contribute to both musculoskeletal and gastrointestinal morbidity. Integrated wellness strategies—including ergonomic interventions, physical activity promotion, movement breaks, and stress management—are recommended to mitigate these coexisting health issues.
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Copyright (c) 2025 Syed Waqas Arshad, Luqman Khan, Hasnain Iqbal, Sujjad Khan (Author)
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