Musculoskeletal symptoms and pain-response behaviors among university students in Palestine: a cross-sectional study.
- 1Department of Medicine, Faculty of Medicine and Allied Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- 2Department of Medicine, Faculty of Medicine and Allied Health Sciences, An-Najah National University, Nablus, 44839, Palestine. [email protected].
- 3Department of Scientific Research and Medical Projects, Faculty of Medicine and Allied Health Sciences, An-Najah National University, Nablus, 44839, Palestine. [email protected].
Abstract
Background
Musculoskeletal (MSK) symptoms are a major contributor to disability worldwide, and university students may be increasingly affected because of prolonged sedentary behavior, intensive digital-device use, and sustained academic workloads. In Palestine, these risks may be compounded by psychosocial stressors and constrained healthcare access. This study assessed the prevalence of MSK symptoms and hand discomfort and examined associated behavioral, ergonomic, and device-use factors among Palestinian university students.Methods
A cross-sectional study was conducted among 1,052 university students in the West Bank, Palestine, between February and April 2026. MSK symptoms were assessed using the Nordic Musculoskeletal Questionnaire, and hand discomfort was evaluated using the Cornell Hand Discomfort Questionnaire. Multivariable logistic and ordinal regression analyses were performed. Additional model diagnostics, false-discovery-rate correction, sparse-cell checks, and sex-weighted sensitivity analyses were conducted to assess model stability and the influence of the female-predominant sample.Results
Twelve-month prevalence was highest for neck (82.4%), shoulders (75.0%), lower back (73.4%), and upper back (65.8%) symptoms. Wrist/hand symptoms affected 49.7% of participants. Moderate pain was the most commonly reported severity level (56.3%). Female participants reported higher MSK symptom prevalence across most body regions. In ordinal regression, younger age, male sex, and shorter uninterrupted study sessions were associated with lower odds of higher pain severity. Continuing study activity without behavioral modification after pain onset was associated with higher odds of several regional symptoms, including upper back symptoms (aOR 9.21, 95% CI 2.91-29.22), although estimates involving pain-response categories were interpreted cautiously because of sparse cells and wide confidence intervals. In hand-pain models, preventive hand/neck stretching was associated with higher odds of hand pain, likely reflecting symptom-driven behavior rather than a harmful effect of stretching. Sex-weighted sensitivity analyses showed that the direction of the main adjusted associations was generally unchanged, although several marginal associations were attenuated after weighting.Conclusions
MSK symptoms were highly prevalent in this convenience sample of Palestinian university students and were associated with behavioral, ergonomic, and device-use factors. Because of the cross-sectional design and non-probability sampling, causal inference and population-level generalizability are limited. These findings may help inform university-based ergonomic education and behavioral strategies, while prospective and more representative studies are needed to clarify temporality and generalizability.
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BibTeX
@article{badawi2026musculoskeletal,
title = {{Musculoskeletal symptoms and pain-response behaviors among university students in Palestine: a cross-sectional study.}},
author = {Ahmed A Badawi and Obada R Al-Mashad and Mohammad Bdair and Mohammad A Badawi and Lana Malhis and Jana M Daraghmeh},
journal = {BMC public health},
year = {2026},
month = jul,
doi = {10.1186/s12889-026-28713-2},
url = {https://europepmc.org/article/MED/42897553},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Musculoskeletal symptoms and pain-response behaviors among university students in Palestine: a cross-sectional study.
AU - Ahmed A Badawi
AU - Obada R Al-Mashad
AU - Mohammad Bdair
AU - Mohammad A Badawi
AU - Lana Malhis
AU - Jana M Daraghmeh
PY - 2026
DA - 2026/07/01
JO - BMC public health
DO - 10.1186/s12889-026-28713-2
UR - https://europepmc.org/article/MED/42897553
AB - Background Musculoskeletal (MSK) symptoms are a major contributor to disability worldwide, and university students may be increasingly affected because of prolonged sedentary behavior, intensive digital-device use, and sustained academic workloads. In Palestine, these risks may be compounded by psychosocial stressors and constrained healthcare access. This study assessed the prevalence of MSK symptoms and hand discomfort and examined associated behavioral, ergonomic, and device-use factors among Palestinian university students.Methods A cross-sectional study was conducted among 1,052 university students in the West Bank, Palestine, between February and April 2026. MSK symptoms were assessed using the Nordic Musculoskeletal Questionnaire, and hand discomfort was evaluated using the Cornell Hand Discomfort Questionnaire. Multivariable logistic and ordinal regression analyses were performed. Additional model diagnostics, false-discovery-rate correction, sparse-cell checks, and sex-weighted sensitivity analyses were conducted to assess model stability and the influence of the female-predominant sample.Results Twelve-month prevalence was highest for neck (82.4%), shoulders (75.0%), lower back (73.4%), and upper back (65.8%) symptoms. Wrist/hand symptoms affected 49.7% of participants. Moderate pain was the most commonly reported severity level (56.3%). Female participants reported higher MSK symptom prevalence across most body regions. In ordinal regression, younger age, male sex, and shorter uninterrupted study sessions were associated with lower odds of higher pain severity. Continuing study activity without behavioral modification after pain onset was associated with higher odds of several regional symptoms, including upper back symptoms (aOR 9.21, 95% CI 2.91-29.22), although estimates involving pain-response categories were interpreted cautiously because of sparse cells and wide confidence intervals. In hand-pain models, preventive hand/neck stretching was associated with higher odds of hand pain, likely reflecting symptom-driven behavior rather than a harmful effect of stretching. Sex-weighted sensitivity analyses showed that the direction of the main adjusted associations was generally unchanged, although several marginal associations were attenuated after weighting.Conclusions MSK symptoms were highly prevalent in this convenience sample of Palestinian university students and were associated with behavioral, ergonomic, and device-use factors. Because of the cross-sectional design and non-probability sampling, causal inference and population-level generalizability are limited. These findings may help inform university-based ergonomic education and behavioral strategies, while prospective and more representative studies are needed to clarify temporality and generalizability.
SN - 1471-2458
ER -