Psychosocial factors and biomechanical factors: what interaction?

R. Bonfiglioli,¹ F. Graziosi,¹ M. Ronchetti² | ¹Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna; ²Department of Medicine, Epidemiology, Occupational and Environmental Hygiene, INAIL, Italy

Introduction. The multifactorial nature of musculoskeletal disorders (MSDs) necessitates a preventive and management approach that considers the entire range of possible causes that can contribute to the onset of these conditions. The latest report from the European Agency on MSDs in Europe (2019)¹ highlights the importance of moving beyond the traditional approach focused primarily on the analysis of biomechanical factors and promoting training campaigns, guidelines, and practical tools to facilitate an integrated assessment that includes organizational and psychosocial risk factors. The importance of analyzing the close relationship that links MSDs to conditions that impact mental well-being also emerges.

Objectives. Illustrate the models that represent the role of biomechanical and psychosocial factors in the genesis of MSDs and their possible interactions. Discuss the potential and limitations of tools and strategies for risk assessment and the definition of intervention measures for the prevention of MSDs.

Methods. Analysis of scientific literature on the relationship between psychosocial and occupational biomechanical risk factors and their influence on the development of musculoskeletal disorders. Presentation of the results of a systematic review aimed at studying the phenomenon in relation to cervical and lumbar spine disorders, conducted as part of a research project in collaboration with INAIL (BRIC2019 ID 26).

Results and Conclusions. The importance of psychosocial factors alongside biomechanical ones in the onset of MSDs has been known for a long time. However, the progressive control of physical ergonomic factors and the rapid evolution of new forms of work have made the contribution of psychosocial factors more relevant as factors capable of both promoting the onset of such disorders and contributing to their chronicity and subsequent work disability. In the clinical setting, not just occupational, this aspect is evidenced by the increasing importance given to the role of psychosocial factors in the assessment of patients with musculoskeletal pain, such as in the guidelines for managing low back pain. There are various possible interactions between biomechanical and psychosocial factors: Variations in task demands can affect the level of muscle contraction, as well as the perception and reporting of DOMS (EU-OSHA, 2021).² One of the major critical issues that emerged is the lack of uniformity in tools used to assess exposure to both biomechanical and psychosocial factors. Similarly, the definition and classification of health effects can vary both in the method of collection (self-reported symptoms, diagnostic investigations) and in the different ability to capture aspects related to changes in physical and/or mental well-being. The need to promote the standardization of minimum criteria for integrated measurement of exposure to psychosocial and biomechanical factors, as well as the definition of possible health effects to be monitored, is emerging.