Risk factors associated with the prevalence of neck and shoulder pain among high school students: a cross-sectional survey in China

BACKGROUND: After the COVID-19 outbreak, many Chinese high school students have increased their dependence on electronic devices for studying and life, which may affect the incidence of neck and shoulder pain (NSP) in Chinese adolescents. METHODS: To evaluate the prevalence of NSP in high school students and its associated risk factors during COVID-19, a survey was conducted among 5,046 high school students in Shanghai, Qinghai, Henan and Macao during the second semester and summer vacation of the 2019–2020 academic year. The questionnaire included questions regarding demographic characteristics, the prevalence of NSP and lifestyle factors such as sedentary behavior, poor posture and electronic device usage. Univariable and multivariable logistic regression was used to analyze the possible influencing factors for neck and shoulder pain. RESULTS: A total of 4793 valid questionnaires (95.0%) were collected. The results indicated that the prevalence of NSP was 23.7% among high school students. Binary logistic regression analysis revealed that female gender (P < 0.05, OR = 1.82), grade (P < 0.05, range OR 1.40–1.51) and subject selection (P < 0.05, range OR 0.49–0.68) were risk factors for NSP in high school students. Sedentary behavior (P < 0.05, range OR 1.74–2.36), poor posture (P < 0.05, range OR 1.19–2.56), backpack weight (P < 0.05, range OR 1.17–1.88), exercise style and frequency (P < 0.05, range OR 1.18–1.31; P < 0.05, range OR 0.76–0.79, respectively), and the time spent using electronic devices (P < 0.05, range OR 1.23–1.38)had a significant correlation with NSP in high school students. CONCLUSIONS: NSP is currently very common among high school students during the outbreak of COVID-19. Sedentary behavior, poor posture and other factors have a great impact on the occurrence of NSP in high school students. Education regarding healthy lifestyle choices should be advocated for to decrease NSP among high school students, such as more physical activity, changing poor postures and reducing the amount of time spent using electronic devices.