Musculoskeletal pain is a global health concern and work-related psychosocial stress might be a potential contributing factor. This cross-sectional study investigates whether job stress is associated with chronic and widespread musculoskeletal pain in 2,051 Brazilian active civil servants included in the ELSA-Brasil MSK cohort. Job stress was assessed using the Effort-Reward Imbalance (ERI) questionnaire. Associations between ERI domains, categorized into tertiles, and chronic musculoskeletal pain (CMP) at any site and per number of affected sites (0, 1-2, ≥3-multisite pain) and body regions (0, 1-2, 3-generalized pain), were investigated using binary and multinomial logistic regression, adjusted for sociodemographic, occupational and health covariates. The prevalence of CMP at any site, multisite and generalized was 52.9%, 18.2% and 9.5%, respectively. Following adjustments, the lower the reward and the greater the overcommitment, the higher the odds of CMP at any site. The ERI domains were more strongly associated with multisite and generalized CMP than with CMP at any site. Multisite CMP was associated with lower reward, and with greater effort, overcommitment, and effort-reward imbalance ratio. CMP according to body regions, especially generalized pain, was also associated with ERI domains effort (OR=2.06; 95%CI=1.33-3.21), overcommitment (OR=3.44; 95%CI=2.20-5.39), and effort-reward imbalance ratio (OR= 2.06; 95%CI=1.30-3.27). Results reveal an association between job stress not only with CMP at any site, but notably with the pain spread to other body sites/regions. Our findings suggest that lowering stress at work and discouraging overcommitment may help reduce the CMP burden including reduction of CMP spread from one sites/regions of the body to another.
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