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Cardiovascular Disease Risk Factors Predict the Development and Numbers of Common Musculoskeletal Disorders

Background:  Previously reported risk factors for common musculoskeletal disorders (MSDs) have been low in magnitude and with unclear pathophysiological mechanisms.  
 
Methods:  Data from a nine-year prospective cohort were analyzed.  Baseline data included computerized questionnaires, structured interviews, physical examinations, anthropometric measurements, nerve conduction studies, and individualized measurement of job physical factors.  Framingham risk scores were calculated.  A priori case definitions were constructed for carpal tunnel syndrome, lateral epicondylopathy, medial epicondylopathy, and rotator cuff tendinopathy.  Monthly follow-ups were conducted to assess symptoms (development, resolution and/or treatments) and to perform physical examinations.  Nerve conduction studies were performed every 6 months if any new-onset paresthesias in the prior six-month interval were reported.    
 
Results:  The relative risk of four different MSDs increased with rising cardiovascular disease risk scores; adjusted relative risks for one or more MSD increased to 3.90 (95% CI, 2.20, 6.90) among those with 10-year cardiovascular risk scores above 15%.  The relative risk of multiple MSDs increased more strongly with rising cardiovascular disease risk; adjusted relative risk for four or more MSDs increased to 17.40 (95% CI, 3.85, 78.62) among those with 10-year cardiovascular risk scores above 15%.  
 
Conclusions: Cardiovascular disease risk factors are strongly associated with the subsequent development of common MSDs.  Risks among those with multiple MSDs are considerably stronger.  Further investigations of this new potential line of prevention are needed, as well as the utility of these MSDs to identify the development of silent coronary artery disease. 
 
Funding Statement: This work was supported, in part, by grants from the National Institute for Occupational Safety and Health (NIOSH/CDC) grant 1R01OH010474–01 and NIOSH Education and Research Center training grant T42/CCT810426–10. 
 
Declaration of Interests: The authors declare that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript. 
 
Ethics Approval Statement: Institutional review boards of the University of Utah, University of Wisconsin-Milwaukee and Medical College of Wisconsin approved this study.