Abstract

Higher education students are prone to experience musculoskeletal issues, which can seriously impair both their general health and academic performance. The goal of this narrative review is to offer thorough insights into the prevalent musculoskeletal problems that this demographic faces, as well as their effect, risk factors, and possible management approaches. Long periods of sitting, bad posture, a lot of homework, not being physically active, and using electronics excessively are all factors that lead to Problems, especially lower back, shoulder, and neck pain. The review emphasizes how these illnesses affect people physically, psychologically, and academically. These effects include decreased focus, absenteeism, productivity, and quality of life. Furthermore, it has been determined that stress and mental health conditions are key variables that make symptoms worse. To reduce the hazards, emphasis is placed on efficient preventative and management tactics such ergonomic treatments, consistent exercise, posture instruction, and stress-reduction methods. In order to avoid chronicity and longterm disability, the review also emphasizes the significance of early identification and intervention. Even though more children are becoming aware of Problems, there is still a lack of awareness and prevention strategies being used in schools. In order to improve students’ musculoskeletal health and academic performance, this review advocates for integrated health promotion programs that address both physical and mental health components. To investigate targeted therapies and their long-term effectiveness in this population, more research is advised.

• 1.   Woolf, A.D., & Pfleger, B. (2003). Burden of major musculoskeletal conditions. Bulletin of the world health organization, 81(9), 646-656.
• 2.   Briggs, A.M., Cross, M.J., Hoy, D.G., SanchezRiera, L., Blyth, F.M., Woolf, A.D., & March, L. (2016). Musculoskeletal health conditions represent a global threat to healthy aging: a report for the 2015 World Health Organization world report on ageing and health. The Gerontologist, 56 (suppl_2), S243-S255.
• 3.   Kandasamy, G., Almanasef, M., Almeleebia, T., Orayj, K., Shorog, E., Alshahrani, A. M., ... & Almutairi, F. (2024). Prevalence of musculoskeletal pain among undergraduate students. Frontiers in Medicine, 11, 1403267.
• 4.   Mody, G.M., & Brooks, P.M. (2012). Improving musculoskeletal health: global issues. Best Practice & Research Clinical Rheumatology, 26(2), 237-249.
• 5.   Aljouhar, L., &Alzayed, M.A. (2024). Musculoskeletal Disorders Amongst Undergraduate Engineering Students at Kuwait University. Journal of Engineering Research.
• 6.   Wang, Y., Kim, Y.J., Moon, K.A., & Jeon, H.S. (2024). A Regression Analysis Study on the Presence of Pain in Specific Body Regions Based on Smartphone Usage Posture, Smartphone Addiction, Smartphone Usage Patterns. Physical Therapy Korea, 31(3), 250-261.
• 7.   Mastnak, W. (2020). Musculoskeletal Pain in Students Under COVID-19 Conditions–A Translational Meta-Synthesis for Personalised Rehabilitation. International Journal, 7, 17.
• 8.   Bradley, L.R. (2001). A healthy approach to classroom computers: Preventing a generation of students from developing repetitive strain injuries. NCL Rev., 80, 275.
• 9.   Osita, F.C., Chukwuemeka-Onuzulike, N.F., Olayinka, H.O., &Onyeizugbe, C.U. (2024). Ergonomic factors and performance of academics in public universities in Nigeria. Annals of Management and Organization Research, 6(2), 139-151.
• 10.   Huang, L., Yang, Z., Wang, R., & Xie, L. (2020). Physiological and biomechanical effects on the human musculoskeletal system while carrying a suspended-load backpack. Journal of Biomechanics, 108, 109894.
• 11.   Lee, J.C., Li, S.S., & Chow, D.H. (2021). School backpack design: A systematic review and a summary of design items. International Journal of Industrial Ergonomics, 84, 103166.
• 12.   Babakhani, F. (2011). The effect of backpack load on the posture of children and its relationship to trunk muscle activity during walking on a treadmill.
• 13.   Abdelaziz, R.A., AbdElnabi, H.A., Ali, M. M., & Elsayed, N.M. (2024). Prevalence of Musculoskeletal Problems and Its Relation to Psychological Distress among General Secondary Students Subjected to Online Learning. Zagazig Nursing Journal, 20(2), 385- 406.
• 14.   Sellschop, I.V. (2015). An evaluation of the effect of a computer-related participatory ergonomics intervention programme on adolescents in a school environment: A randomised controlled trial (Doctoral dissertation).
• 15.   Olaniyi, B.I. (2017). Ergonomic and Anthropometric Evaluation of Computer Laboratories in Universities in Oyo State, Nigeria (Doctoral dissertation, University of Ilorin (Nigeria)).
• 16.   El Ansari, W., Oskrochi, R., &Haghgoo, G. (2014). Are students’ symptoms and health complaints associated with perceived stress at university? Perspectives from the United Kingdom and Egypt. International journal of environmental research and public health, 11(10), 9981-10002.
• 17.   Saglietti, M., Marini, M., & Livi, S. (2024). In their narratives: academic socialization in the experience of sensory processing sensitivity among university students. Frontiers in Psychology, 15, 1448443.
• 18.   Gheysvandi, E., Dianat, I., Heidarimoghadam, R., Tapak, L., Karimi-Shahanjarini, A., & Rezapur-Shahkolai, F. (2019). Neck and shoulder pain among elementary school students: prevalence and its risk factors. BMC public health, 19(1), 1-11.
• 19.   Namwongsa, S., Puntumetakul, R., Neubert, M. S., & Boucaut, R. (2018). Factors associated with neck disorders among university student smartphone users. Work, 61(3), 367-378.
• 20.   Elnaffar, S., & El Allam, A. (2018, February). An app approach to correcting the posture of smartphone users. In 2018 Advances in Science and Engineering Technology International Conferences (ASET) (pp. 1-4). IEEE.
• 21.   Abdel-Aziem, A.A., Abdel-Ghafar, M.A.F., Ali, O.I., & Abdelraouf, O.R. (2022). Effects of smartphone screen viewing duration and body position on head and neck posture in elementary school children. Journal of Back and Musculoskeletal Rehabilitation, 35(1), 185-193
• 22.   Warda, D.G., Nwakibu, U., & Nourbakhsh, A. (2023, March). Neck and upper extremity musculoskeletal symptoms secondary to maladaptive postures caused by cell phones and backpacks in school-aged children and adolescents. In Healthcare (Vol. 11, No. 6, p. 819). MDPI.
• 23.   Parcells, C., Stommel, M., & Hubbard, R. P. (1999). Mismatch of classroom furniture and student body dimensions: empirical findings and health implications. Journal of adolescent health, 24(4), 265-273.
• 24.   McGill, S. (2015). Low back disorders: evidencebased prevention and rehabilitation. Human Kinetics.
• 25.   Tegtmeier, P. (2018). A scoping review on smart mobile devices and physical strain. Work, 59(2), 273-283.
• 26.   Banadaki, F.D., Rahimian, B., Moraveji, F., & Varmazyar, S. (2024). The impact of smartphone use duration and posture on the prevalence of hand pain among college students. BMC Musculoskeletal Disorders, 25(1), 574.
• 27.   Keeratisiroj, O., & Siritaratiwat, W. (2018). Prevalence of self-reported musculoskeletal pain symptoms among school-age adolescents: age and sex differences. Scandinavian Journal of Pain, 18(2), 273-280.
• 28.   Wijnhoven, H.A., De Vet, H.C., & Picavet, H. S.J. (2007). Sex differences in consequences of musculoskeletal pain. Spine, 32(12), 1360-1367.
• 29.   Ramos, E., Frontera, W.R., Llopart, A., & Feliciano, D. (1998). Muscle strength and hormonal levels in adolescents: gender related differences. International journal of sports medicine, 19(08), 526-531.
• 30.   Izquierdo, M., Hakkinen, K., Ibanez, J., Garrues, M., Antón, A., Zuniga, A., ... & Gorostiaga, E. M. (2001). Effects of strength training on muscle power and serum hormones in middle-aged and older men. Journal of applied physiology, 90(4), 1497-1507.
• 31.   Østerås, B., Sigmundsson, H., & Haga, M. (2015). Perceived stress and musculoskeletal pain are prevalent and significantly associated in adolescents: an epidemiological crosssectional study. BMC public health, 15, 1-10.
• 32.   Wurm, M., Anniko, M., Tillfors, M., Flink, I., & Boersma, K. (2018). Musculoskeletal pain in early adolescence: A longitudinal examination of pain prevalence and the role of peerrelated stress, worry, and gender. Journal of Psychosomatic Research, 111, 76-82.
• 33.   Kokic, I.S., Znika, M., & Brumnic, V. (2019). Physical activity, health-related quality of life and musculoskeletal pain among students of physiotherapy and social sciences in Eastern Croatia-Cross-sectional survey. Annals of Agricultural and Environmental Medicine, 26(1), 182-190.
• 34.   Ogunlana, M.O., Govender, P., & Oyewole, O.O. (2021). Prevalence and patterns of musculoskeletal pain among undergraduate students of occupational therapy and physiotherapy in a South African university. Hong Kong Physiotherapy Journal, 41(01), 35-43.
• 35.   Barbieri, D.F., Srinivasan, D., Mathiassen, S.E., Nogueira, H.C., & Oliveira, A.B. (2015). The ability of non-computer tasks to increase biomechanical exposure variability in computer-intensive office work. Ergonomics, 58(1), 50-64.
• 36.   da Silva Mota, J.A., Santos, R.M., & da Silva, I.M. The effect of a workplace physical activity intervention program on musculoskeletal pain and related symptoms in different body regions in Portuguese workers.
• 37.   Ghanbari, L., Khazaei, S., Mortazavi, S. S., Saremi, H., &Naderifar, H. (2022). The effect of online teaching on the prevalence of musculoskeletal pain in female students during the Covid-19 pandemic. Journal of Rehabilitation Sciences & Research, 9(1), 36-41.
• 38.   Guneş, S., Ulusoy, B.H., Aygen, E., Murat, E., Kokluoglu, B., Kuzyaka, B.A., ... & Kutlay, S. (2022). Musculoskeletal system pain and related factors during online education in the COVID-19 pandemic among Ankara university faculty of medicine students, Turkey.
• 39.   Salameh, M.A., Boyajian, S.D., Odeh, H. N., Amaireh, E.A., Funjan, K.I., & Al‐ Shatanawi, T.N. (2022). Increased incidence of musculoskeletal pain in medical students during distance learning necessitated by the COVID‐19 pandemic. Clinical anatomy, 35(4), 529-536.
• 40.   Rafiq, K., Mehboob, S., Khalid, A., Nesar, S., Khan, Z., Saad, S.M., ... & Ghafoor, B.A. (2024). The Ignorance of Ergonomics; Digital Lifestyle in COVID-19 Pandemic among University Students in Pakistan. Pak-Euro Journal of Medical and Life Sciences, 7(2), 299-306.
• 41.   Medona, R.S.D.L. V., Punitha, E.C., Bhuvaneswari, M.R., & Ponmalar, M. M. An Interventional Study on Effects of Mobile Screen Usage on Digital Eye Strain and Insomnia Among Prospective Teachers.
• 42.   SALMAN, M., Saltikov, J.B., Kandasamy, G., & Racero, G.A. (2024). Knowledge regarding ergonomics and posture, postural behaviour as well as incidence of musculoskeletal pain in university students in the Northeast of England: A web-based survey.
• 43.   GBD 2013 Risk Factors Collaborators. (2015). Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet (London, England), 386(10010), 2287.
• 44.   Kamalia, N., Pramita, I., &Antari, N.K. A.J. (2024). Prevalence and risk factors of musculoskeletal disorders among undergraduate students. Kinesiology and Physiotherapy Comprehensive, 3(2), 41-46.
• 45.   Ogunlana, M.O., Govender, P., & Oyewole, O.O. (2021). Prevalence and patterns of musculoskeletal pain among undergraduate students of occupational therapy and physiotherapy in a South African university. Hong Kong Physiotherapy Journal, 41(01), 35-43.
• 46.   Paananen, M.V., Taimela, S.P., Auvinen, J.P., Tammelin, T. H., Kantomaa, M. T., Ebeling, H.E., ... & Karppinen, J.I. (2010). Risk factors for persistence of multiple musculoskeletal pains in adolescence: a 2-year follow-up study. European Journal of Pain, 14(10), 1026-1032.
• 47.   Can, S., & Karaca, A. (2019). Determination of musculoskeletal system pain, physical activity intensity, and prolonged sitting of university students using smartphone. Biomedical Human Kinetics, 11(1), 28-35.
• 48.   Grimes, P., & Legg, S. (2004). Musculoskeletal disorders (MSD) in school students as a risk factor for adult MSD: a review of the multiple factors affecting posture, comfort and health in classroom environments. Journal of the HumanEnvironment System, 7(1), 1-9.
• 49.   Rana, M., & Shaheen Khanum, M.A. Association between Hours of Online Class Work and Musculoskeletal Problems among the Physiotherapy College Students in Delhi.
• 50.   Eldho, Z.C., & Muthukumar, K. (2022). Ergonomic Risk Assessment of Students in Digital Learning. In Advances in Behavioral Based Safety: Proceedings of HSFEA 2020 (pp. 161-177). Singapore: Springer Nature Singapore.
• 51.   Islam, S. (2023). Effect of postural awareness program on neck pain among the long time smartphone user of students (Doctoral dissertation, Bangladesh Health Professions Institute, Faculty of Medicine, the University of Dhaka, Bangladesh).
• 52.   Honan, M. (2015). Mobile work: Ergonomics in a rapidly changing work environment. Work, 52(2), 289-301.
• 53.   Binboğa, E., & Korhan, O. (2014). Posture, musculoskeletal activities, and possible musculoskeletal discomfort among children using laptops or tablet computers for educational purposes: A literature review. Journal of Science Education and Technology, 23, 605-616.
• 54.   Stacy, M. (2020). Assessment of Antebrachial and Carpal Muscle Activity During Smartphone Use: is “Selfie Wrist” a Real Phenomenon?.
• 55.   Proma, F.A. (2014). Joint kinematics, muscle activity and postural strain for finger-intensive operation of small hand-held devices.
• 56.   Fiebert, I., Kistner, F., Gissendanner, C., & DaSilva, C. (2021). Text neck: An adverse postural phenomenon. Work, 69(4), 1261-1270.
• 57.   Arndt, R. (1983). Working posture and musculoskeletal problems of video display terminal operators—review and reappraisal. American Industrial Hygiene Association Journal, 44(6), 437-446.
• 58.   Rai, A., &Agarawal, S. (2013). Back problems due to heavy backpacks in school children. IOSR J Hum Soc Sci, 10, 1-5.
• 59.   Perrone, M., Orr, R., Hing, W., Milne, N., & Pope, R. (2018). The impact of backpack loads on school children: A critical narrative review. International journal of environmental research and public health, 15(11), 2529.
• 60.   Vuori, I. (1995). Exercise and physical health: musculoskeletal health and functional capabilities. Research quarterly for exercise and sport, 66(4), 276-285.
• 61.   Vuori, I. (2004). Physical inactivity is a cause and physical activity is a remedy for major public health problems. Kinesiology, 36(2), 123- 153.
• 62.   Peterson, N.E., Osterloh, K.D., & Graff, M. N. (2019). Exercises for older adults with knee and hip pain. The Journal for Nurse Practitioners, 15(4), 263-267
• 63.   Abdelaziz, R.A., AbdElnabi, H.A., Ali, M.M., & Elsayed, N.M. (2024). Prevalence of Musculoskeletal Problems and Its Relation to Psychological Distress among General Secondary Students Subjected to Online Learning. Zagazig Nursing Journal, 20(2), 385-406.
• 64.   Behera, P., Majumdar, A., Verma, M., Kumarasamy, A.P., & Mishra, N. (2023). Musculoskeletal pain affecting undergraduate nursing students: A cross sectional study on
• 65.   Narainsamy, N. (2022). Upper body musculoskeletal pain associated with remote working of academics at the Durban University of Technology during the COVID-19 pandemic (Doctoral dissertation).
• 66.   Bobbett, J.J. (2001). School culture, teacher efficacy, and decision-making in demonstrably effective and ineffective schools. Louisiana State University and Agricultural & Mechanical College.
• 67.   National Research Council, Commission on Behavioral, Panel on Musculoskeletal Disorders, & the Workplace. (2001). Musculoskeletal disorders and the workplace: low back and upper extremities.
• 68.   Woolf, A.D., & Pfleger, B. (2003). Burden of major musculoskeletal conditions. Bulletin of the world health organization, 81(9), 646-656.
• 69.   Ragnarsson, S., Myleus, A., Hurtig, A. K., Sjöberg, G., Rosvall, P. Å., & Petersen, S. (2020). Recurrent pain and academic achievement in school-aged children: a systematic review. The Journal of School Nursing, 36(1), 61-78.
• 70.   Ho, H.Y.G. (2005). Cognitive functioning and academic achievement in children and adolescents with chronic pain.
• 71.   Heinrich, L.M., & Gullone, E. (2006). The clinical significance of loneliness: A literature review. Clinical psychology review, 26(6), 695-718.
• 72.   Arnold, L.M., Crofford, L.J., Mease, P.J., Burgess, S.M., Palmer, S.C., Abetz, L., & Martin, S.A. (2008). Patient perspectives on the impact of fibromyalgia. Patient education and counseling, 73(1), 114-120.
• 73.   Meleger, A.L., & Krivickas, L.S. (2007). Neck and back pain: musculoskeletal disorders. Neurologic clinics, 25(2), 419-438.
• 74.   Shuai, J., Yue, P., Li, L., Liu, F., & Wang, S. (2014). Assessing the effects of an educational program for the prevention of work-related musculoskeletal disorders among school teachers. BMC public health, 14, 1-9.
• 75.   Syazwan, A.I., Azhar, M.M., Anita, A.R., Azizan, H.S., Shaharuddin, M.S., Hanafiah, J. M., ... & Kasani, A. (2011). Poor sitting posture and a heavy schoolbag as contributors to musculoskeletal pain in children: an ergonomic school education intervention program. Journal of pain research, 287-296.
• 76.   Shinn, J., Romaine, K.A., Casimano, T., & Jacobs, K. (2002). The effectiveness of ergonomic intervention in the classroom. Work, 18(1), 67-73.
• 77.   Gallo, L.H., Gurjao, A.L., Prado, A.K., Ceccato, M., Goncalves, R., Gobbi, L.T., & Gobbi, S. (2012). Stretching Training, Maximum Muscle Strength and Flexibility, in the Elderly. Journal of Aging and Physical Activity, S264-S265.
• 78.   Csuhai, É.A., Nagy, A.C., Szőllősi, G.J., & Veres-Balajti, I. (2021). Impact analysis of 20- week multimodal progressive functional–proprioceptive training among sedentary
• 79.   Liu, A.M., Chu, I.H., Lin, H.T., Liang, J.M., Hsu, H.T., & Wu, W.L. (2021). Training benefits and injury risks of standing yoga applied in musculoskeletal problems: lower limb
• 80.   Karatrantou, K., Batatolis, C., Chatzigiannis, P., Vasilopoulou, T., Melissopoulou, A., Ioakimidis, P., & Gerodimos, V. (2023). An Enjoyable Workplace Combined Exercise Program for Health Promotion in Trained Employees: Yoga, Pilates, and Circuit Strength Training. Sports, 11(4), 84.
• 81.   Alami, A., Tehrani, H., Lael-Monfared, E., Moghaddam, F.S., Boghsani, G.T., & Jafari, A. (2020). Ergonomic factors of school bags and their adaptation to the weight of students. Work, 65(4), 809-820.
• 82.   Mackie, H. W. (2006). Schoolbag carriage: design, adjustment, carriage duration and weight: a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Ergonomics at Massey University, Palmerston North, New Zealand (Doctoral dissertation, Massey University).
• 83.   Mackie, H.W. (2006). Schoolbag Carriage: design, adjustment, carriage duration and weight. Massey University, New Zealand.
• 84.   Vate-U-Lan, P. (2015). Text neck epidemic: a growing problem for smart phone users in Thailand. International Journal of the Computer, the Internet and Management, 23(3), 551-556.
• 85.   Dolah, J., Yie, J.L. J., & Gee, L.L.S. (2020). Improving knowledge of text neck and neck pain using interactive smartphone application for undergraduate students in Universiti Sains Malaysia. Jurnal Gendang Alam (GA), 10.
• 86.   Flynn, D.M. (2020). Chronic musculoskeletal pain: nonpharmacologic, noninvasive treatments. American family physician, 102(8), 465-477.
• 87.   Crofford, L.J. (2015). Psychological aspects of chronic musculoskeletal pain. Best practice & research Clinical rheumatology, 29(1), 147-155.
• 88.   Larsen, A.K., Holtermann, A., Mortensen, O.S., Punnett, L., Rod, M.H., & Jørgensen, M.B. (2015). Organizing workplace health literacy to reduce musculoskeletal pain and
• 89.   Al Maini, M., Al Weshahi, Y., Foster, H.E., Chehade, M.J., Gabriel, S.E., Saleh, J.A., ... & Woolf, A.D. (2020). A global perspective on the challenges and opportunities in learning about rheumatic and musculoskeletal diseases in undergraduate medical education: white paper by the World Forum on Rheumatic and Musculoskeletal Diseases (WFRMD). Clinical rheumatology, 39, 627-642.

Data Sharing Statement

Funding