Patient-friendly summary
If you read nothing else
Bottom line
Evidence on whether teleworking causes musculoskeletal disorders is conflicting, though a possible rise in nonspecific pain (especially low back and neck) linked to poor ergonomics and work organization appears to emerge; the underlying studies are mostly low-quality and self-reported.
Preliminary evidencePublished
Evidence hierarchy
Study participants
Workers and students exposed to teleworking or working from home, mostly office workers under mandatory COVID-19 lockdown teleworking
Study Summary
This qualitative systematic review (PRISMA-guided) examined whether teleworking affects musculoskeletal disorders (MSD), drawing on 25 studies selected from 205 identified records. The findings were conflicting: some studies reported increased prevalence or intensity of musculoskeletal pain (most often low back and neck pain) during work-from-home periods, while others found no association. The authors note that an increase in nonspecific MSD linked to organizational and ergonomic factors appears to emerge, but the overall risk of bias was high — only 5 of 25 studies had low or probably low risk of bias, and most used cross-sectional designs. They conclude that longitudinal studies accounting for ergonomic, work-organization, and socioeconomic factors are needed.
Key Findings
| Finding | Detail | Impact |
|---|---|---|
| Evidence on teleworking and MSD is conflicting | Across the 25 included studies, some found increased prevalence or pain intensity during work-from-home periods or when comparing groups with different telework frequency, while others found no association between MSD and telework. | High |
| Low back pain and neck pain were the most reported MSD | Most articles inquired about pain from various body regions; the most reported musculoskeletal disorders were low back and neck pain, with some studies focusing specifically on neck pain or lower back pain. | High |
| Ergonomic and psychosocial factors appear to modify the effect | Certain ergonomic and psychosocial factors were associated with increased intensity or frequency of musculoskeletal pain; having an appropriate location to work from home with sufficient space and less demanding workloads decreased the effect of WFH on MSD. A study of workers with prior low back pain found increased pain during lockdown telework that was not significant among those with a dedicated workstation. | High |
| Overall risk of bias was high | Only 5 of the 25 studies had low or probably low risk of bias for the review-specific criteria (population representativeness and presence of a control group). Only 8 studies considered confounders in analyses, 6 extensively; only 7 had a control group. | High |
| All MSD outcomes were subjective, with no medical diagnoses | Outcomes were self-reported pain intensity, frequency, or change before/after lockdown; there were no medical diagnoses of conditions such as carpal tunnel syndrome or sciatica. Validated questionnaires (most often the Nordic Musculoskeletal Questionnaire) were used in nearly half the studies. | Medium |
| Almost all evidence comes from the COVID-19 pandemic context | All 25 studies were published during or after 2020, and only one used pre-pandemic data; the pandemic itself is a potential strong confounder, and most studies involved mandatory teleworking due to lockdowns. | Medium |
Across the 25 included studies, some found increased prevalence or pain intensity during work-from-home periods or when comparing groups with different telework frequency, while others found no association between MSD and telework.
Most articles inquired about pain from various body regions; the most reported musculoskeletal disorders were low back and neck pain, with some studies focusing specifically on neck pain or lower back pain.
Certain ergonomic and psychosocial factors were associated with increased intensity or frequency of musculoskeletal pain; having an appropriate location to work from home with sufficient space and less demanding workloads decreased the effect of WFH on MSD. A study of workers with prior low back pain found increased pain during lockdown telework that was not significant among those with a dedicated workstation.
Only 5 of the 25 studies had low or probably low risk of bias for the review-specific criteria (population representativeness and presence of a control group). Only 8 studies considered confounders in analyses, 6 extensively; only 7 had a control group.
Outcomes were self-reported pain intensity, frequency, or change before/after lockdown; there were no medical diagnoses of conditions such as carpal tunnel syndrome or sciatica. Validated questionnaires (most often the Nordic Musculoskeletal Questionnaire) were used in nearly half the studies.
All 25 studies were published during or after 2020, and only one used pre-pandemic data; the pandemic itself is a potential strong confounder, and most studies involved mandatory teleworking due to lockdowns.
Strengths
- Exhaustive search protocol across multiple databases (PubMed, Web of Science, Embase, Cairn, EBSCO, Google Scholar) with a librarian, plus cross-reference checking
- PRISMA-guided two-step selection with at least two independent reviewers and third-reviewer consensus for disagreements
- Formal risk-of-bias assessment using the Navigation Guide, with an added criterion specific to the review's aim (population representativeness and control group)
- Good geographic representation of included studies (Asia, Europe, America, Australia)
Limitations
- No quantitative pooling or grading of evidence was possible due to heterogeneous methods and bias among included studies
- High overall risk of bias — only 5 of 25 studies had low/probably low risk; most were cross-sectional, raising risk of reverse causation and differential reporting
- All MSD outcomes were subjective (self-reported pain), with no medical diagnoses
- Nearly all evidence is from the COVID-19 pandemic context, a potential strong confounder, with only one pre-pandemic dataset
- Only studies in English or French were included, and the lack of a 'Teleworking' MeSH term before 2021 may have missed earlier studies
Key Takeaways for Patients
What This Means for You
- 01Working from home does not automatically cause musculoskeletal pain — the research is mixed, and much depends on your setup and circumstances.
- 02Low back and neck pain are the complaints most often reported by people who work from home.
- 03A proper, dedicated workspace with enough room, a reasonable workload, and good ergonomics appears to reduce the impact of home working on pain.
- 04Long stretches of sitting with fewer breaks and less movement may add to the risk, so building in regular movement during the workday is sensible.
- 05Because most of this evidence is lower-quality and based on self-reported pain during the pandemic, conclusions should be viewed with caution.
Read the Full Paper
Access the complete peer-reviewed study from International Journal of Environmental Research and Public Health
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