Prevalence and risk factors of thumb pain in Italian manual therapists: An observational cross-sectional study

BACKGROUND: Work-related musculoskeletal disorders (WMSDs) affect physical therapists with loss of health status and social costs. MSD is a relevant problem in upper limb extremities, especially when associated with manual techniques. OBJECTIVE: The study aims to investigate the prevalence and risk factors associated with thumb pain in Italian physiotherapists who perform manual therapy. METHODS: A self-administered questionnaire was sent by email, exploring demographics, thumb mobility, job, thumb pain, manual techniques, aggravating factors, management strategies and consequences of thumb pain. RESULTS: The survey was sent to 523 manual therapists, 219 of which fully completed it. 49.3% of respondents experienced thumb pain at least once in the previous 12 months and 70.8% at least once in their lifetime. Statistically significant associations suggest that within 12 months manual therapists with more than 5 years of experience are less likely to report thumb pain (6-10 years of work: OR = 0.408, 95% CI: 0.215-0.775; 11-20 years of work: OR = 0.346, 95% CI: 0.139-0.859), whereas those who performs trigger point pressure release (OR = 1.832, 95% CI: 1.005-3.340), trigger point ischemic compression (OR = 2.999, 95% CI: 1.184-7.597) and fascial neuro-connective manipulation (OR = 3.086, 95% CI: 1.346-7.077) are more likely to experience it. In terms of lifetime prevalence, female manual therapists and those who perform trigger point ischemic compression are more likely to suffer from thumb pain (females: OR = 2.569, 95% CI: 1.339-4.930; trigger point ischemic compression: OR = 2.878, 95% CI: 1.319-6.281). CONCLUSIONS: Special attention should be paid to prevention during manual skills training, since inexperience exposes manual therapist to a higher risk of developing thumb pain.