Screen Time, Sitting Time, Physical Activity, and Multisite Musculoskeletal Pain in University Students: Implications...

Background/Objectives: This cross-sectional study examined whether daily screen time, sitting time, and physical activity were associated with musculoskeletal pain-site count among university students. Methods: A total of 255 students aged 18-25 years were included. Musculoskeletal pain during the previous 12 months was assessed in nine anatomical regions using the Extended Nordic Musculoskeletal Questionnaire. The primary outcome was pain-site count. Poisson regression with robust standard errors was used for the primary analysis, and region-specific outcomes were examined using multivariable logistic regression. Results: Multisite pain was reported by 81 students (31.8%). The most common pain regions were the neck (29.0%), lower back (25.9%), and shoulder (22.7%). In the adjusted Poisson model, each additional hour of daily screen time was associated with a 10% higher pain-site count (IRR = 1.10, 95% CI: 1.04-1.15), and each additional hour of sitting time was associated with a 7% higher pain-site count (IRR = 1.07, 95% CI: 1.03-1.11). Higher physical activity was associated with a lower pain-site count (IRR = 0.93 per 1000 MET-min/week, 95% CI: 0.88-0.98). Female sex and younger age were also associated with higher pain-site count. In region-specific analyses, screen time was associated with neck pain, whereas sitting time was associated with lower back, shoulder, and upper back pain. Conclusions: Musculoskeletal pain burden in university students was associated with multiple movement-related behaviors. These findings may inform screening and future longitudinal or intervention studies addressing screen use, sitting time, and physical activity.