Association of Shoulder Pain and Disability with Depression, Anxiety, and Stress Among Primary School Teachers

Abstract

Background: Shoulder pain and disability are common among primary school teachers and can contribute to mental health issues such as tension, nervousness, and feelings of discontent. Improving their physical and psychological well-being is crucial for enhancing teachers’ overall well-being and performance, ultimately benefiting students. Objective: To investigate the association between shoulder pain and disability with levels of depression, anxiety, and stress among primary school teachers. Methodology: An analytical cross-sectional study was conducted in government and private schools in Lahore, Pakistan. The study lasted six months from September 2024 to March 2025. The target population was primary school teachers aged 25 to 40 years with at least a bachelor’s degree and more than two years of experience, while teachers with diabetes, pregnancy, and recent upper-extremity fracture or surgery were excluded. A non-probability convenience sample of 379 teachers was used, with data collected through the shoulder pain and disability index and the depression, anxiety, stress scale. Data were gathered through structured protocols after approvals from the school and briefings, with 30-minute completion windows and on-site posture guidance. The study complied with the Helsinki Statement on Human Rights, obtaining informed, voluntary consent from all teachers and ensuring confidentiality and anonymity throughout. Analyses were performed in SPSS 26. The SPADI association was assessed using the Chi-square and Spearman’s rho. Results: The study sampled 379 teachers aged 25 to 40 years from government and private schools using non-probability convenience sampling. Findings show that 15% of the teachers reported severe pain and disability. Descriptive stats indicate a mean pain score of 32.49±26.52 and a mean disability score of 17.05±18.99. Total pain score % showed a strong positive correlation with the total disability score (r=0.681 and p-value≤0.00). Stress and anxiety scores had a very strong positive correlation (r=0.77 and p-value≤0.00). Total pain score % also showed a positive correlation with depression score (r=0.35 and p-value≤0.00). Higher pain and disability are associated with greater stress, anxiety, and depression. Conclusion: The study found a strong link between pain, disability, and mental health issues among teachers in Lahore. Higher pain and disability were associated with increased anxiety, depression, and stress.