Musculoskeletal pain among final-year undergraduates at the University of Colombo: Prevalence and association with stress and body mass index

Background & Aim: Musculoskeletal pain is a leading cause of long-term functional impairments globally, increasingly affecting younger populations due to sedentary lifestyles and academic stress. Despite growing international research, limited data exist on the interrelationship between musculoskeletal pain and stress among undergraduates in Sri Lanka. This study aims to determine the prevalence and distribution of musculoskeletal pain among final-year students at the University of Colombo and to assess its associations with stress level, body mass index (BMI), and musculoskeletal pain.
Methods: A cross-sectional analytical study was conducted among 420 final-year undergraduates across five faculties of the University of Colombo. Musculoskeletal pain was assessed using the Standardized Nordic Musculoskeletal Questionnaire (SNMQ), while stress level was evaluated using a modified Student Life Stress Inventory (SLSI). BMI was calculated based on height(kg) and weight(m) (kg/m²). Data were analysed by descriptive statistics and inferential statistical tests including Pearson correlation test using SPSS version 26.
Results: The 12-month and 7-day point prevalence of musculoskeletal pain were 82.1% and 64.5%, respectively. The lower back (48.8%), neck (46.7%), and upper back (42.4%) were the most affected regions, with 49.3% reporting interference with daily activities. Medical students showed the highest musculoskeletal pain prevalence (91.8%). A significant association was observed between stress level and musculoskeletal pain in the neck, shoulders, upper and lower back (p<0.05). BMI was significantly associated with lower back (p =0.018) and knee pain (p = 0.047). Females reported higher stress levels, especially in response to academic changes and pressures.
Conclusions & Recommendations: Musculoskeletal pain is highly prevalent among final-year undergraduates at the University of Colombo, with stress emerging as a key contributor, particularly to axial pain. Context-specific interventions combining ergonomic and psychological strategies are essential to address this dual burden.