Association Between Internet Addiction and the Risk of Musculoskeletal Pain in Chinese College Freshmen - A Cross-Sectional Study

Background: It is well established that increased Internet use is related to an increased risk of musculoskeletal pain among adolescents. The relationship between Internet addiction (IA), a unique condition involving severe internet overuse, and musculoskeletal pain has, however, not been reported. This study aimed to investigate the association between IA and the risk of musculoskeletal pain among Chinese college students. Methods: A cross-sectional study was conducted among 4211 Chinese college freshmen. IA status was evaluated using the 20-item Young's Internet Addiction Test (IAT). IA was defined as internet addiction score >= 50 points. Musculoskeletal pain was assessed using a self-reported questionnaire. Multiple logistic regression analysis was performed to determine association between IA categories (normal, mild, and moderate-to-severe) and musculoskeletal pain. Results: Among all participants; neck, shoulder, elbow, wrist/hand, and low back and waist pain was reported by 29.2, 33.9, 3.8, 7.9, and 27.9%, respectively. The prevalence of IA was 17.4%. After adjusting for potential confounders, the results showed significant differences in the risk of musculoskeletal pain among different IA categories. The odds ratios (ORs) and 95% confidence intervals (CI) for neck pain with IA categories were 1.000 (reference), 1.451 (1.221, 1.725), and 1.994 (1.608, 2.473), respectively (P for trends: < 0.001). For shoulder pain, these were 1.000 (reference), 1.520 (1.287, 1.795), and 2.057 (1.664, 2.542), respectively (P for trends: < 0.001). For elbow pain, ORs (95% CIs) were 1.000 (reference), 1.627 (1.016, 2.605), and 2.341 (1.382, 3.968), respectively (P for trends: 0.001). Those for wrist/hand pain were 1.000 (reference), 1.508 (1.104, 2.060), and 2.236 (1.561, 3.202), respectively (P for trends: < 0.001). For low back and waist pain with severe IA categories, these were 1.000 (reference), 1.635 (1.368, 1.955), and 2.261 (1.813, 2.819), respectively (P for trends: < 0.001). Conclusion: This cross-sectional study showed that severe IA was associated with a higher risk of musculoskeletal pain in Chinese college freshmen. In future research, it will be necessary to explore causality regarding this relationship using interventional studies.