Citation: Cezar-Vaz, M.R.; Xavier, D.M.; Bonow, C.A.; Vaz, J.C.; Cardoso, L.S.; Sant’Anna, C.F.; da Costa, V.Z.; Nery, C.H.C.; Alves, A.S.; Vettorello, J.S.; et al. Musculoskeletal Pain in the Neck and Lower Back Regions among PHC Workers: Association between Workload, Mental Disorders, and Strategies to Manage Pain. Healthcare 2023, 11, 365. https://doi.org/10.3390/ healthcare11030365 Academic Editors: Alberto Modenese and Fabriziomaria Gobba Received: 26 December 2022 Revised: 25 January 2023 Accepted: 26 January 2023 Published: 28 January 2023 Copyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). healthcare Article Musculoskeletal Pain in the Neck and Lower Back Regions among PHC Workers: Association between Workload, Mental Disorders, and Strategies to Manage Pain Marta Regina Cezar-Vaz 1, * , Daiani Modernel Xavier 1 , Clarice Alves Bonow 2 , Jordana Cezar Vaz 3 , Letícia Silveira Cardoso 4 , Cynthia Fontella Sant’Anna 4 , Valdecir Zavarese da Costa 5 , Carlos Henrique Cardona Nery 6 , Aline Soares Alves 7 , Joice Simionato Vettorello 7 , Jociel Lima de Souza 7 and Helena Maria Almeida Macedo Loureiro 8 1 School of Nursing, Federal University of Rio Grande, Rio Grande 96203-900, Brazil 2 Faculty of Nursing, Federal University of Pelotas, Pelotas 96010-610, Brazil 3 Institute of Dermatology Professor Rubem David Azulalay (Medical Residency), Rio de Janeiro 20020-020, Brazil 4 Department of Nursing, Federal University of Pampa, Uruguaiana 97501-970, Brazil 5 Department of Nursing, Federal University of Santa Maria, Santa Maria 97105-900, Brazil 6 Institute of Human and Information Sciences—ICHI, Federal University of Rio Grande—Santa Vitória do Palmar Campus, Santa Vitória do Palmar 96230-000, Brazil 7 School of Nursing (Ph.D. Program), Federal University of Rio Grande, Rio Grande 96203-900, Brazil 8 School of Health Sciences, Santiago University Campus, University of Aveiro (ESSUA), Aveiro 3810-193, Portugal * Correspondence: mrcezarvaz@gmail.com; Tel.: +55-053-3237-4618 Abstract: Scientific evidence indicates that workers in the health sector are commonly exposed to work-related musculoskeletal pain. Objectives: We aimed to identify the relationship between the presence and intensity of musculoskeletal pain in the neck and lumbar regions reported by Primary Health Care (PHC) workers with workloads and occupational risks, analyze musculoskeletal pain in the presence and absence of self-reported mental disorders based on a medical diagnosis, and identify workers’ strategies to manage pain. Method: This cross-sectional study addressed 338 health professionals working in PHC outpatient services in the extreme South of Brazil. One questionnaire addressed sociodemographic questions concerning occupation, occupational risks, and mental disorders. The Nordic Musculoskeletal Questionnaire was used to assess self-reported musculoskeletal pain. The National Aeronautics and Space Administration Task Load Index (NASA- TLX) measured the workload. A descriptive and inferential analysis was performed using SPSS version 21.0. Results: Most (55.3%) participants reported neck and (64.5%) lower back pain in the previous 12 months, and 22.5% and 30.5% reported intense neck and lower back pain, respectively, in the previous 12 months. The results showed different independent associations with increased musculoskeletal pain among health workers. Dentists presented the highest prevalence of neck pain, while female workers presented the highest prevalence of lower back pain. Furthermore, the perception of ergonomic risk and virtually all self-reported mental disorders (except panic syndrome for neck pain) were associated with pain in the neck and lower back regions and a higher frustration level (mental demand). Additionally, professionals with graduate degrees, nurses, and professionals working the longest in PHC services reported seeking complementary therapies more frequently, while physicians and those with self-reported mental disorders self-medicated more frequently. Keywords: health personnel; musculoskeletal pain; lower back pain; neck pain; working conditions; workload; mental disorders; primary health care Healthcare 2023, 11, 365. https://doi.org/10.3390/healthcare11030365 https://www.mdpi.com/journal/healthcare