Authors: Asmaa sobhy soliman , Fahad Almuzaini ,

Abstract

Background: Musculoskeletal pain (MSP) represents a major occupational health problem among nurses due to the substantial physical and psychosocial demands of nursing practice. Although numerous studies from Arab countries have investigated MSP among nurses, pooled regional evidence remains limited. We aimed to comprehensively evaluate the burden of musculoskeletal disorders among nurses in Arab countries by estimating pooled prevalence across different anatomical sites and summarizing associated occupational, psychosocial, and individual risk factors.

Methods: A systematic review and meta-analysis was conducted according to PRISMA guidelines. PubMed, Scopus, and Web of Science were searched from inception until May 2026. Random-effects meta-analyses were performed to estimate pooled prevalence rates with 95% confidence intervals (CIs). Heterogeneity was assessed using the I² statistic, while publication bias was evaluated using Doi plots and the Luis Furuya-Kanamori (LFK) index. Sensitivity analyses were conducted using a leave-one-out approach.

Results: Sixteen cross-sectional studies involving 3,467 nurses from seven Arab countries were included. Low back pain (LBP) was the most prevalent musculoskeletal complaint, with a pooled prevalence of 69% (95% CI: 64–73%), followed by upper back pain at 51% (95% CI: 43–59%), shoulder pain at 48% (95% CI: 27–69%), ankle/foot pain at 42% (95% CI: 37–47%), neck pain at 38% (95% CI: 21–57%), and knee pain at 34% (95% CI: 19–51%). Substantial heterogeneity was observed across most analyses. Frequently reported associated factors included prolonged working hours, manual patient lifting, frequent patient handling, work-related stress, lack of physical activity, poor sleep quality, female sex, older age, higher body mass index, and longer nursing experience.

Conclusion: Musculoskeletal pain is highly prevalent among nurses in Arab countries, particularly affecting the lower and upper back regions. The burden appears to be driven by a complex interaction of occupational, psychosocial, and individual risk factors. These findings highlight the urgent need for ergonomic interventions, safer patient-handling strategies, occupational health policies, and longitudinal regional research to reduce the burden of musculoskeletal disorders among nurses.

Keywords: Musculoskeletal pain, musculoskeletal disorders, nurses, low back pain, occupational health, Arab countries, prevalence, work-related musculoskeletal disorders, meta-analysis.