BMI as a suboptimal predictor of musculoskeletal pain among academic health professionals: A cross-sectional institutional study

Background: Many studies have used Body mass index (BMI) as an important risk factor for musculoskeletal pain. However, its validity remains questionable, with debate over the relative contributions of adiposity and muscle mass. This study aims to evaluate BMI a predictor of MSK pain among academic health staff.
Methods: This is a cross-sectional institutional study conducted at Al Mustaqbal University in Babylon, Iraq. 150 academic staff from the medical and health departments have been involved in the study. MSK pain was evaluated using the Arabic version of the Nordic Musculoskeletal Questionnaire. BMI was categorized according to the WHO classification. Logistic regression and Spearman correlation were used to investigate the association between BMI and MSK pain. 
Results: The prevalence of 12-Month MSK pain was 80%. An inverse relationship was noticed between normal-weight participants, who reported the highest pain prevalence (84.3%) compared to overweight (89.1%) and obese (67.9%) participants (p = 0.020). Multivariable logistic regression showed a non-significant association between BMI and MSK pain. In comparison, clinical job role emerged as the strongest independent predictor of MSK pain (adjusted OR = 2.61, 95% CI: 1.08–6.32, p = 0.033). Neck pain was significantly more prevalent among normal-weight participants (64.7% vs. 21.7% among overweight participants, p < 0.001).
Conclusion: BMI was not a significant independent predictor of MSK pain in this study. Clinical-related academic job roles involving repetitive tasks and prolonged abnormal postures are independently related to high BMI