"The objective of this review is to establish whether the epidemiologic literature presents evidence of an association between psychosocial work factors and musculoskeletal disease. In a hypothetical model it is suggested that individual characteristics and stress symptoms can modify this relationship. The reviewed studies do not present conclusive evidence due to high correlations between psychosocial factors and physical load and to difficulties in measuring dependent and independent variables. Nevertheless, it is concluded that monotonous work, high perceived work load, and time pressure are related to musculoskeletal symptoms. The data also suggest that low control on the job and lack of social support by colleagues are positively associated with musculoskeletal disease. Perceived stress may be an intermediary in this process. In addition, stress symptoms are often associated with musculoskeletal disease, and some studies indicate that stress symptoms contribute to the development of this disease."

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