A Cross-Sectional Survey on Musculoskeletal Pain Among Professional an

Introduction

Over the previous 5 a long time, the digital gaming business has quickly expanded, changing into a major cultural and financial drive worldwide. Since the launch of early consoles just like the Atari 2600 in 1977, gaming has reworked right into a pervasive type of leisure and competitors.¹ However, alongside these developments, considerations about potential unfavorable well being outcomes—significantly relating to musculoskeletal (MSK) well being—have emerged. Increasing proof means that extended gaming periods, mixed with poor ergonomics and sedentary conduct, are related to a excessive burden of MSK ache throughout ages and ranges of play.²

Consistent with this, a latest assessment discovered that almost all research determine gaming as related to MSK complaints.³ International knowledge likewise present excessive charges of 77.8% MSK ache in players.⁴ In line with the worldwide image, in Saudi Arabia, a latest survey reported MSK ache in 86.2% of aggressive players.⁵

Gamers generally expertise MSK ache within the neck, decrease again, shoulders, higher again, and wrists/palms. This ache is related to extended static postures similar to forward-head posture, repetitive actions like mouse clicks and keystrokes, and poor ergonomics associated to watch and desk peak, which might worsen the chance of pressure and damage.⁶ Additionally, private traits similar to gender and age appear to affect susceptibility to MSK ache. Female players, as an illustration, are likely to report larger ache charges, doubtlessly as a consequence of organic, psychosocial, and ergonomic elements.^5,7 Moreover, prolonged gaming length has been linked to elevated MSK ache in each genders.^8,9 Age and way of life elements, similar to sedentary behaviors frequent amongst older adults and people in superior academic or occupational roles, might additional exacerbate the chance of MSK ache.^2,10

In addition to non-public elements, particular gaming-related variables additionally play a important position within the improvement of MSK ache. For occasion, a latest examine of smartphone-based play-to-earn players confirmed excessive charges of MSK issues, suggesting that each the gaming platform and goal can affect threat.¹¹ Competitive standing might have an effect on MSK ache threat, with skilled players experiencing better pressure as a consequence of longer and extra structured coaching routines.⁵ In distinction, non-professional players usually have decrease publicity. Studies spotlight that structured coaching in esports will increase MSK threat, supporting the necessity to assess variations between gamer subgroups to develop tailor-made ergonomic and preventive methods.⁸ Moreover, system sort has emerged as a key determinant, with desktop and laptop computer customers continuously reporting decrease again ache, whereas smartphone and pill customers extra generally expertise neck and shoulder discomfort as a consequence of poor posture.³ Virtual actuality (VR) gaming additionally presents distinctive ergonomic challenges; extended standing and repetitive head and neck actions in VR environments have been linked to larger charges of decrease again and neck ache.^12,13 When contemplating sport genres, sure sorts—similar to puzzle video games—might contribute to localized MSK discomfort as a consequence of extended high-quality motor engagement and static posture necessities.¹⁴ Such genres typically require sustained hand positioning or mouse use, which might stress particular muscle teams and joints.Recent literature highlights how repetitive high-quality motor actions, significantly in puzzle video games, can result in tendinopathy and localized ache. In distinction, motion-controlled and sports-racing video games have been related to shoulder and higher limb pressure as a consequence of their repetitive and forceful motion calls for.¹⁵

Given the rising reputation of gaming and accumulating proof of its potential well being impacts, a extra detailed understanding of MSK ache contributors amongst players is warranted. Previous analysis has largely centered on remoted elements and particular populations,^5,8,10 leaving gaps in our understanding of how private traits and gaming habits work together to have an effect on MSK outcomes. This situation is especially related in Saudi Arabia, the place gaming has expanded quickly and nationwide coverage has made esports a strategic precedence; development and governance are being actively steered to place the Kingdom as a world hub,¹⁶ but the well being implications stay under-investigated. To handle this hole, the present examine investigated the prevalence and places of MSK ache amongst Saudi players and examined its predictors, specializing in how demographic and gaming-related variables—similar to sport style, system sort, gaming length, {and professional} gaming standing—contributed to ache outcomes. We hypothesized that sure variables, significantly skilled gaming standing and particular sport genres, would considerably predict larger MSK ache prevalence as a consequence of extended publicity, repetitive actions, and insufficient ergonomic situations. We additional hypothesized that the neck and higher limbs would display better ache prevalence in comparison with different physique areas, given their steady involvement in frequent gaming actions.

Materials and Methods

Research Design and Sampling

This analytic cross-sectional descriptive examine was carried out utilizing a self-administered web-based questionnaire designed with Microsoft Forms between February and April 2024. The examine included grownup players (≥18 years) in Saudi Arabia, each skilled and leisure players of all genders. Individuals with a historical past of fractures up to now six months, pre-existing medical situations, surgical historical past, bodily disabilities, or cognitive impairments had been excluded from the examine.

Professional players had been outlined as people formally registered with the Saudi Esports Federation who compete for awards and financial prizes. While non-professional players participated in gaming purely for leisure with none formal aggressive affiliation.

A non-probability comfort sampling methodology was employed, and the required pattern dimension was decided to be 384 individuals primarily based on OpenEpi, making certain a 5% margin of error at a 95% confidence stage.

Participants had been invited by means of Email and WhatsApp. Professional players had been contacted utilizing data obtained from the Saudi Esports Federation (SEF) registry, whereas non-professional players had been invited by means of the dissemination of the questionnaire through social media platforms.

Data Collection Tool

Data had been collected by means of a web-based questionnaire comprising two major parts. The first part centered on demographic data and gaming traits. Participants supplied background knowledge similar to age, gender, training stage, occupation, and marital standing. The frequency of digital gaming per week, common day by day gaming time, registration with the SEF, participation in native or nationwide tournaments, the kinds or genres of digital video games performed, and the gadgets used for gaming (eg, smartphones, consoles, or PCs). To guarantee content material validity, the survey was reviewed by three specialists in musculoskeletal well being and gaming conduct and piloted with 5 individuals to evaluate readability, circulation, and the performance of branching logic. Professional players reported each aggressive and leisure sport genres to mirror their full vary of gaming exercise.

The second part of the questionnaire featured the Extended Nordic Musculoskeletal Questionnaire (NMQ-E), utilized to evaluate MSK ache. The Arabic model of the NMQ-E was employed on this examine, with prior permission obtained from the unique authors.¹⁷ The NMQ-E assessed musculoskeletal ache throughout 9 anatomical areas: neck, higher again, decrease again, shoulder, elbow, hand/wrist, hip, knee, and ankle/foot.¹⁸ A physique map diagram was included to help individuals in precisely figuring out ache places. The questionnaire measured ache prevalence at 4 closing dates: lifetime, annual, month-to-month, and level prevalence, whereas additionally analyzing the implications of ache, similar to interference with work, healthcare visits, remedy use, absenteeism, and hospitalization. Response choices had been binary (“yes” or “no”). The NMQ-E has demonstrated sturdy reliability and validity in evaluating musculoskeletal signs and their penalties.¹⁸ The Arabic model has additionally proven robust content material and assemble validity, together with excessive test-retest reliability.¹⁸ Furthermore, lifetime prevalence responses had been numerically coded (1 for “Yes,” 0 for “No”) to compute a complete rating that displays the variety of painful physique websites.

Statistical Analysis

Statistical evaluation was performed utilizing SPSS software program (model 27.0). Descriptive outcomes are offered as means ± customary deviation (SD) and in percentages. For the affiliation evaluation, physique areas with a prevalence of MSK ache of 20% or larger—particularly the neck, higher again, decrease again, shoulders, and wrists/palms—had been chosen for additional examination. The associations amongst categorical variables, together with gender, system sort, prize positive factors, and varieties of video games performed, had been evaluated utilizing Pearson’s chi-square take a look at (X²). The impact dimension was measured utilizing Cramér’s V Phi coefficient (φ) for categorical associations and interpreted in line with established pointers. Where associations had been recognized, odds ratios (OR) with 95% confidence intervals (CI) had been calculated. Eta was used to evaluate the connection between categorical and interval variables, with interpretation primarily based on standard cutoffs reported within the literature.¹⁹ Binary logistic regression evaluation was performed to find out the predictive worth of the chosen demographic and gaming-related elements on MSK ache outcomes, adjusting for potential confounders. Three fashions had been performed for every physique area: Model 1 (unadjusted) analyzed every predictor individually with out covariate adjustment; Model 2 (age- and gender-adjusted) included solely age and gender as predictors to evaluate their impartial results; and Model 3 (totally adjusted) concurrently included all predictors—age, gender, gaming publicity, system sort, and sport genres—inside a multivariable mannequin. In these fashions, age was handled as a steady variable, and gender was entered as a binary categorical variable (male = 0, feminine = 1). Relevant demographic and gaming-related variables had been entered into the multivariable regression mannequin to look at their associations with musculoskeletal ache. A subgroup comparability between skilled and non-professional male players was performed to account for gender confounding, as all skilled players within the pattern had been male and gender was recognized as a major predictor of MSK ache. The significance stage was set at a p-value of <0.05.

Ethical Considerations

This examine complies with the Declaration of Helsinki. All individuals supplied knowledgeable consent at the beginning of the survey, making certain confidentiality and safety. The examine acquired moral approval from the Institutional Review Board at Princess Nourah Bint Abdulrahman University, which was granted (IRB: 24–0490).

Results

In this examine, a complete of 641 people had been approached, with 593 individuals included within the evaluation. The remaining 48 respondents had been excluded for numerous causes: 14 selected to not take part, 9 had been disqualified as a consequence of age, 15 had a historical past of musculoskeletal accidents up to now six months, 7 had undergone latest surgical procedures, and three didn’t have interaction in digital gaming (Figure 1).

Figure 1 Flow Chart of Inclusion and Exclusion of the Study.

Demographics

The current study involved 593 participants, the majority of whom were male (71.3%), with an average age of 25.70± (8.980) years. Most participants primarily resided in the Central Region (65.3%). As illustrated in Table 1, a good portion of the individuals held a bachelor’s diploma (67.8%), with half figuring out as college students (50.4%), and a big majority being single (80.8%).

Table 1 Demographics and Gaming Behavior

The study also explored the characteristics of the gamers. Among the participants, 43.7% reported involvement in local or national tournaments, while 30.9% indicated they had won prizes. Additionally, 37.4% were registered with the Saudi Esports Federation as members of a team. When it came to preferred gaming devices, most players (33.4%) used personal computers. In terms of input devices, a substantial number of gamers (55.3%) favored controllers. Notably, 58.2% of players reported gaming for more than four hours each day, with the average gaming duration among participants being 4.83±2.07 hours. Moreover, First Person Shooters (FPS) are the most popular genre (65.1%). This is followed by Competitive (33.7%) and Sports/Racing (33.1%). Role-Playing Games (RPGs) and Card/Board also show notable popularity (28.3% and 28.2%, respectively). (Table 1).

Prevalence and Consequences of Musculoskeletal Pain

The majority of examine individuals reported experiencing MSK ache in no less than one physique area, particularly 78.2%, with a better prevalence noticed amongst females (86.47%) in comparison with males (74.95%). The most continuously affected areas of MSK ache over a lifetime included the neck (49.4%), decrease again (40.0%), shoulder (29.7%), higher again (25.3%), and hand/wrist (24.5%). The neck additionally had the longest length of reported ache, averaging 4.6 years, adopted carefully by the shoulder and decrease again, each with a median length of 4.4 years (Table 2). Participants reported a variety of affected physique areas as a consequence of MSK ache, various from one to 9, with the bulk experiencing ache in both one (22.3%) or two (18.5%) areas.

Table 2 Prevalence of Musculoskeletal Pain by Period for Each Region

Table 3 illustrates the affect of MSK ache amongst individuals. While hospitalization charges as a consequence of musculoskeletal ache had been comparatively low, knee ache was essentially the most continuously reported at 8.8%, adopted carefully by elbow ache at 8.3%. The impact of musculoskeletal ache on exercise and participation was significantly important for ankle and foot ache (52.3%), adopted by knee ache (49.5%) and neck ache (43.9%). Additionally, the interference of ache with day by day dwelling actions was notably reported for neck ache (33.9%), knee ache (30.1%), and ankle/foot ache (29.2%). Visits to healthcare practitioners (HCPs) as a consequence of MSK ache had been predominantly related to ankle/foot points (29.2%), neck issues (23.8%), and knee ache (20.3%). Furthermore, the necessity for remedy to handle MSK ache was most linked to ankle/foot ache (29.2%), neck ache (26.7%), and hip ache (25.7%).

Table 3 Prevalence of Musculoskeletal Pain Consequences for Each Region

The Association Between Musculoskeletal Pain and Personal or Gaming Factors

Correlation analysis between pain location and participant demographics uncovered several statistically significant associations (Table 4).

Table 4 Association of Pain Location and Sample Characteristics

Gender was significantly associated with MSK pain. For neck pain, a significant association and large effect size was observed (χ²=15.973, df=1, p<0.001, V=0.16); with males had lower odds (OR = 0.478, 95% CI [0.332, 0.689]). A similar pattern was observed for wrist/hand pain, with a significant association (χ²=12.053, df=1, p=0.001; V=0.14). Males had lower odds of experiencing wrist/hand pain (OR=0.500, 95% CI 0.337–0.724). Additionally, shoulder pain showed a significant association with sex and a moderate effect size, with females more likely than males to report shoulder pain (χ²=39.317, df=1, p<0.002; V=0.13).

When evaluating the impact of age on MSK pain, the results indicate a moderate relationship between age and pain in the shoulder and lower back, with Eta values of 0.374 and 0.313, respectively. A weak-to-moderate relationship was identified between age and neck pain, reflected by an Eta value of 0.291. Furthermore, a relatively weak relationship was noted between age and pain in the upper back, hands, upper limbs, and back, with Eta values of 0.235, 0.264, 0.254, and 0.268, respectively.

In addition, significant associations were found between MSK pain and gaming-related variables. The type of device used was associated with shoulder pain (X² = 22.386, df = 1, p <0.001, V = 0.19). Prizes won demonstrated a moderate association with neck pain (X² = 9.959, df = 1, p =0.002, V = 0.13) and a strong association with shoulder pain (X² = 22.386, df = 1, p <0.001, V = 0.19). Moreover, neck and upper limb pain exhibited a moderate correlation with prizes won (X² = 6.709, df = 1, p =0.010, V = 0.10).

To investigate the association between daily gaming hours and pain experienced in different body regions, Eta values were computed to evaluate the strength of these relationships. The findings indicated various levels of correlation, with the strongest associations identified for wrist and hand pain, as well as combined neck and upper limb pain, both showing an Eta value of 0.396. In contrast, lower back and shoulder pain demonstrated weaker correlations.

The Association Between Musculoskeletal Pain and Game Type/Genre

The correlation analysis examining the relationship between pain location and game type uncovered several significant findings. Puzzle games were notably linked to various pain regions, with the exception of wrist and hand pain. In contrast, sports and racing games displayed significant correlations with pain in the shoulder and upper back. However, no significant associations were identified between any pain regions and virtual reality (VR), role-playing games (RPG), massively multiplayer online (MMO), or competitive game types (Table 5).

Table 5 Associations Between Pain Location and Game Type/Genre Played

Regression Analysis

Binary logistic regression identified predictors of MSK pain across five regions. In unadjusted Model 1 analyses, female sex was associated with higher odds of neck, shoulder, wrist/hand, and lower-back pain, while age showed region-specific effects.

In the age- and gender-adjusted models (Model 2), female gender remained significantly associated with pain in the neck (OR = 2.06, 95% CI: 1.43–2.98, p < 0.001), shoulder (OR = 3.23, 95% CI: 2.18–4.77, p < 0.001), wrist/hand (OR = 2.02, 95% CI: 1.36–3.00, p < 0.001), and lower back (OR = 1.75, 95% CI: 1.22–2.51, p = 0.003). Gender was not significantly associated with upper back pain (p = 0.544). Age was a significant predictor of shoulder pain (OR = 1.06, 95% CI: 1.04–1.08, p < 0.001), and a borderline association was observed for lower back pain (OR = 1.02, 95% CI: 1.00–1.04, p = 0.051). No significant association was found between age and pain in the neck, upper back, or wrist/hand regions. Model 2 results are presented in Table 6.

Table 6 Age- and Gender-Adjusted Logistic Regression Results for Predictors of Musculoskeletal Pain Across Body Regions

In the fully adjusted models (Model 3), which included all demographic variables, gaming exposure, and game genres, gender and age remained significantly associated with MSK pain in several regions. Female participants had higher odds of reporting pain in the neck (OR = 2.080, p = 0.002), shoulders (OR = 2.426, p < 0.001), upper back (OR = 2.426, p = 0.001), and lower back (OR = 1.787, p = 0.014) compared to males. Increasing age was also associated with higher odds of pain in the shoulders (OR = 1.047, p < 0.001). No significant associations were found between device type (eg, laptop, PlayStation), tool used (eg, keyboard/mouse, touch), or average gaming hours per day and pain in any of the examined regions.

Several game genres were significantly associated with MSK pain. Puzzle games were a consistent predictor, associated with increased odds of pain in the neck (OR = 1.189, p = 0.008), shoulders (OR = 2.459, p < 0.001), and lower back (OR = 1.839, p = 0.009). Participants who frequently played first-person shooter (FPS) games had higher odds of reporting wrist and hand pain (OR = 1.920, p = 0.010). Likewise, sports/racing games were significantly associated with both upper back pain (OR = 1.627, p = 0.026) and lower back pain (OR = 1.532, p = 0.035). Conversely, engagement with fighting games was associated with lower odds of pain in the shoulders (OR = 0.441, p = 0.010). Notably, VR games were associated with a reduced likelihood of neck pain (OR = 0.364, p = 0.004), potentially reflecting different physical demands compared to sedentary gaming styles. Other genres such as strategy, simulation, role-playing, MMO, and platformers did not show significant associations with pain in any region (Table 7).

Table 7 Binary Logistic Regression Models for Predictors of Gamers’ Musculoskeletal Pain

Comparison of Pain Locations and Consequences Between Professional and Non-Professional Male Gamers

Table 8 compares the prevalence of MSK ache between skilled and non-professional players throughout numerous physique areas. The statistical evaluation confirmed no important variations between the 2 teams relating to the variety of ache websites or particular ache places. A chi-square take a look at was utilized to match the prevalence of MSK ache in 5 key physique areas. Among these areas, higher again ache revealed no statistically important distinction between skilled and non-professional male players (X² = 0.656, df = 1, p =0.418), with a negligible impact dimension (φ = 0.04) and comparable odds of experiencing ache (OR = 0.871, 95% CI [0.624, 1.216]).

Table 8 Comparison Between Professional and Non-Professional Gamers

In contrast, significant associations were noted in the other body regions assessed. Neck pain was found to be more prevalent among non-professional gamers than their professional counterparts (X² = 5.666, df = 1, p =0.017), with a small effect size (φ = 0.12) and lower odds for professionals (OR = 0.771, 95% CI [0.524, 1.136]). A similar trend was identified for shoulder pain, which was significantly higher in non-professional gamers (X² = 8.343, df = 1, p =0.004) and demonstrated a moderate effect size (φ = 0.14). Professionals exhibited lower odds of experiencing shoulder pain (OR = 0.588, 95% CI [0.377, 0.916]). Additionally, lower back pain was less prevalent among professionals compared to non-professionals, with a significant difference (X² = 6.718, df = 1, p =0.010), a small effect size (φ = 0.13), and reduced odds of pain (OR = 0.714, 95% CI [0.552, 0.923]). Conversely, wrist and hand pain was significantly more common among professional gamers (X² = 4.036, df = 1, p =0.045), with a small effect size (φ = 0.10) and increased odds of experiencing pain compared to non-professionals (OR = 1.482, 95% CI [1.004, 2.186]).

Discussion

This study explored the prevalence and predictors of MSK pain among gamers, with particular attention to pain locations and how demographic and gaming-related factors contributed to these outcomes. A majority of participants reported experiencing MSK pain in at least one area of their body, with the neck, lower back, shoulders, upper back, and wrists/hands being the most commonly affected regions. Neck pain was identified as the most disruptive to daily activities, followed by lower back and wrist/hand pain—areas that are crucial for mobility and everyday tasks. Although hospitalizations were relatively rare, they were most frequently associated with lower back pain, followed by neck and shoulder pain. Interestingly, professional gamers were significantly less likely to report neck, shoulder, and lower back pain, although wrist/hand pain was more prevalent in this group. No significant differences were observed between groups for upper back pain.

Many gamers reported seeking healthcare services and using medications, indicating the chronic nature of pain in some cases. However, it is important to note that literature specifically investigating hospitalization, healthcare visits, and medication use in gamers is still scarce. In this study, gender, age, and certain game genres emerged as significant predictors of MSK pain.⁵

Gender emerged as a constant threat issue, with feminine players considerably extra more likely to report ache within the neck, shoulders, higher again, and decrease again. These findings align with broader literature noting gender-related variations in MSK ache, doubtlessly influenced by physiological, ergonomic, or hormonal elements. This sample is supported by Wijnhoven et al (2006), who linked larger MSK ache prevalence in females to hormonal, physiological, and psychosocial elements.²⁰ Similarly, Fathuldeen et al (2023) discovered that neck, decrease again, and palms/wrists had been essentially the most painful areas for players, areas closely engaged throughout gaming periods.⁵ Cankurtaran et al (2022) additional demonstrated that females, regardless of enjoying lower than males, reported larger charges of head, hand/wrist, and again ache.²¹ Additionally, Arvidsson et al (2020) highlighted the position of psychosocial elements and ergonomics in MSK ache amongst females.⁷ Such patterns underscore the significance of incorporating gender-specific ergonomic training and focused interventions. Nevertheless, additional analysis is required to make clear gender-specific threat elements, particularly given the underrepresentation of feminine players. Age was positively related to ache within the shoulders, indicating that even inside a comparatively younger gaming inhabitants, age-related vulnerability exists and will compound ergonomic pressure. This examine’s findings agree with Lindberg et al (2020), who prompt that older adults typically keep poor ergonomics throughout work and leisure actions, which, mixed with age-related physiological adjustments and sedentary habits, might enhance MSK susceptibility.²

Beyond demographic influences, gameplay style emerged as an vital determinant of MSK ache. In addition to non-public elements, particular gaming-related variables—significantly sport style—had been related to MSK ache in a number of physique areas. Puzzle, FPS, and sports activities/racing video games confirmed important associations with ache within the neck, decrease again, and wrists/palms, highlighting the potential affect of particular sport genres on bodily pressure. Virtual actuality (VR) gaming stood out, with individuals reporting appreciable neck and decrease again ache, seemingly as a consequence of extended standing and head actions. Gregory et al (2008) discovered that standing for 2 hours with out relaxation may end in decrease again ache.¹² Furthermore, Tyrrell et al (2018) linked VR gameplay to extreme neck and head movement, which can worsen pre-existing situations.¹³ Puzzle video games had been a constant predictor throughout a number of areas, whereas sports activities/racing and FPS video games had been additionally related to particular ache areas, similar to decrease again and wrist/hand. Conversely, preventing video games had been related to decrease odds of shoulder and higher again ache.

These findings emphasize the significance of contemplating sport style as a central issue when evaluating MSK ache threat amongst players. Puzzle video games, FPS, and sports activities/racing genres confirmed constant associations with ache in a number of physique areas, underscoring the necessity for genre-specific prevention methods. Ergonomic interventions that handle extended static postures, repetitive inputs, and system use—tailor-made to frequent patterns inside particular sport genres—might assist scale back MSK burden in gaming populations.^15,22,23 This highlights the necessity for genre-specific ergonomic pointers, as sure sport mechanics might place disproportionate pressure on the musculoskeletal system.

In addition to sport style, the kind of system and the ergonomics of its use additionally performed a important position in shaping MSK outcomes. Although system sort initially confirmed a major affiliation with shoulder and wrist/hand ache within the bivariate evaluation, this relationship didn’t stay important after adjusting for covariates within the regression fashions. This means that system sort might not independently contribute to MSK ache threat, however as a substitute could also be confounded by different elements similar to gender, sport style, or enter methodology. This interpretation is supported by Gholami et al (2025), who discovered excessive charges of MSK issues amongst smartphone-based play-to-earn players, indicating that each platform and gaming motivation can affect musculoskeletal outcomes.¹¹ However, general, the system appeared to outweigh the sport style in figuring out MSK ache dangers. Alnuman et al (2022) concluded that system sort was a important think about MSK ache prevalence, a conclusion supported by our findings.²²

While the regression fashions counsel system sort might not independently drive MSK ache, ergonomics associated to system use stay a decisive issue. Consistent with Geer et al (2023), poor posture, lengthy gaming hours, and sleep disruption considerably exacerbate MSK ache threat. Taken collectively, these findings assist the necessity for ergonomic coaching, adaptive seating, and scheduled breaks, significantly in high-risk system contexts.²³ Alnuman et al (2022) additionally discovered larger ache charges amongst players in comparison with non-gamers, significantly within the higher physique, reinforcing the affect of device-specific pressure patterns noticed within the present examine.²² Tholl et al (2022) recognized smartphones and tablets as frequent contributors to neck and shoulder ache as a consequence of hunched postures.³ While these device-specific patterns had been famous, the adjusted regression mannequin means that system sort alone will not be an impartial predictor of MSK ache. Despite these observations, analysis on device-specific MSK ache patterns stays restricted.

Similar to the present examine, a number of investigations have highlighted excessive charges of MSK ache amongst skilled players, significantly affecting the neck, shoulders, and decrease again. Lindberg et al (2020) reported that 42.6% of Danish esports athletes skilled MSK ache, whereas DiFrancisco-Donoghue et al (2019) noticed analogous developments amongst collegiate gamers.^2,24 Goh et al (2023) corroborated these dangers in a scientific assessment; nevertheless, none of those research included non-professional players for comparability.¹

In distinction to earlier analysis, our findings revealed important variations within the prevalence of ache throughout numerous areas. Non-professional players had been extra more likely to report neck, shoulder, and decrease again ache, whereas wrist and hand ache had been extra prevalent amongst skilled players. Notably, higher again ache confirmed no important variations between the 2 teams. These outcomes diverge from these of Reeves et al (2024), who discovered no distinctions in MSK dysfunction indicators between skilled and informal players, suggesting that the interaction between professionalization, ergonomics, and ache is complicated and deserves additional examine.²⁵ The present findings counsel that whereas aggressive standing might affect ache in particular areas, different elements—similar to extended sitting, poor ergonomics, and repetitive pressure—are seemingly important contributors for all sorts of players.⁹ It is vital to acknowledge that the gender distribution differed between the skilled and non-professional teams in our pattern, which can have influenced our comparisons. Future analysis ought to undertake stratified or matched designs to extra successfully isolate the consequences of gender {and professional} standing on musculoskeletal outcomes. These findings spotlight the necessity for tailor-made prevention methods that think about each gaming roles and ergonomic dangers, making certain assist for musculoskeletal well being no matter skilled standing. The scientific implications are important, as early identification and intervention for at-risk players may assist mitigate long-term musculoskeletal points and improve useful outcomes.

Recognizing that each skilled and informal players are susceptible to MSK issues highlights the significance of well being promotion applications, workplace-style ergonomic training, and early screening in gaming populations. This is especially important within the Saudi Arabian context, the place gaming is quickly increasing as each a leisure exercise and knowledgeable pursuit. Cultural elements—similar to extended sedentary conduct, preferences for indoor leisure, and evolving health-seeking behaviors—might uniquely affect each ache prevalence and healthcare utilization amongst Saudi players. These contextual components improve the applicability of the findings regionally, whereas additionally offering a precious perspective for international comparisons in gaming-related MSK analysis.

While this examine supplies vital insights into the connection between gaming behaviors and MSK ache amongst Saudi players, a number of methodological issues warrant consideration. Its cross-sectional design limits causal inference, and reliance on self-reported knowledge might introduce recall or reporting biases. Future research would profit from longitudinal designs to evaluate causality, the incorporation of goal ergonomic/postural measures, and consideration of cumulative publicity (complete years of gaming). Furthermore, objectively assessing ache severity, useful incapacity, and comorbidities similar to sleep disturbance or sedentary way of life may add important scientific relevance. Given the underrepresentation of feminine players and the fast development of e-sports in Saudi Arabia, additional gender-sensitive and culturally contextualized analysis is warranted. Additionally, the noticed variations between skilled and non-professional players have to be interpreted with warning, as gender imbalance throughout teams seemingly influenced prevalence patterns. The use of comfort sampling and exclusion of people with prior accidents might restrict generalizability. Cultural elements distinctive to the Saudi context, similar to gaming preferences and health-seeking conduct, advantage additional exploration. Future analysis would profit from incorporating comparative experimental designs with management variables to allow stronger causal interpretation.

Conclusions

This examine revealed a notable prevalence of MSK ache amongst players in Saudi Arabia, with essentially the most generally affected areas being the neck, decrease again, shoulders, higher again, and wrists/palms. Pain incidence was influenced by numerous elements, together with gender, age, and sport genres. Notably, puzzle, FPS, and sports-racing video games had been related to heightened discomfort ranges, whereas digital actuality gaming was considerably linked to neck ache. These findings underscore that MSK issues are frequent amongst players and that particular person traits and genre-specific calls for are important predictors, supporting the necessity for ergonomic training and gender-sensitive prevention applications. While the examine presents precious insights, its reliance on a younger, culturally particular pattern and self-reported knowledge limits generalizability, highlighting the necessity for future work with numerous populations and goal scientific measures. Future analysis ought to undertake longitudinal and interventional designs to check ergonomic methods and higher set up causal relationships. In conclusion, this examine emphasizes the widespread incidence of MSK ache amongst players and the significance of culturally contextualized, evidence-based approaches to prevention and intervention.

Abbreviations

MSK, Musculoskeletal; VR, Virtual actuality; FPS, First Person Shooter; SEF,Saudi Esports Federation; NMQ-E, Extended Nordic Musculoskeletal Questionnaire.

Data Sharing Statement

The datasets generated and/or analyzed through the present examine aren’t publicly accessible however can be found from the corresponding creator upon affordable request.

Ethics Approval and Informed Consent

Princess Nourah Bint Abdulrahman University granted moral approval for the examine (IRB No. 24-0490). Participants supplied their written knowledgeable consent. Informed consent was obtained from all topics concerned within the examine. The examine complies with the Declaration of Helsinki.

Consent for Publication

Not relevant. This examine didn’t contain any identifiable private knowledge, photos, or recordings requiring particular person consent for publication.

Acknowledgments

The authors acknowledge the assist supplied by means of the Princess Nourah Bint Abdulrahman University Researchers Supporting Project (No. PNURSP2026R285), Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.

Author Contributions

All authors made a major contribution to the work reported, whether or not that’s within the conception, examine design, execution, acquisition of information, evaluation and interpretation, or in all these areas; took half in drafting, revising or critically reviewing the article; gave closing approval of the model to be printed; have agreed on the journal to which the article has been submitted; and conform to be accountable for all facets of the work.

Funding

The authors declare that this examine acquired no funding from any public, non-public, or non-profit companies.

Disclosure

The authors state that the analysis was performed with none industrial or monetary relationships that would result in a battle of curiosity.

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