The major health problems in the industrialized countries have a multifactorial etiology, where stress and other psychosocial factors seem to play an important role. Mental stress is not only induced by high demands, but also by demands that are too low, which happens in many repetitive and monotonous work situations and, e.g., in response to unemployment. For a long time, musculoskeletal disorders were mainly considered to be caused by physical conditions. However, accumulating evidence from several sources now indicate that psychosocial factors are also significantly associated with, e.g., back pain and shoulder problems. Studies of assembly line workers with a high incidence of back pain complaints indicate that the physical load on the spine at work is low, whereas psychophysiological stress levels are high and work satisfaction is low. Female assembly workers were found to have higher physiological arousal than men in traditional assembly line work, whereas their stress levels were lower in a more flexible and autonomous work organisation. In a recent laboratory experiment, both mental and physical stress was found to increase physiological stress levels and muscular tension. It was concluded, that data consistently support the assumption that mental stress is of importance for the development of musculoskeletal symptoms.
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