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Introduction

Neck, shoulder and back pain is relatively common among photographers and has a negative impact on their physical and psychological health. Neck, shoulder and back pain is relatively mild musculoskeletal condition, but in recent years it has become a major health problem and has imposed a heavy burden on the person and community ^[2,3]. The World Health Organization (WHO) has ranked neck, shoulder and other musculoskeletal diseases as the 4^th and 10^th health problems, respectively, for years lived with disability ^[1].

 A typical photographer’s posture is with upper body forward, shoulders rolled in, and neck bent forward with chin extended. Work-related musculoskeletal disorders (WMSDs) result from the workplace risk factors and are well known by the terms such as cumulative trauma disorders and repetitive strains injuries^[2]. 

Musculoskeletal disorders are the injuries that affect the human body’s movement or musculoskeletal system (muscle, tendon, ligament, nerve, discs, blood vessel). Neck, shoulder and back pain is relatively mild musculoskeletal condition, but in recent years it has become a major health problem and has imposed a heavy burden on the person and community^[3]. Body posture refers to the position of a person’s body in space, the alignment of body parts in relationship to one another and to the environment at one point in time and is influenced by each of the body’s joints^[4]. Habitual postural patterns are associated with musculoskeletal pain, and improving a maladaptive posture requires postural awareness to lead to clinical improvements^[4,5].Postural control refers to building up posture against gravity and to ensuring that balance is maintained. It enables postural stabilization during voluntary movements and recovery of balance after disturbance. Postural control also constructs a reference frame for proprioception, i.e., the perception of joint angles and muscle tensions, of movement, balance and posture^[6]. When less attention is paid to the physical damage caused by holding a certain position over time causes holding injuries technically called excessive positioning injuries⁷. Swelling and heat in joints, physical stiffness and discomfort, headaches, jaw pain, and chronic neck or low back pain are all signs of excessive positioning injuries. The findings of a study showed that camera usage increased the risk of developing musculoskeletal disorders^[7,8,9]. Such an increase is mediated by ergonomic factors such as standing for prolonged periods, adoption of inadequate or uncomfortable postures, hiking miles for perfect photo, performing certain angles for photograph, carrying heavy lens luggage on the back and psychosocial factors. Standing for more than half a day in an awkward position increases the likelihood of having musculoskeletal problems^[10]. This study is done to assess the prevalence of shoulder, neck, and back pain among photographers and to investigate the relationship between this pain and its risk factors using Work-related musculoskeletal disorders (WMSDs) and rapid upper limb assessment (RULA).

Methodology

Prior collecting the data, permission was received from Institutional Ethics committee from the Krishna Institute of Medical Sciences “deemed to be university" to collect data. Participants were informed and the participation was voluntary. Participants were selected by simple random sampling method according to inclusion criteria and exclusion criteria.   Ninety photographers working in and around local area were taken for this study with full consent. The selected photographers were working in the profession with more than one year experience, either freelancers or professional photographers. A professional photographer is typically part of a company or agency and works full-time either have their own photo studio, On the other hand, a freelancer takes on jobs on a contract basis as opposed to being an employee for a company.

 All the participants were males in the age between 20– 60 years. The 90 participants divided into 2 groups with 45 participants in each group.

Group A: 45 freelance photographers

Group B: 45 professional photographers

The procedure and purpose of the study was explained to the participants. Assessment was carried out by using RULA (rapid upper limb assessment)  .The Rapid Upper Limb Assessment (RULA) method has been developed in 2004 by Dr. Lynn McAtamney and Professor E. Nigel Corlett, ergonomists from the University of Nottingham in England . RULA is a postural targeting method for estimating the risks of work-related upper limb disorders. A RULA assessment gives a quick and systematic assessment of the postural risks to a worker. The analysis can be conducted before and after an intervention to demonstrate that the intervention has worked to lower the risk of injury. They were asked to perform their task in their working posture. Using RULA assessment, scores were given according to their respective posture during work. Work-related musculoskeletal disorder questionnaire (WMSDs) . Using the scores obtained from RULA assessment and musculoskeletal disorder questionnaire a comparative statistical analysis, interpretation was obtained.

RESULT

The prevalence of neck and shoulder pain is slightly higher in photographers. The causes of the pain are repeated strain and awkward working postures, excessive positioning injuries and other musculoskeletal conditions. In this study the professional photographers (57%) showed more neck and shoulder pain than freelance photographer (35%).

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DISCUSSION