<b>Prevalence of Back Pain Among Madrassah Teachers in Karachi: An Occupational Health Concern</b>

Background: Musculoskeletal disorders (MSDs) are among the most prevalent occupational health problems globally and a leading cause of disability and reduced productivity. Teachers are at particular risk due to prolonged sitting, awkward postures, and limited ergonomic awareness. Madrassah teachers in Pakistan often conduct classes in floor-sitting positions without proper ergonomic support, predisposing them to musculoskeletal strain, yet this occupational group remains understudied. Objective: To determine the prevalence, characteristics, and associated risk factors of back pain and other musculoskeletal disorders among madrassah teachers in Karachi. Methods: A cross-sectional survey was conducted among 109 male madrassah teachers with at least one year of teaching experience. Data were collected using a structured self-administered questionnaire assessing demographics, body mass index (BMI), teaching practices, pain characteristics, and intensity measured using a Visual Analogue Scale (VAS). Descriptive statistics, chi-square tests, and odds ratios were calculated to examine associations between musculoskeletal pain and demographic or occupational factors. Results: Musculoskeletal discomfort related to teaching was reported by 58.7% of participants, with back pain being the most prevalent symptom (33.9%), followed by shoulder (32.1%) and knee pain (24.8%). Most participants (79%) reported symptom onset during teaching, and 81.7% described the pain as slow and persistent. Moderate pain severity (VAS 2–7) was reported by 73.4% of participants. A positive but non-significant association was observed between elevated BMI and musculoskeletal pain (OR = 2.00; 95% CI: 0.88–4.55; p = 0.146). Teaching hours were not significantly associated with pain prevalence (p = 0.765). Conclusion: Back pain and other MSDs are highly prevalent among madrassah teachers in Karachi, primarily associated with prolonged static postures, floor-sitting positions, and elevated BMI. These findings underscore the need for ergonomic interventions, posture education, and weight management strategies to reduce musculoskeletal burden and improve occupational health in this population