Prevalence and multifactorial determinants of musculoskeletal pain among family caregivers of stroke survivors in Northwestern Nigeria: a cross-sectional analysis with implications for policy and practice

Musculoskeletal pain (MSP) is a critical but often overlooked health outcome for family caregivers of stroke survivors, particularly in low-resource settings like Nigeria where caregiving demands are intensified by socioeconomic and cultural factors. This study aimed to determine the prevalence of MSP, identify the most affected anatomical regions, and evaluate the socio-demographic, occupational, and cultural predictors among family caregivers of stroke survivors in Kano, Northwestern Nigeria. A hospital-based cross-sectional study was conducted with 183 primary caregivers. Data were collected using structured interviews incorporating the Nordic Musculoskeletal Questionnaire (NMQ) and the Modified Rankin Scale (mRS). Multivariate logistic regression analysis was used to identify independent predictors of MSP at a significance level of α = 0.05. The 12-month prevalence of MSP among caregivers was 83.2%. The shoulder (34.4%) and upper extremities (35.0%) were the most prevalent sites of pain over 12 months, while the neck (26.2%) and upper extremities (26.2%) were most prevalent in the preceding 7 days. Multivariable analysis identified four independent predictors of MSP: engagement in manual labor (Adjusted Odds Ratio [AOR] = 2.45; 95% CI:1.32–4.56), low educational attainment (AOR = 2.12; 95% CI:1.24–3.62), caregiving duration exceeding 12 months (AOR = 3.78; 95% CI:2.05–6.97), and providing support for Islamic ablution rituals (AOR = 1.89; 95% CI:1.15–3.10). This high MSP burden results from a confluence of biomechanical strain, socioeconomic disadvantage, and culturally-specific tasks. Findings urgently call for culturally-adapted ergonomic training, supportive workplace policies, and the integration of caregiver health into national stroke and rehabilitation strategies to protect this vulnerable population.