Association between premenstrual syndrome severity and musculoskeletal pain among nursing students: a cross-sectional study

BACKGROUND: Musculoskeletal pain is highly prevalent among nursing students and may negatively affect their physical functioning and readiness for clinical practice. Premenstrual syndrome (PMS), characterized by physical and psychological symptoms, has been suggested to be associated with pain sensitivity and musculoskeletal discomfort. However, the relationship between PMS severity and musculoskeletal pain in nursing students has not been well established. METHODS: This study employed a descriptive cross-sectional design and included 257 female nursing students. Data were collected using the Premenstrual Syndrome Scale (PMSS) to evaluate the presence and severity of PMS symptoms and the Extended Nordic Musculoskeletal Questionnaire (NMQ-E) to assess musculoskeletal complaints (pain, discomfort, or ache) across nine distinct body regions. Descriptive statistics, independent samples t-tests, chi-square tests, and logistic regression analysis were performed. All inferential statistical analyses were performed with a significance level set at p < 0.05. RESULTS: PMS was identified in 82.9% (n = 213) of participants, and 90.7% (n = 233) reported musculoskeletal pain. Students with pain had significantly higher PMSS scores (148.5 ± 28.5) than those without pain (90.5 ± 26.5; p < 0.001). Logistic regression analysis showed that PMS severity was independently associated with musculoskeletal pain (OR = 1.08, 95% CI: 1.05-1.11, p < 0.001). Chi-square analysis revealed that musculoskeletal pain in the neck, shoulder, lower back, and hips was significantly associated with increased healthcare utilization, medication use, and sick leave (p < 0.05). The lower back (75.9%, n = 195), upper back (42.0%, n = 108), and hip regions (39.3%, n = 101) were the most commonly affected regions. CONCLUSIONS: PMS severity is significantly associated with musculoskeletal pain in nursing students and may be linked to pain-related functional limitations. Early identification of students with severe PMS symptoms and incorporation of menstrual health considerations into musculoskeletal assessments may support preventive strategies aimed at reducing absenteeism, healthcare utilization, and pain-related disability, while improving the occupational health and clinical functioning of future nurses.