Screen Time, Sitting Time, Physical Activity, and Multisite Musculoskeletal Pain in University Students: Implications for Preventive Healthcare

Background/Objectives: This cross-sectional study examined whether daily screen time, sitting time, and physical activity were associated with musculoskeletal pain-site count among university students. Methods: A total of 255 students aged 18–25 years were included. Musculoskeletal pain during the previous 12 months was assessed in nine anatomical regions using the Extended Nordic Musculoskeletal Questionnaire. The primary outcome was pain-site count. Poisson regression with robust standard errors was used for the primary analysis, and region-specific outcomes were examined using multivariable logistic regression. Results: Multisite pain was reported by 81 students (31.8%). The most common pain regions were the neck (29.0%), lower back (25.9%), and shoulder (22.7%). In the adjusted Poisson model, each additional hour of daily screen time was associated with a 10% higher pain-site count (IRR = 1.10, 95% CI: 1.04–1.15), and each additional hour of sitting time was associated with a 7% higher pain-site count (IRR = 1.07, 95% CI: 1.03–1.11). Higher physical activity was associated with a lower pain-site count (IRR = 0.93 per 1000 MET-min/week, 95% CI: 0.88–0.98). Female sex and younger age were also associated with higher pain-site count. In region-specific analyses, screen time was associated with neck pain, whereas sitting time was associated with lower back, shoulder, and upper back pain. Conclusions: Musculoskeletal pain burden in university students was associated with multiple movement-related behaviors. These findings may inform screening and future longitudinal or intervention studies addressing screen use, sitting time, and physical activity.