This study revealed a high frequency of musculoskeletal complaints (74.7%) among administrative employees at least in one region of the body during the previous 12 months. The most common body region reported by the present cohort was the neck (47.1%), followed by the lower back (40.7%) and shoulder (36.3%).

This could be attributed to the inadequate ergonomic knowledge and practices employed by the administrative personnel, with the application of a continuous work pattern over extended periods without adequate breaks, the maintenance of static and awkward postures, and workplace environments with poor ergonomic circumstances.

Similarly, a Nigerian study among office workers in higher education institutions demonstrated a high prevalence rate of musculoskeletal complaints (71.9%). It also reported that body regions affected by musculoskeletal complaints were the lower back (58.1%) and shoulders (50.2%) [10]. Similar results were reported in studies in Iran, Turkey, and Jordan which indicated that the prevalence rates of neck, shoulders, and lower back symptoms were higher among administrative employees [11,12,13].

However, a Saudi study revealed a much higher prevalence of musculoskeletal problems (84.5%) for Saudi office workers in the past 12 months [14] and it also reported a similar pattern of the most affected areas in the form of low back region (54.5%), shoulder (51.7%), and neck (50.1%). These variations could be attributed to the sociocultural differences and the differences in the work setting.

Another important finding was that general and occupational characteristics including gender, age, duration of employment, and physical activity were statistically associated with developing musculoskeletal complaints. The rate of musculoskeletal complaints was higher in females, those over the age of 40 years, those with work experience higher than 10 years, and those who were physically inactive. Additionally, multiple regression revealed that older age (OR = 1.039) and female gender (OR = 2.175) were predictors for WMSDs. Regarding gender, similar previous studies have reported that female office workers were more affected by musculoskeletal complaints than men [10, 12, 15]. Women may experience varying anthropometrics and physiology which could explain the observed differences. Additionally, women frequently undertake non-work-related tasks, such as household chores, which may contribute to muscle strain and increase their susceptibility to WMSDs [16].

These results are in line with those of Ahmed and Oraby in Egypt who also found that age more than 40 years and duration of work more than 10 years were the most significant predictors of work-related musculoskeletal disorders [17]. Likewise, many studies have reported a significant association between the prevalence of WMSDs and both advancing age and increasing work experience [10, 14, 18]. The aging process can lead to degenerative changes and a decline in functional capacity among older workers. This, in turn, may enhance the body’s susceptibility to mechanical stress and make it more vulnerable to MSDs. Additionally, chronic musculoskeletal fatigue can result in the accumulation of stress on muscles and tendons, ultimately leading to reduced blood flow to the corresponding areas as work experience increases [19].

Our findings regarding physical activity align with the results of studies from Turkey and Indonesia. These studies have shown a clear significant association between physical activity habits and the prevalence of MSDs. Additionally, the lack of exercise has been found to increase the occurrence of these problems [20, 21]. This could be attributed to the impact that physical activity has on the status of muscles, as it increases their mass and functionality. Therefore, the absence of physical activity, coupled with low body fitness, may result in reduced flexibility and an elevated risk of MSDs [19].

In terms of the factors that contribute to the development of MSDs, both psychological and ergonomic aspects were considered. Upon conducting a correlation analysis, it was found that workplace stress, sustained body position, awkward posture, and inadequate rest breaks all had a statistically significant positive correlation with the development of MSDs. Multivariate analysis further demonstrated that insufficient rest breaks is a significant predictor of MSDS (OR = 1.979).

This finding demonstrates similarities to a study conducted in Nigeria, which found that awkward posture, workplace stress, inadequate rest breaks, and sustained body position were significantly associated with MSDS [10]. Another study by Ahmed and Oraby also supports these results, revealing that awkward body postures play a significant role as a risk factor for the development of WMSD (OR = 2.46) [17]. Similarly, Celik et al. [12], as well as Ardahan and Simsek [11], reported that working without adequate rest breaks was a risk factor for WMSD. A possible reason could be that awkward positions often necessitate the body to assume unnatural and unbalanced positions. Consequently, this leads to an increase in muscle tension, a decrease in blood flow, and an increase in pressure on joints and nerves, ultimately resulting in microtrauma and inflammation in the affected tissues. The association between not taking sufficient rest breaks and musculoskeletal disorders may be linked to the continuous and excessive load placed on the muscles and joints. Without proper rest, the tissues are unable to recover and adapt, and the wear and tear on the musculoskeletal system increases over time.

Similar studies on workplace stress have found that work-related stress can increase the risk of musculoskeletal problems among employees [22, 23]. Occupational stress can have an impact on nerves, hormones, and blood pressure, which can result in increased muscle and skeletal activity. This can put extra strain on the musculoskeletal system, potentially leading to the development or worsening of MSDs.

Regarding work productivity, our results showed that the mean absenteeism was 28.13 ± 24.70 h/month, while the mean presenteeism was 81.47 ± 19.51 h/month. Furthermore, gender, age, marital status, educational level, physical activity, BMI, working experience, and development of WMSDS were significantly associated with absenteeism. The highest mean of absenteeism was found in females, those over the age of 50 years, widowers, those with secondary education, physically inactive individuals, obese, those with more than 30 years of work experience, and individuals with WMSDs.

Our study findings were similar to those of previous studies. A study by Dos Reis França et al. in Brazil, displayed an association between absenteeism and both advanced age and female gender [24]. Additionally, a prior study by Rodrigues et al. in Brazil found that absenteeism was significantly higher among females [25]. Our finding also aligns with the research conducted by Haeffner et al. in Brazil where they demonstrated a significant correlation between education and absenteeism [26]. Similar prior research found that absenteeism was associated with musculoskeletal complaints [27, 28].

Nevertheless, there was no statistically significant difference observed between presenteeism and employee characteristics, including the prevalence of musculoskeletal complaints, in this study. This finding is consistent with that of Balta and Alagüney in Turkey who did not find a relationship between musculoskeletal pain and presenteeism [29]. The finding is contrary to a previous study by Bae among physical therapists in Korea which found that WMSDs are associated with presenteeism and individuals exhibit significant presenteeism [15]. A potential explanation for this finding is that the influence of WMSDs on presenteeism could rely on different issues, like the seriousness of the condition, the nature of the job tasks, workplace culture, job satisfaction, and organizational support and how individuals cope with the studied population. Additionally, the subjective evaluation of occupational musculoskeletal exposures in the present study may also contribute to this explanation.

This study has several limitations. Firstly, this study employs a cross-sectional design, which captures data at a specific point in time and therefore prevents the establishment of causal relationships between risk factors and musculoskeletal disorders. Longitudinal studies that track participants over time would provide a more comprehensive understanding of the prevalence and potential progression of musculoskeletal disorders among administrative employees. Secondly, this cross-sectional study was conducted in a specific university setting among the Egyptian administrative employee population. So, caution should be exercised when generalizing the findings beyond the study population. Thirdly, this study is based on self-reported data, which predisposes our results to recall bias.