Associations Among Stress Level, Musculoskeletal Disorders, and Body Mass Index (BMI) Among Final-Year Students at the University of Colombo

Introduction: Musculoskeletal disorders (MSDs) are a leading cause of long-term pain and functional impairment globally, increasingly affecting younger populations due to sedentary lifestyles and academic stress. Despite growing international research, limited data exist on the interrelationship between MSDs and stress among undergraduates in Sri Lanka. Objective: To determine the prevalence and distribution of musculoskeletal disorders among final-year students at the University of Colombo and to assess associations between academic stress, body mass index (BMI), and musculoskeletal pain. Methods: A cross-sectional analytical study was conducted among 420 final-year undergraduates across five faculties of the University of Colombo. Musculoskeletal symptoms were assessed using the Standardized Nordic Musculoskeletal Questionnaire (SNMQ), while academic stress was evaluated using a modified Student Life Stress Inventory (SLSI). BMI was calculated based on self-reported height and weight. Data were analyzed using descriptive statistics and inferential tests including Chi-square and p-value analysis using SPSS v26. Results: The 12-month and 7-day point prevalence of MSDs were 82.1% and 64.5%, respectively. The lower back (48.8%), neck (46.7%), and upper back (42.4%) were the most affected regions, with 49.3% reporting interference with daily activities. Medical students showed the highest MSD prevalence (91.8%). A significant association was observed between academic stress and MSDs in the neck, shoulders, upper and lower back (p < 0.05). BMI was significantly associated with lower back (p = 0.018) and knee pain (p = 0.047). Females reported higher stress levels, especially in response to academic changes and pressures. Conclusion: MSDs are highly prevalent among final-year undergraduates at the University of Colombo, with academic stress emerging as a key contributor, particularly to axial pain. Context-specific interventions combining ergonomic and psychological strategies are essential to address this dual burden.