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ders, are speculative. Also, if biological pathways linking job stress to work-related musculoskeletal disorders exist, it is currently unknown whether they are specific to these disorders or, more likely, represent the final common pathway by which exposure to both work-related and nonwork-related stressors exert an effect on a number of health disorders (e.g., cardiovascular disease). That is, the specificity of these pathways is unknown. It is generally accepted that musculoskeletal pain can be experienced in the absence of evident physiological change or tissue damage (Melzack, 1999) and that such pain is modulated primarily by cognitive processes.

This chapter reviews general models of occupational stress, biological correlates of stress exposure, selected theories related to how occupational stress might impact musculoskeletal disorders, and hypothesized pathways that may account for the relationship.


Several general models of occupational stress have emerged that define job stress and explain how certain aspects of work can contribute to the experience of stress. An early model proposed by Levi (1972) includes the components of most models of occupational stress. A simplified version of the major features of this and most models of stress is depicted in Figure 7.1.

The Levi model describes a process by which a worker is in constant interchange with his or her work environment; these interactions require

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FIGURE 7.1 Generic psychosocial stress model. From Sauter and Swanson (1996:6). Reprinted with permission.

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