Abstract

Objective: To document musculoskeletal pain frequencies and examine associations with water carrying parameters among women in rural Khyber Pakhtunkhwa (KP), Pakistan.
Methodology: This cross-sectional study included 60 women aged 20-60 years with primary household water collection responsibility across six KP districts. GPS-validated distance and calibrated weight measurements quantified carrying parameters. Pain at five body sites was assessed using the Visual Analog Scale (VAS, 0-10). Pearson correlation with Bonferroni correction (alpha=0.0167) and multiple linear regression were applied.
Results: Lower back pain was reported by 70.0% (mean VAS 5.9±2.5), shoulder pain by 58.3%, upper back pain by 43.3%, arm/hand pain by 35.0%, and neck pain by 26.7%. Multi-site pain was reported by 85.0%. Container weight correlated significantly with lower back pain (r=0.376, p=0.003), the only association surviving Bonferroni correction. Regression was non-significant overall (R²=0.102, p=0.20); age was an independent predictor (beta=0.130, p=0.040).
Conclusion: Women carrying water in rural KP bear a substantial musculoskeletal burden. Container weight predicts lower back pain specifically. Larger community-based studies are needed.

Key words: Water carrying, musculoskeletal disorders, occupational health, back pain, Khyber Pakhtunkhwa, Pakistan.