Smartphone addiction and multisite musculoskeletal pain among parents: The potential mediating role of sleep disturbance and the moderating role of physical activity.

OBJECTIVE

To examine the association between smartphone addiction and multisite musculoskeletal pain burden among parents, and whether this association is mediated by smartphone-related sleep disturbance and moderated by physical activity.

METHODS

A total of 1444 parents (447 fathers and 997 mothers) completed a cross-sectional online survey. Smartphone addiction was assessed using the Smartphone Addiction Scale-Short Version (SAS-SV). Total pain burden was assessed by participants rating their pain in each of four predefined areas over the past week (neck, upper back, lumbar region, and wrist/fingers) on a 0-10 numerical rating scale, with the four regional scores summed. Sleep-related variables were daily sleep duration and smartphone-related sleep disturbance. Physical activity was assessed using the International Physical Activity Questionnaire-Short Form (IPAQ-SF).

RESULTS

Smartphone addiction showed a weak but statistically significant positive association with total pain burden (rho = 0.106, p < 0.001) and remained independently associated with pain burden after adjustment for demographic and behavioral factors (B = 0.106, p < 0.001). Smartphone-related sleep disturbance partially mediated this association (indirect effect = 0.016, 95% CI 0.003-0.030). Physical activity moderated the association (B = -0.563, p = 0.015), which was weaker at higher levels of physical activity. Participants with more severe pain profiles had significantly higher smartphone addiction scores.

CONCLUSIONS

The findings identify problematic smartphone use as a small-magnitude behavioural correlate of multisite pain burden among parents, independent of the modelled covariates, and best interpreted within a broader behavioural health context encompassing sleep and physical activity rather than through screen time or posture alone.