Abstract / Summary
Abstract Women report more musculoskeletal (MSK) pain than men, but this is often summarised as a single prevalence difference. Whether the gap varies across the adult age range, and whether women and men with equally rated pain experience the same consequences, is less clear, particularly in the growing desk-based workforce. We examined how the MSK pain gap between women and men varies across age and across functional domains. Cross-sectional analysis of 18,516 desk-based workers (10,521 women, 7,995 men) who completed a digital workplace MSK assessment during 2025. Pain intensity was self-reported on an 11-point numerical rating scale (NRS). Participants reporting any pain indicated whether it affected each of five functional domains (mental health, productivity, sleep, social participation, concentration) and whether they had sought healthcare or been absent from work. Gender was self-reported (woman or man). We compared prevalence (chi-square), intensity (t-test) and domain-specific impact using logistic regression (unadjusted and age-adjusted), and tested gender-by-age interactions on the odds of reporting pain and on pain intensity. Reporting follows the STROBE guidance for cross-sectional studies. Pain prevalence was higher in women than men (59.4% vs 46.8%; odds ratio [OR] 1.66, 95% confidence interval [CI] 1.56 to 1.76; p < 0.001). The gap was progressively larger across older age bands (10.6, 12.8 and 14.0 percentage points [pp] at 18 to 30, 31 to 50 and 50+), reflecting a steeper decline in men, although the gender-by-age interaction on prevalence did not reach significance (OR 1.005 per year, 95% CI 0.999 to 1.010; p = 0.10). Among those in pain, mean intensity was higher in women (4.47 vs 4.13; p < 0.001) and diverged with age as women's intensity rose and men's fell, a divergence confirmed by a significant gender-by-age interaction on intensity (0.009 NRS points per year, 95% CI 0.001 to 0.016; p = 0.024). Impact was domain-specific rather than uniform: at equivalent pain, women had higher odds of having sought healthcare (OR 1.40), of sleep disturbance (1.31), of mental-health impact (1.31), of concentration impact (1.14) and, more modestly, of absence (1.13), whereas productivity (0.96) and social participation (1.01) did not differ. In a large desk-based sample, the gender gap in MSK pain was larger in older workers and concentrated in specific domains, suggesting the burden differs in kind, not only in degree. The age-related divergence was clearest and statistically supported for pain intensity. Workplace MSK programmes that report a single pooled prevalence may understate the burden carried by older women and miss where that burden falls.