Musculoskeletal pain and psychological flourishing among Saudi male gamers: The role of physical activity and gaming status

Background Gamers are increasingly at risk for musculoskeletal (MSK) pain due to prolonged screen exposure and poor posture. However, the relationship between MSK pain and psychological flourishing remains underexplored. Objective To (1) assess the prevalence and distribution of upper body and back MSK pain among Saudi gamers, (2) examine the effects of age, gaming status, physical activity, and gaming exposure on pain prevalence, and (3) explore the association between MSK pain and psychological flourishing. Methods A cross-sectional survey was conducted among 428 male gamers in Saudi Arabia, categorized as professional or casual. Validated instruments assessed MSK pain (Extended Nordic Musculoskeletal Questionnaire), physical activity levels, gaming patterns, and flourishing (Flourishing Scale). Statistical analyses included chi-square tests, Mann–Whitney U tests, binary logistic regression, and a bootstrapped Generalized Linear Model (GLM). Results MSK pain affected 71.0% of participants, with the neck and lower back most commonly reported. Casual gamers had significantly higher pain prevalence than professionals. Vigorous physical activity was associated with lower odds of neck and shoulder pain. Binary logistic regression identified physical activity as the only consistent predictor of reduced pain, while gaming exposure and age were not significant. No significant association was found between MSK pain and psychological flourishing in bivariate or multivariable models. Conclusion MSK pain is common among Saudi gamers, particularly casual players. Regular physical activity may reduce pain risk and should be encouraged among gamers. Psychological flourishing appeared unaffected by MSK pain or gaming status, suggesting other factors may influence well-being in this population.