Pain and disability retirement: A prospective cohort study

Saastamoinen, Peppiina; Laaksonen, Mikko; Kääriä, Sanna; Lallukka, Tea; Leino-Arjas, Päivi; Rahkonen, Ossi; Lahelma, Eero

doi:10.1016/j.pain.2011.11.005

Cited by 52 publications

(42 citation statements)

References 25 publications

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“…There was a clear association between lower utility values and greater pain intensity, with severe neuropathic pain particularly having low utility values (ie, 0.2 to 0.3). Publications since 2008 (date of the search of the abovementioned review) have confirmed these conclusions in neuropathic pain, back pain, and fibromyalgia …”

Section: Resultsmentioning

confidence: 92%

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The Costs and Consequences of Adequately Managed Chronic Non‐Cancer Pain and Chronic Neuropathic Pain

et al. 2013

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Strenuous efforts should be put into obtaining good levels of pain relief for people in chronic pain, including the opportunity for multiple drug switching, using reliable, validated, and relatively easily applied patient-centered outcomes. Detailed, thoughtful and informed decision analytic policy modeling would help understand the key elements in organizational change or service reengineering to plan the optimum pain management strategy to maximize pain relief and its stream of benefits against budgetary and other constraints. This paper contains the information on which such models can be based.

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Section: Resultsmentioning

confidence: 92%

“…Chronic pain of any sort is more likely to be associated with disability retirement, due to musculoskeletal disorders, especially when there is a longstanding illness . In the U.K., 44% of working age people with severe pain were unable to work and 41% claimed a state benefit .…”

Section: Resultsmentioning

confidence: 99%

The Costs and Consequences of Adequately Managed Chronic Non‐Cancer Pain and Chronic Neuropathic Pain

et al. 2013

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“…A recently published systematic review revealed that approximately two thirds of patients with non-specific lower back pain still experience pain 1 year after its onset, contrary to a commonly held belief that this normally resolves spontaneously in most patients [37]. In Finland, researchers found that chronic pain accounted for up to 30% of medically certified absence lasting more than 2 weeks [38] and that it was independently associated with early retirement due to disability [39]. Other studies have also documented the contribution of chronic pain to early retirement and disability pensions [40,41].…”

Section: Introductionmentioning

confidence: 99%

The individual and societal burden of chronic pain in Europe: the case for strategic prioritisation and action to improve knowledge and availability of appropriate care

2013

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BackgroundChronic pain is common in Europe and elsewhere and its under treatment confers a substantial burden on individuals, employers, healthcare systems and society in general. Indeed, the personal and socioeconomic impact of chronic pain is as great as, or greater, than that of other established healthcare priorities. In light of review of recently published data confirming its clinical and socioeconomic impact, this paper argues that chronic pain should be ranked alongside other conditions of established priority in Europe. We outline strategies to help overcome barriers to effective pain care resulting in particular from deficiencies in education and access to interdisciplinary pain management services. We also address the confusion that exists between proper clinical and scientific uses of opioid medications and their potential for misuse and diversion, as reflected in international variations in the access to, and availability of, these agents.DiscussionAs the economic costs are driven in part by the costs of lost productivity, absenteeism and early retirement, pain management should aim to fully rehabilitate patients, rather than merely to relieve pain. Accredited education of physicians and allied health professionals regarding state-of-the-art pain management is crucial. Some progress has been made in this area, but further provision and incentivization is required. We support a tiered approach to pain management, whereby patients with pain uncontrolled by non-specialists are able to consult a physician with a pain competency or a specialist in pain medicine, who in turn can recruit the services of other professionals on a case-by-case basis. A fully integrated interdisciplinary pain service should ideally be available to patients with refractory pain. Governments and healthcare systems should ensure that their policies on controlled medications are balanced, safeguarding public health without undue restrictions that compromise patient care, and that physician education programmes support these aims.SummaryStrategic prioritization and co-ordinated actions are required nationally and internationally to address the unacceptable and unnecessary burden of uncontrolled chronic pain that plagues European communities and economies. An appreciation of the ‘return on investment’ in pain management services will require policymakers to adopt a long-term, cross-budgetary approach.

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“…Work-related factors are of particular interest, as acute and chronic pain among employees increase the risk of sickness absence and disability retirement 3. Globally, LBP attributable to occupation has a notable contribution to the number of disability-adjusted life years lost each year 4…”

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confidence: 99%

Early work-related physical exposures and low back pain in midlife: the Cardiovascular Risk in Young Finns Study

et al. 2016

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Objective To examine whether heavy physical workload in young adulthood increases the risk of local and radiating low back pain (LBP) in midlife. Methods Longitudinal nationally representative Young Finns Study data among women (n=414) and men (n=324), aged 18-24 years in 1986 (baseline), were used. Physical heaviness of work was reported at baseline and follow-up (2007), and local and radiating LBP at follow-up. Covariates were age, smoking and body mass index. Logistic regression was used to examine the associations between physical heaviness of work and LBP. Additionally, the mediating effect of back pain at baseline was examined (the Sobel test). Results After adjustment for the covariates, and as compared with sedentary/light physical workload, heavy physical workload was associated with radiating LBP among women (OR 4.09, 95% CI 1.62 to 10.31) and men (OR 2.01, 95% CI 1.06 to 3.82). Among men, early back pain mediated the association ( p value from the Sobel test=0.006). Among women, early exposure to physically heavy work showed the most consistent associations, while early and late exposures were associated with radiating and local LBP among men. Persistently heavy physical work was associated with radiating LBP among women and men. Conclusions Physically heavy work at a young age can have a long-lasting effect on the risk of LBP, radiating LBP in particular. These results highlight the need to consider early and persistent exposures to prevent the adverse consequences of physical workload for the low back.Low back pain (LBP) is a highly prevalent and persistent condition and its determinants have been widely examined for decades.1 2 Work-related factors are of particular interest, as acute and chronic pain among employees increase the risk of sickness absence and disability retirement.3 Globally, LBP attributable to occupation has a notable contribution to the number of disability-adjusted life years lost each year. 4 Several physical workload factors, such as nonneutral trunk postures and various manual handling activities have been associated with LBP.5 A recent individual participant data meta-analysis showed that the risk estimates for posture and force-related variables were small to moderate.6 Also, heavy physical work in general has been associated with LBP.7 Physically heavy work usually involves forceful activities and awkward postures that are loading for the low back. The importance of life course perspective in the study of LBP has been highlighted. [8][9][10] Although there are several studies on the associations between physical exposures and LBP, the focus has largely been on non-specific pain among midlife or older employees. A cross-sectional study showed that work-related physical factors are associated with LBP already in the first job.11 Similarly, in a Finnish study 12 among individuals aged 16 years, physical workload was associated with incident LBP at the age of 18. However, the long-term consequences of early exposure to heavy physical work for the low back are largely u...

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Pain and disability retirement: A prospective cohort study

Cited by 52 publications

References 25 publications

The Costs and Consequences of Adequately Managed Chronic Non‐Cancer Pain and Chronic Neuropathic Pain

The Costs and Consequences of Adequately Managed Chronic Non‐Cancer Pain and Chronic Neuropathic Pain

The individual and societal burden of chronic pain in Europe: the case for strategic prioritisation and action to improve knowledge and availability of appropriate care

Early work-related physical exposures and low back pain in midlife: the Cardiovascular Risk in Young Finns Study

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