Pain in multiple sites and sickness absence trajectories: A prospective study among Finns

Abstract

We studied the number of musculoskeletal pain sites as a predictor of sickness absence during a 7-year follow-up among a nationally representative sample (the Health 2000 survey) of occupationally active Finns 30 to 55years of age (3420 subjects who did not retire or die during the follow-up). Baseline data (questionnaire, interview, clinical examination by a physician) were gathered in 2000 to 2001 and linked with information from national registers on annual compensated sickness absence periods (⩾10workdays) covering the years 2002 to 2008. Pain during the preceding month in 18 body locations was inquired and combined into 4 sites (neck, upper limbs, low back, lower limbs). Demographic factors, BMI, smoking, leisure-time physical activity, sleep disorders, physical and psychosocial workload, and chronic diseases were assessed. Four distinct sickness absence trajectories emerged, labeled as Low (59% of the subjects), Ascending (21%), Mixed (11%), and High (9%). In multinomial logistic regression, the odds ratios (ORs) for belonging to the High vs. the Low trajectory increased with the number of pain sites, being 2.1 for single-site pain, 2.6 for 2 pain sites, 2.9 for 3 pain sites, and 4.1 for 4 pain sites, after adjustment for chronic diseases, demographic and lifestyle factors, and workload. The confidence intervals of the ORs did not include unity. The adjusted ORs for belonging to the Ascending trajectory were 1.1, 1.3, 1.7, and 1.7, respectively. As the number of pain sites was a strong independent predictor of work absenteeism, early screening of workers with multisite pain and interventions to support work ability seem warranted.

Predictors of sickness absence related to musculoskeletal pain: a two-year follow-up study of workers in municipal kitchens

“…Although statistically non-significant, the effect sizes of these factors in the high trajectory were yet comparable to those regarding membership in the "intermediate" trajectory. The results correspond Predictors of sickness absences related to musculoskeletal pain to those found in previous studies relative to all SA regardless of diagnosis (10,11,37). Overweight and obesity, being pro-inflammatory states, may increase pain perception and its consequences for work ability.…”

“…This suggests that part of the negative experiences in the domain of psychosocial working conditions may be expressed as musculoskeletal pain, diminishing the discernible association of the former with SA. In our population-level study, physical workload and low job control (but neither job demands nor supervisor or coworker support) independently predicted the course of SA over time (11).…”

“…With regard to musculoskeletal disorders, neck pain and low-back pain have received most attention in this respect (5,(7)(8). While a range of other factors, such as female gender (9), increasing age, high physical workload (9)(10)(11), poor psychosocial working conditions, obesity, smoking (9)(10)(11), and being physically inactive during leisure-time (12), have been implicated as risk factors for SA in general, little is known about their importance regarding SA due to musculoskeletal pain specifically.…”

Results of a feasibility study: barriers and facilitators in implementing the Sherbrooke model in France

“…The aging of the working population and intensification of work are structural trends tending to increase the incidence of musculoskeletal pain and disability (1). Interventions in the workplace have been developed to facilitate return to and maintenance of work (2).…”

A Tailored Learning Program for Prevention of Musculoskeletal Disorders

“…Recent studies have indicated that a high number of pain regions are an independent risk factor for reduced work ability [30]. A high number of pain regions also have a negative impact on health in general [31] and increase the risk for long term sickness absence [32].…”