Study Identifies Factors Linked to Lower Work Disability for Chronic Pain Risk

A new study explored demographic, health, and psychosocial work environment factors that may be correlated with future work disability and unemployment among workers with low back pain (LBP) and/or neck shoulder pain (NSP).

“Chronic musculoskeletal pain, that affects over 20% of the adult population, is the most common cause of severe, long-term, physical disability,” the researchers reported, adding that, “Moreover, unemployment rates are usually twice as high for people with health problems or disability such as chronic pain.”

The study included data from the Study of Twin Adults Genes and Environment (STAGE) web-based questionnaire study conducted by the Swedish Twin Registry (STR) in 2004-2006, as well as national register data. All twins in the STR born in 1959-1985 received STAGE. Patients were aged 19-47 years at baseline and 28-58 years at follow-up. A total of 25,496 twins responded; for the present study, those with a six-month history of LBP and/or NSP were included.

The current analysis included 5,556 participants, who were followed up for work disability (sick leave >90 days or a disability pension) and unemployment (>180 days in a year) through Dec. 31, 2013. Most of the study sample (60.5%) was female, 48.7% was aged between 38 and 47 years, and 45.3% only had NSP.

Incident sick leave (>90 days) or disability pension was observed in 13.7% of participants; 10.8% were unemployed for more than 90 days during a one-year period. Women were more likely than men to experience sick leave/disability pension or unemployment. The youngest age group, compared to the oldest, was more likely to have unemployment but less likely to have sick leave/disability pension.

When assessing the study sample as a whole, participants with a higher education were less likely than those with secondary education to have sick leave/disability pension, but the researchers posited that this was due to familial factors.

“In the analysis for the risk of unemployment, having only a compulsory education was a risk factor but there was no significant difference between secondary or higher education. These associations do not seem to be influenced by familial factors,” the study authors observed.

Other factors associated with a reduced risk of work disability included no history of depression or anxiety, good self-rated health, low job demands, and high job control; factors correlated with a lower unemployment risk included no history of anxiety and depression and high job control.

The study was published in BMC Musculoskeletal Disorders.

“To conclude, among those with low back and/or neck-shoulder pain, good health in terms of self-rated health and absence of mental or few pain sites, as well as good psychosocial working conditions seem to indicate a lower risk for work disability,” concluded the authors. “For unemployment only absence of mental symptoms and high job control played a protective role. Furthermore, means to prevent work disability or unemployment that focus on increasing education may prove successful.”