Secular trends in work disability and its relationship to musculoskeletal pain and mental health: a time-trend analysis using five cross-sectional surveys (2002–2010) in the general population

Abstract

ObjectivesInternational evidence suggests that rates of inability to work because of illness can change over time. We hypothesised that one reason for this is that the link between inability to work and common illnesses, such as musculoskeletal pain and mental illness, may also change over time. We have investigated this in a study based in one UK district.MethodsFive population surveys (spanning 2002–2010) of working-age people aged >50 years and ≤65 years were used. Work disability was defined as a single self-reported item ‘not working due to ill-health’. Presence of moderate–severe depressive symptoms was identified from the Mental Component Score of the Short Form-12, and pain from a full-body manikin. Data were analysed with multivariable logistic regression.ResultsThe proportion of people reporting work disability across the surveys declined, from 17.0% in 2002 to 12.1% in 2010. Those reporting work disability, one-third reported regional pain, one-half widespread pain (53%) and two-thirds moderate–severe depressive symptoms (68%). Both factors were independently associated with work disability; their co-occurrence was associated with an almost 20-fold increase in the odds of reporting work disability compared with those with neither condition.ConclusionsThe association of work disability with musculoskeletal pain was stable over time; depressive symptoms became more prominent in persons reporting work disability, but overall prevalence of work disability declined. The frequency and impact of both musculoskeletal pain and depression highlight the need to move beyond symptom-directed approaches towards a more comprehensive model of health and vocational advice for people unable to work because of illness.

Pain trends among American adults 2002-2018: Patterns, disparities, and correlates

“…Additionally, two recent analyses (using data from 2004-2016 and 2002-2010) found no change over time in the association between self-reported pain and more objective measures of painrelated function, specifically walking speed and work disability (Grol-Prokopczyk, Zimmer and Zajacova 2019;Wynne-Jones et al 2018). And finally, our own findings show that the correlation between most health conditions and pain has not changed over time (Table 6, Panel B2).…”

Healthy working life expectancy at age 50 for people with and without osteoarthritis in local and national English populations

“…These symptoms are likely to be influenced by various lifestyle, socioeconomic, workplace, and social factors 31 – 33 . Health-related quality of life is closely related to pain severity, and pain interference is strongly associated with work disability and premature work loss 34 , 35 . However, supportive workplaces can improve return to work, sickness absence, and presenteeism outcomes for people with chronic conditions 32 , 36 .…”

Pain Trends Among American Adults, 2002–2018: Patterns, Disparities, and Correlates

“…'s(2019) doc u men ta tion of steep rises in U.S. pain from 1997 to 2014 relies on di ag nosed pain-re lated health con di tions and ICD-9 categories (e. g., os te o ar thri tis, tem po ro man dib u lar joint dis or der), which are ar gu ably more re sis tant to chang ing reporting norms than ques tions about less well-spec i fiedpain.Next,stud iespro videev i dencethatU.S.painprev a lencein creased be fore the reg u la tory and com mer cial de vel op ments of the mid-1990s/early 2000s (Zimmer and Zajacova 2020) as well as af ter the CDC's 2011 dec la ra tion of an opi oid ep i demicandthesub se quentback lashagainstthe"fifthvi talsign"andopi oidman ufac tur ers (Jones et al 2018). That is, pain lev els in creased be fore, dur ing, and af ter the cul turalshiftsthe o rizedtoshapereporting.Furthermore,painap pearstobein creas ing glob ally (Shupler et al 2019;, in clud ing in Western Eu ro pean countries with dif fer ent ther a peu tic re gimes and much tighter reg u la tion of phar ma ceuti cal mar ket ing than found in the United States (Meyer et al 2020).Thefind ingswe re portherearethusnotuniquetotheU.S.po lit i cal-eco nomiccon text.Additionally,two re cent an a ly ses (us ing data from 2004-2016 and 2002-2010) found no change over time in the as so ci a tion be tween self-reported pain and more ob jec tive mea sures of painre lated func tion-spe cifi cal ly, walk ing speed and work dis abil ity (Grol-Prokopczyk et al 2019;Wynne-Jones et al 2018).Finally,ourownfind ingsshowthatthecor re lation be tween most health con di tions and pain has not changed over time (Table 6, panel B2).However,wealsoac knowl edgethatamongolderadults,alargecom po nentofthe pain in crease could not be explained by the chang ing dis tri bu tion of pain de ter mi nants (Table 6, panel A), leav ing open the pos si bil ity of reporting changes as par tial con trib utors to the ob served trends. Overall, how ev er, al though reporting fac tors may be at play and should be ex plored fur ther, ev i dence of ris ing pain prev a lence now comes from too many countries, con texts, and data sources to be eas ily dismissed.…”

“…The findings we report here are thus not unique to the U.S. political-economic context. Additionally, two recent analyses (using data from 2004–2016 and 2002–2010) found no change over time in the association between self-reported pain and more objective measures of pain-related function—specifically, walking speed and work disability ( Grol-Prokopczyk et al 2019 ; Wynne-Jones et al 2018 ). Finally, our own findings show that the correlation between most health conditions and pain has not changed over time ( Table 6 , panel B2).…”