Sickness absence and concurrent low back and neck–shoulder pain: results from the MUSIC-Norrtälje study

Abstract

In Sweden, musculoskeletal disorders, in particular low back disorders (LBD) and neck-shoulder disorders (NSD) constitute by far the most common disorders, causing sick leave and early retirement. Studies that compare sickness absence in individuals with LBD and individuals with NSD are lacking. Moreover, it is likely that having concurrent complaints from the low back region and the neck-shoulder region could influence sickness absence. The purpose of the present study was to explore potential differences in sickness absence and in long-term sickness absence during a 5-year period, 1995-2001, among individuals with (1) solely LBD, (2) solely NSD, and (3) concurrent LBD and NSD. The present study was based on 817 subjects from the MUSIC-Norrtä lje study, whom were working at baseline and whom at both baseline and follow-up reported LBD and/or NSD. Three groups were identified based on pain and pain-related disability at both baseline and follow-up: (1) solely LBD, (2) solely NSD, and (3) concurrent LBD and NSD. Subjects who did not give consistent answers at both the baseline and follow-up occasionswere assigned a fourth group: (4) migrating LBD/NSD. Two outcomes were analysed: (1) prevalence of sickness absence, and (2) long-term sickness absence among those with sickness absence days. Logistic regression analysis was used to calculate odds ratios (OR) for sickness absence in the different disorder groups, taking into account confounding factors such as gender, age and other non-musculoskeletalrelated disorders. In the group concurrent LBD and NSD, 59% had been sickness absent between baseline and follow up, compared to 42% in the group solely LBD, 41% in the group solely NSD, and 46% in the group migrating LBD/NSD. No difference in sickness absence was found between the group solely LBD compared to the group solely NSD [OR 0.65 (0.36-1.17)]. The adjusted OR for sickness absence in the group concurrent LBD and NSD compared to subjects with solely LBD or solely NSD was [OR 1.69 (1.14-2.51)]. The adjusted OR for having long-term sickness absence was 2.48 (95% CI = 1.32-4.66) for the group concurrent LBD and NSD. In the present study, having concurrent LBD and NSD were associated with a higher risk for sickness absence and also long-term sickness absence. This suggests that, when research on sickness absence and return to work after a period of LBD or NSD is performed, it is important to take into consideration any concurrent pain from the other spinal region. The study also implies that spinal co-morbidity is an important factor to be considered by clinicians and occupational health providers in planning treatment, or in prevention of these disorders.

Effects of Physical and Personal Risk Factors on Sick Leave Due to Musculoskeletal Disorders

“…As some recent studies show, back pain is an important problem at work and it can generate diverse costs [15]. In the present study, back pain led to many sick leave absences and many lost working days.…”

A prospective cohort study on musculoskeletal risk factors for long-term sickness absence among healthcare workers in eldercare

“…Although a direct comparison due to methodological differences between studies is difficult, the annual prevalence of low back pain is approximately 50% in the general population (Leboeuf-Yde et al 1996). While epidemiological studies report that low back pain and neck/shoulder pain are risk factors for sickness absence (Andersen et al 2011;Bergstrom et al 2007;Holmberg and Thelin 2006;Morken et al 2003;Natvig et al 2002;Nyman et al 2007;van den Heuvel et al 2004), fewer large prospective studies concerning risks from musculoskeletal pain in other regions of the body exist (e.g., Andersen et al 2011;Kamaleri et al 2008;Morken et al 2003;Natvig et al 2002).…”

Shoulder disorders and occupation

“…Symptoms can be persistent and disabling in terms of an individual's ability to carry out daily activities both at home and in the workplace [5,6]. There are also substantial economic costs involved, with increased demands on health care, impaired work performance, substantial sickness absence, and early retirement or job loss [7][8][9][10].…”

“…Symptoms can be persistent and disabling in terms of an individual's ability to carry out daily activities both at home and in the workplace [5,6]. There are also substantial economic costs involved, with increased demands on health care, impaired work performance, substantial sickness absence, and early retirement or job loss [7][8][9][10].The shoulder has evolved to withstand heavy physical demands and to do so over an unusually wide range of motion. To achieve this, it is not a simple 'ball and socket' joint but rather a complex composed of four articulations and a supporting arrangement of bones, muscles and ligaments within and outside of the joint capsule.…”