Musculoskeletal pain intensity and risk of long-term sickness absence in the general working population: A prospective cohort study with register follow-up

Sebastian Venge Skovlund*, Rúni Bláfoss, Joaquín Calatayud, Rubén López Bueno, Emil Sundstrup, Lars Louis Andersen

*Corresponding author for this work

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Abstract

Determining predictors of sickness absence could allow for better screening, guidance, and development of preventive efforts aimed at those in increased risk. This study aimed to determine the prospective association between musculoskeletal pain intensity and risk of incident register-based long-term sickness absence in the general working population, as well as to determine the population attributable fraction. Drawing on data from a nation-wide questionnaire survey, this prospective cohort study followed a representative sample of the Danish general working population without recent long-term sickness absence (≥6 consecutive weeks) (n = 69,273) for long-term sickness absence up to two years (mean follow-up: 93 weeks) in a national register. The predictor was musculoskeletal pain intensity in the neck/shoulder and low-back during the preceding three months rated on an 11-point numerical rating scale from 0 to 10. The weighted incidence of long-term sickness-absence was 8.9% during two-year follow-up (n = 6165). We observed a clear dose-response association between musculoskeletal pain intensity of the neck/shoulder or low-back and the risk of incident long-term sickness absence, with a lower threshold of increased risk of 4 and 3 (scale 0–10) for neck/shoulder (HR (95% CI): 1.25 (1.09–1.42)) and low-back pain (HR (95% CI): 1.13 (1.00–1.29)), respectively. Prevention of pain intensities at or above 4 out of 10 could potentially prevent 17% (population attributable fraction, PAF (95% CI): 16.8 (13.6–20.1)) of the total long-term sickness absence in the general working population. Large-scale interventions to prevent and manage musculoskeletal pain need to be documented and implemented.

Original languageEnglish
Article number107636
JournalPreventive Medicine
Volume174
Number of pages7
ISSN0091-7435
DOIs
Publication statusPublished - Sept 2023

Bibliographical note

Funding Information:
The authors would like to thank data managers from The National Research Centre for the Working Environment and Statistics Denmark for data management. This manuscript was possible due to a grant from The Danish Working Environment Research Fund for this project (Arbejdsmiljøforskningsfonden, grant number 20195100758). The funder had no role in the study design, collection, analysis and interpretation of data, in the writing of the manuscript, nor in the decision to submit the manuscript for publication. The authors declare no conflicts of interest.

Keywords

  • Musculoskeletal diseases
  • Occupational health
  • Registry research
  • Sickness absence
  • Sustainable employment
  • Workplace

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