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Risk factors for new episodes of sick leave due to neck or back pain in a working population. A prospective study with an 18-month and a three-year follow-up

¹ The Karolinska Institute, Section for Personal Injury Prevention, Stockholm, Sweden
² Unit of Statistics and Epidemiology, Clinical Research Centre, Örebro University Hospital, Örebro, Sweden

Correspondence to:
Correspondence to:
Dr G Bergström
Section for Personal Injury Prevention, Karolinska Institute, Box 127 18, S-112 94 Stockholm, Sweden; gunnar.bergstrom{at}ki.se

Objectives: To identify risk factors for new episodes of sick leave due to neck or back pain.

Methods: This prospective study comprised an industrial population of 2187 employees who were followed up at 18 months and 3 years after a comprehensive baseline measurement. The potential risk factors comprised physical and psychosocial work factors, health-related and pain-related characteristics and lifestyle and demographic factors. The response rate at both follow-ups was close to 73%.

Results: At the 18-month follow-up, 151 participants reported at least one episode of sick-listing due to neck or back pain during the previous year. Risk factors assessed at baseline for sick leave due to neck or back pain at the follow-up were blue-collar work, back pain one or several times during the previous year, 1–99 days of cumulative sickness absence during the previous year (all causes except neck or back pain), uncertainty of one’s own working ability in 2 years’ time and the experience of few positive challenges at work. After 3 years, 127 participants reported at least one episode of sick leave due to back or neck pain during the year previous to follow-up. The risk factors for this pain-related sick leave were blue-collar work, several earlier episodes of neck pain, no everyday physical activities during leisure time (cleaning, gardening and so on), lower physical functioning and, for blue-collar workers separately, repetitive work procedures.

Conclusion: The most consistent risk factors for new episodes of sick leave due to neck or back pain found during both the follow-ups were blue-collar work and several earlier episodes of neck or back pain assessed at baseline. Preventive efforts to decrease sick leave due to neck or back pain may include measures to increase the occurrence of positive challenges at work and to minimise repetitive work procedures. An evidence-based secondary prevention of neck and back pain including advice to stay active is also warranted.

Abbreviations: SF-36, short form-36

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