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During a 4-year
follow-up period, the number of body regions with musculoskeletal pain was
found to be strongly linked with absence due to long-term sickness.
Until now, the effect of pain
intensity on the association between widespread pain and sickness absence had
not been studied although, both musculoskeletal pain-intensity with respect to
a specific location (like lower back or shoulder) and pain in multiple body
regions have been shown to be related with impaired function and sickness
absence. Also, it is unknown whether care-seeking in general practice because
of musculoskeletal disorders has a positive or negative effect on future
absenteeism.
The aim of the study mentioned here
was to investigate the influence of pain intensity on the association between
number of musculoskeletal pain sites and sickness absence, and to assess the
effect on absenteeism from care-seeking in general because of musculoskeletal
disorders.
In February 2008, a total of 3745
Danish adults registered with eight General Practitioners (GPs) in one primary
medical center delineated location and intensity of experienced musculoskeletal
pain in seven different body regions. From 4 years, the outcome was timespan of
sickness absence based on register data split into long-term (>52 weeks
during follow-up) and sickness absence of shorter timespan (12–52 weeks
during follow-up). The data on pain-intensity were investigated at three
different cut-off stages for each body region: i) > 1 (any pain), ii) > 2
(bothersome pain), iii) > 3 (very bothersome pain). The analyses were
divided and distinguished between people without GP contact and people with GP
contact because of musculoskeletal disorders.
Musculoskeletal pain in more than
two body regions was strongly analogous to long-term sickness absence in an
exposure-response pattern. Different cut-off levels of pain intensity and
adjustment for age, sex, educational level and work environmental factors did
not have any impact on the results. Although the association was weaker,
similar findings were noticed for sickness absence of shorter duration.
It was thus concluded that the intensity of pain and care-seeking because of musculoskeletal disorders did not seem to influence the association between the number of pain locations and later sickness absence. The number of musculoskeletal pain locations seems to be a powerful risk factor for later sickness absence.
BMC Musculoskelet Disord. 2016 May 04
Widespread pain – do pain intensity and care-seeking influence sickness absence? – A population-based cohort study
Soren Mose et al.
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