Recurrent pain and work disability: a record linkage study

Tea Lallukka,Aapo Hiilamo,Olli Pietiläinen,Minna Mänty,Jodi Oakman,Ossi Rahkonen,Jaana I Halonen,Anne Kouvonen

doi:10.1007/s00420-019-01494-5

Abstract

PurposeWe examined the associations between recurrent single- and multisite pain and incident sickness absence (SA) of different lengths and the risk of disability pension (DP).MethodsThe data were derived from the Finnish Helsinki Health Study. Pain measures were recorded for panel 1 in 2000/2 and 2007, and for panel 2 in 2007 and 2012 (altogether 3191 employees). SA data were obtained from the employer’s personnel register and DP events from the Finnish Centre for Pensions. Negative binomial regression models with generalized estimation equations were used to model the incidence of self-certified short- (1–3 days), and medically certified medium- (4–14 days) and long-term (more than 14 days) SA episodes. Cox regression models were fitted for the associations between pain and all-cause DP and competing risk models for DP by diagnostic groups. Social and health-related covariates were adjusted for.ResultsRecurrent pain was associated with short-, medium- and long-term SA. Additionally, recurrent single- and multisite pain increased the risk of long-term SA. Recurrent single or multisite pain was further associated with an increased risk of DP, while a single instance of pain did not increase the risk.ConclusionsThese results suggest that recurrent pain is a robust determinant of subsequent SA and DP risk. Improved understanding of determinants of recurrent pain is needed to inform the development of targeted measures to reduce SA and premature exit from employment.

Highlights

IntroductionWhile multisite pain is a stronger predictor of sickness absence than single site pain (de Fernandes and Burdorf 2016; Haukka et al 2015; Neupane et al 2011), longitudinal research examining recurrent single or multisite pain as predictors of SA and disability pension (DP) are rare
The prevalence of common mental disorders (CMDs) and obesity were lowest among participants who reported no current or past pain, while the prevalence figures were higher among participants with single or multisite recurrent or current pain
We examined the contribution of recurrent single and multisite pain to the severity of the work disability

Summary

Introduction

While multisite pain is a stronger predictor of sickness absence than single site pain (de Fernandes and Burdorf 2016; Haukka et al 2015; Neupane et al 2011), longitudinal research examining recurrent single or multisite pain as predictors of SA and DP are rare. Research Institute of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland. No diagnostic groups could be distinguished, i.e., any health-related exit, short and long-term and all diagnoses were merged. It is not known, to what extent recurrent pain predicts exit from paid employment due to both musculoskeletal diseases and mental disorders. To the best of our knowledge, recurrent multisite pain as a predictor of work disability across a range of severity measures has not been previously examined

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Conclusion