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Chronic pain and sick leave in a 21-year follow up
Institute of medicine, University of Gothenburg, Primary Health Care Unit, Department of Public Health and Community Medicine, Gothenburg, Sweden.
Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). RandD Spenshult, Halmstad, Sweden & Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.ORCID iD: 0000-0003-4260-7399
Halmstad University, School of Business, Engineering and Science, The Rydberg Laboratory for Applied Sciences (RLAS). RandD Spenshult, Halmstad, Sweden.ORCID iD: 0000-0002-1445-5247
Institute of medicine, University of Gothenburg, Primary Health Care Unit, Department of Public Health and Community Medicine, Gothenburg, Sweden & RandD Spenshult, Halmstad, Sweden.ORCID iD: 0000-0002-6294-538X
2019 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 78, no Suppl 2, p. 122-122Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Background: Chronic musculoskeletal pain (CMP) is a common cause of disability and impaired quality of life. In Sweden, chronic pain and mental illness are major causes of sick leave. But sick leave itself is also proposed as a risk factor for prolonged sick leave and disability pension.

Objectives: To study CMP and sick leave as potential risk factors for long term sick leave or disability pension in a 21 year follow up of a general population cohort.

Methods: In a cohort study, with a baseline survey in 1995, 1466 individuals aged 20-67 years were followed for 3 years and 691 for 21 years, or up to the age of 67. CMP (>3 months duration) was reported on a pain mannequin. Sick leave and disability pension were self-reported. Mental health was measured by the mental health (MH) score of the SF-36 health status, and categorized into tertiaries (best, medium and worst). CMP, sick leave, and mental health at baseline, were studied as potential predictors for long term sick leave (disability pension or sick leave >3 months) at a 3 and 21 year follow up. Other potential predictors (socioeconomic group, education, and immigrant status) were introduced in multiple regression analyzes but did not add to the results and were removed from the final models, which were controlled for age and sex.

Results: CMP and mental health predicted long term sick leave at the 3 year follow up (OR 2.11, p=0.010 and OR 3.52, p<0.001). Mental health (OR 1.92, p=0.046), but not CMP (OR 0.77, p=0.409), was also a predictor at the 21 year follow up. Sick leave >3 months, irrespectively if due to pain or not, predicted long term sick leave both at the 3 and the 21 year follow up (Table). Sick leave for ≤3 months also predicted long term sick leave at both follow ups when due to pain (OR 2.70, p=0.008 and OR 2.78, p=0.012), but not when due to other causes (OR 1.52, p=0.212 and OR 1.17, p=0.606).

Conclusion: Sick leave and especially sick leave due to pain predicted long term sick leave up to 21 years later, independently of pain status or mental health at baseline. It is thus important to early identify individuals at risk and minimize sick leave by providing proper rehabilitation.

© Drab, Aili, Haglund & Bergman 2019. No commercial re-use. See rights and permissions. Published by BMJ.

Place, publisher, year, edition, pages
London, UK: BMJ Publishing Group Ltd, 2019. Vol. 78, no Suppl 2, p. 122-122
Keywords [en]
Chronic pain, Sickness absence
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:hh:diva-40944DOI: 10.1136/annrheumdis-2019-eular.2021ISI: 000472207100311OAI: oai:DiVA.org:hh-40944DiVA, id: diva2:1370136
Conference
Annual European Congress of Rheumatology (EULAR 2019), Madrid, Spain, June 12-15, 2019
Available from: 2019-11-14 Created: 2019-11-14 Last updated: 2019-11-27Bibliographically approved

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Aili, KatarinaHaglund, EmmaBergman, Stefan

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