Are psychosocial factors associated with low back pain and work absence for low back pain in an occupational cohort?

OBJECTIVES To examine the relationship between individual and work-related psychosocial factors and low back pain (LBP) and associated time off work in an occupational cohort. METHODS A self-administered questionnaire was completed by nurses working across 3 major public hospitals. Participants provided sociodemographic data and information on the occurrence of LBP, time off work, and psychosocial factors. RESULTS One thousand one hundred eleven participants (response rate 38.6%) were included in the study. Fifty-six percent of participants reported LBP in the previous year. When individual psychosocial factors were examined in the same model, the relationship between somatization and LBP persisted (OR 1.64; 95% confidence interval [CI], 1.35, 2.01). Low job security was also significantly associated with LBP independent of the other work-related factors (OR 0.82; 95% CI, 0.69, 0.98). Of those participants with LBP, 30% reported absence from work due to LBP. When absence from work was examined, negative beliefs (OR 0.97; 95% CI, 0.94, 1.00) and pain catastrophizing (OR 1.33; 95% CI, 1.04, 1.71) were independently associated with time off work, along with low job satisfaction (OR 0.71; 95% CI, 0.51, 0.97) and high job support (OR 1.35; 95% CI, 1.04, 1.75). CONCLUSIONS Somatization and low job security were found to be independently associated with occupational LBP, whereas negative beliefs, pain catastrophizing, reduced job satisfaction, and high job support were independently related to time off work. Longitudinal studies are needed to determine whether these individual and work-related psychosocial factors predict, or alternatively, are outcomes of pain and time off work associated with LBP.