Diagnosing an occupational cause of low back pain may improve the chances of recovery, according to a research report published in the Annals of Internal Medicine.

The National Health Interview Survey collected in 2015 data concerning work-relatedness and effects of low back pain on work in US workers (response rate, 55.2%). The overall prevalence for any low back pain was 26.4%, with a 5.6% prevalence of work-related low back pain, and an 8.1% prevalence of frequent and severe low back pain. The lowest prevalence of any of these types of low back pain was in workers employed in mathematical and computer occupations, and the highest prevalence was in extraction and construction occupations. The highest prevalence of severe and frequent low back pain was in building and grounds cleaning and maintenance occupations. Workers reporting frequent standing or exertion were more likely to report all 3 types of low back pain than workers who did not.

Approximately 21.4% of workers with any low back pain and 23.7% of workers with frequent and severe lower back pain reported a health professional telling them that their pain was likely to be work-related. Most workers did not recall ever discussing with a healthcare professional whether their low back pain may be work-related. Overall, 18.4% of workers with work-related low back pain, 10.2% of workers with frequent and severe lower back pain, and 6.0% of workers with any low back pain were found to have ever filed a claim for workers’ compensation. Regardless of cause, 16.9% of workers with any low back pain and 19.0% of workers with frequent and severe low back pain missed at least 1 full workday in the previous 3 months due to low back pain, and an additional 6.1% of workers with any low back pain and 10.7% of workers with frequent and severe low back pain had changed jobs, stopped working, or made a major change in work activities in the previous 3 months due to low back pain.

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Due to the short recall period of the study and the exclusion of former workers — many of whom may have left the workforce due to work-related lower back pain — these findings may underestimate the total occupational effect of low back pain. Despite this and other study limitations, a study strength lies in the use of a large, nationally representative sample of workers in the United States.

“Low back pain has been linked to both physical and psychosocial occupational factors in many studies. Diagnosing an occupational cause may improve the chances of a patient’s recovery if an occupational exposure precipitating the pain can be reduced or eliminated and may allow the patient to apply for workers’ compensation to cover medical costs and lost wages,” concluded the study authors.

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Reference

Luckhaupt SE, Dahlhamer JM, Gonzales GT, Lu M-L, Ward, BW. Prevalence, recognition of work-relatedness, and effect on work of low back pain among U.S. workers [published online May 14, 2019]. Ann Intern Med. doi: 10.7326/M18-3602