Psychosocial risks for low back pain: are these related to work?

Objectives-To examine whether psychosocial risks for low back pain, reported in previous studies, are specific to the working population or are more widely relevant. Methods-A large population-based survey identified subjects free of low back pain, and obtained information on the degree of satisfaction with work (or not working) and the adequacy of income for their family's needs. New episodes of consulting and non-consulting low back pain were identified prospectively over 12 months. The psychosocial risks for developing a new low back pain episode are examined in employed and non-employed groups separately. Results-Dissatisfaction with work status doubled the risk of reporting a new low back pain episode in both the employed (odds ratio 2.0, 95% confidence intervals 1.2, 3.3) and non-employed (OR 2.0, 1.2, 3.1). Those perceiving their income as inadequate were at a threefold risk of consulting for this symptom regardless of their employment status (employed: OR 3.6, 1.8, 7.2; non-employed: OR 3.6, 1.4, 9.0). Conclusion-Psychosocial factors pose similar risks for a new low back pain episode in workers and the non-employed. This suggests that such influences may not be related solely to work but be a function of general aspects of life. The economic and individual impact of psychosocial interventions in the workplace, therefore, are likely to be limited unless account is taken of the influence of broader nonwork related aspects.