Low back pain as a predictor of long-term work disability

Aim: To investigate low back pain (LBP), with and without other musculoskeletal pains, as a predictor of long-term work disability. Method: A four-year prospective study was conducted. All inhabitants in the municipality of Ullensaker, Norway, born in 1928-30, 1938-40, 1948-50, 1958-60 and 1968-70, received a mailed questionnaire in 1990 and 1994. The present study comprised the 1,788 responders who were working in 1990. Of these, 1426 (80%) returned the questionnaire four years later. The main outcome measure was long-term work disability (>eight weeks) in 1994. Results: LBP in 1990 predicted long-term work disability in 1994 (odds ratio (OR) = 1.95, 95% confidence interval (CI) = 1.39-2.74). Localized LBP however, did not predict long-term work disability, while LBP accompanied by widespread pain did (OR = 3.52, 95% CI = 1.09-11.37), also after adjustments for demographic, lifestyle, and work-related factors. Other predictors of long-term work disability were high age, sick leave last year, heavy lifting in the job, poor sleep quality and smoking. Conclusion: LBP in persons with widespread musculoskeletal pain predicted long-term work disability, while localized LBP did not.