Connections between lower back pain, interventions, and absence from work: A time-based meta-analysis

We conducted qualitative and quantitative reviews of the medical literature to develop an understanding of the linkages between nonspecific lower back pain (LBP) and employee absenteeism, and the efficacy of lower back pain interventions (LBPI) in reducing absenteeism. First, we offered a general time-based framework to clarify the causal flows between LBP and absence. Second, we inspected LBPIs designed to ameliorate LBP, which should, in turn, lead to reduced absence-taking. Third, we conducted a meta-analysis of 45 effect sizes involving 12,214 people, to examine the relationships between both LBP and LBPIs and absenteeism. Consistent with a presumption in the medical literature, we found support for the idea that chronic LBP has a positive overall relationship with absence-taking. The relationship was stronger for absence frequency measures than time lost measures. In addition, we found that increasing aggregation time (i.e., increases in the periods over which absence is observed) enhances the size of the chronic LBP-absence connection. Further, evidence showed that LBPIs were effective overall in reducing absenteeism. Finally, when there was a temporal mismatch between the form of LBP (acute vs, chronic) and the absenteeism aggregation period in LBPI studies, effect sizes were significantly smaller. We concluded with a discussion of these results, methodological limitations, and suggestions for future research that blends medical with organizational approaches to the etiology of absence.