Staying at work with chronic musculoskeletal pain: A new reference for pain rehabilitation

Background and Aims: Chronic nonspecific musculoskeletal pain (CMP) results often in work disability and sick-leave, confronting employers, insurance companies, and society with considerable costs. However, a substantial amount of workers stay at work despite CMP. It is currently unknown on which factors people who stay at work despite CMP differ from those who do not. Attention to workers who stay at work despite CMP will enlarge our understanding of work participation in people with CMP. The main question of this study was: what are the characteristics of workers who manage to stay at work despite CMP, and what can be learned from this successful group? Methods: Cross-sectional design. Medical, physical, psychological and social variables of workers who stay at work with CMP were described (n = 120), and compared with sick-listed workers with CMP who sought multidisciplinary pain rehabilitation care (n = 120). Results: Relevant differences were observed on pain disability, physical and mental health, lifting low, static overhead work, forward bending, pain catastrophizing, pain self-efficacy, work satisfaction and presenteeism. Non-relevant differences were observed on pain intensity, activity level, dynamic bending, pain acceptance, fear avoidance, psycho-neuroticism, pain coping, responses of significant others, need for recovery, and work demands. Conclusions: Relevant and non-relevant differences exist between workers with CMP who stay at work and sick-listed workers who search pain rehabilitation. The results of this study can be used to develop interventions to promote staying at work. The knowledge gathered in this study provides a new reference for clinicians working in rehabilitation, occupational, and insurance medicine