The combined association of musculoskeletal pain, physical activity, and BMI on the risk of disability pension. - Prospective data from the HUNT-study.

Abstract

Many in the working population today obtain disability pension and a significant part of the population receive sick leave compensation or other kinds of public support in shorter or longer periods of time. In our society today, one of the most frequent reasons of sick leave and disability pension is pain in neck and/or back. This study will examine the association between musculoskeletal pain in relation to risk of disability pension, and include lifestyle factors, such as physical activity and BMI, to examine if these factors can modify the association. We ran cox regression analyses on a HUNT population including 45654 individuals to estimate RRs of disability pension with 95% CI. The results show that musculoskeletal pain in neck/shoulder/back increases the risk of disability pension (RR 2,57, CI 2,44 – 2,72). A combined analysis including musculoskeletal pain and different levels of BMI showed that the risk of disability pension increases from normal weight (RR 2,67, CI 2,46 – 2,94) to obese (RR 4,02, CI 3,64 – 4,45) among people with musculoskeletal pain, compared to normal weight without pain. High BMI also gives an increased risk of disability pension among people without pain (RR 1,55, CI 1,37 – 1,75). Physical activity is also showing to be a contributing factor. People with pain, already have a risk of disability pension, but it can be reduced from the inactive (RR 2,54, CI 2,11 – 3,05) to the highly active (RR 1,48, CI 1,25 – 1,75), when compared to inactive people without pain. A similar preventive effect can be seen among people without pain, where the risk of disability pension descends to RR 0,55 (CI 0,47 – 0,66) with high activity, compared to the inactive without pain. Our main findings are the relation between musculoskeletal pain in the neck, shoulders and back towards risk of disability pension. This study also found that physical activity and BMI may affect the relation between musculoskeletal pain and risk of disability pension, where increased physical activity reduce the risk of disability pension and increased BMI has the opposite effect. In conclusion, it seems that physical activity and achieving normal weight may reduce the unfortunate effects of musculoskeletal pain when it comes to risk of disability pension.