title: Impact of musculoskeletal co-morbidity of neck and upper extremities on healthcare utilisation and sickness absence for low back pain.
abstract: OBJECTIVE
  To describe the presence of musculoskeletal co-morbidity of the neck and upper extremities among industrial workers with low back pain, and to examine whether it has an impact on healthcare utilisation and sickness absence for low back pain.
  
  
  METHODS
  A self administered questionnaire was used to collect data from 505 industrial workers (response 86%).
  
  
  RESULTS
  The 12 month prevalence of low back pain was 50%. Among subjects with low back pain the 12 month prevalence of musculoskeletal co-morbidity of the neck and upper extremities was 68%. Among workers with low back pain, subjects with high pain intensity or disabling low back pain were more likely to have musculoskeletal co-morbidity. In comparison to the subjects who report back pain only, subjects with co-morbidity showed worse general health and health related quality of life. No impact of upper extremity co-morbidity was found on healthcare utilisation, and sickness absence due to low back pain.
  
  
  CONCLUSIONS
  This study provides no evidence that musculoskeletal co-morbidity of the neck and upper extremities influences the choice to seek care or take sick leave due to low back pain among industrial manual workers. For occupational health practitioners the finding of a high co-morbidity is important to consider when implementing workplace interventions aimed at the reduction of specific musculoskeletal complaints, since the controls for one musculoskeletal complaint may impact adversely on another musculoskeletal complaint. Researchers who perform low back pain intervention studies using generic health measures, should take into account the impact of musculoskeletal co-morbidity on these measures.
authors.affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO Box 1738, 3000 DR Rotterdam, Netherlands. w.ijzelenberg@erasmusmc.nl
authors.forename: W
authors.initials: W
authors.lastname: IJzelenberg
authors.forename: A
authors.initials: A
authors.lastname: Burdorf
mesh_terms: D000041:Absenteeism; D000328:Adult; D001132:Arm; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D017116:Low Back Pain / Q000453:epidemiology*; D008297:Male; D009140:Musculoskeletal Diseases / Q000453:epidemiology*; D019547:Neck Pain / Q000150:complications*; D009784:Occupational Diseases / Q000453:epidemiology*; D016017:Odds Ratio; D012044:Regression Analysis; D018582:Sick Leave / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires