title: Musculoskeletal pain at multiple sites and its effects on work ability in a general working population.
abstract: OBJECTIVE
  Musculoskeletal pain often occurs at multiple sites concurrently. The aim of this study was to examine the associations between multi-site pain and self-rated work ability and retirement plans among actively working people.
  
  
  METHODS
  The Health 2000 Survey was carried among a representative sample of Finnish adults. Musculoskeletal pain during the preceding month in the lower back, neck or shoulders, upper extremities, hips and lower extremities, and work ability and intentions to retire early were assessed. Subjects were also clinically examined. Analyses were restricted to 30-64-year-old subjects actively working during the preceding 12 months who provided information on work ability outcomes (population-weighted number of subjects=4087). Log-binomial regression was used to estimate prevalence ratios of reduced work ability.
  
  
  RESULTS
  Single-site pain was reported by 33% of subjects, 20%, 9% and 4% reported pain in two, three and four sites, respectively, and 8%-15% reported poor work ability. Every fifth person had thought about retiring early. Age- and gender-adjusted risks of poor physical work ability and own prognosis of poor future work ability increased from 2 for single-site pain to 8 for pain at four sites. Risks remained considerably elevated after adjustment for various covariates, including clinical musculoskeletal disorders and functional capacity. Poor current work ability was most affected by multi-site pain at older age (50-64 years) and intentions to retire early at age 40-49 years.
  
  
  CONCLUSIONS
  Co-occurring pain is a considerable threat to work ability. Workers with multi-site pain may benefit from targeted preventive measures to sustain their work ability. Future studies should also consider multi-site pain as an important risk factor for reduced work ability.
authors.affiliation: Finnish Institute of Occupational Health, Helsinki, Topeliuksenkatu 41 aA, Helsinki, Finland. helena.miranda@ttl.fi
authors.forename: Helena
authors.initials: H
authors.lastname: Miranda
authors.forename: Leena
authors.initials: L
authors.lastname: Kaila-Kangas
authors.forename: Markku
authors.initials: M
authors.lastname: Heliövaara
authors.forename: Päivi
authors.initials: P
authors.lastname: Leino-Arjas
authors.forename: Eija
authors.initials: E
authors.lastname: Haukka
authors.forename: Juha
authors.initials: J
authors.lastname: Liira
authors.forename: Eira
authors.initials: E
authors.lastname: Viikari-Juntura
mesh_terms: D000041:Absenteeism; D000328:Adult; D003627:Data Interpretation, Statistical; D004185:Disability Evaluation; D005260:Female; D005387:Finland / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control; D009784:Occupational Diseases / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control; D010146:Pain / Q000191:economics / Q000453:epidemiology* / Q000523:psychology; D015995:Prevalence; D012179:Retirement; D012307:Risk Factors; D011795:Surveys and Questionnaires