The transitional pattern of pain and disability, from perceived pain to sick leave. Experience from a longitudinal study.
OBJECTIVE
To investigate the prospective value of the transitional and dynamic patterns of pain disability over time on sick leave in chronic recurrent back/neck pain cases.


METHODS
The material used was based on a longitudinal study with three repeated measurements. The graded Chronic Pain Scale was used to assess levels of pain disability. The relationship between the transitional patterns of the pain disability score (ten defined states of decrease, increase or no change, between two time points) and sick leave was analyzed for 909 chronic/recurrent cases in three different models using logistic regression.


RESULTS
Those with high level of pain disability have a more transitional pattern and their pain level changed during the time period studied. When adjusting for age, gender, education and previous sick leave, the final model indicated that the current level of pain disability was a risk factor in taking sick leave. The likelihood of sick leave was highest in the transition of pain into the highest levels of disability, independent of past disability level of pain. Earlier sick leave remained as an important predictor of sick leave.


CONCLUSIONS
From a clinical and prognostic perspective the probability of sick leave will be different and can be predicted based on previous sick leave but not from former history of pain disability level or its transitional pattern.
Division of Intervention and Implementation Research, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
Akbar
A
Alipour
Lennart
L
Bodin
Gunnar
G
Bergstrom
Irene
I
Jensen
D000293:Adolescent; D000328:Adult; D001416:Back Pain / Q000175:diagnosis* / Q000503:physiopathology; D059350:Chronic Pain / Q000175:diagnosis* / Q000503:physiopathology; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000175:diagnosis* / Q000503:physiopathology; D009784:Occupational Diseases / Q000175:diagnosis* / Q000503:physiopathology; D012008:Recurrence; D012307:Risk Factors; D018582:Sick Leave
Back and neck pain; disability transition; sick leave