title: The interactions between pain, pain-related fear of movement and productivity.
abstract: BACKGROUND
  Employees with physically heavy work have an increased risk of musculoskeletal disorders leading to reduced work ability.
  
  
  OBJECTIVE
  To investigate if a high level of musculoskeletal pain or pain-related fear of movement was associated with low productivity among employees with physically heavy work and differing work ability levels.
  
  
  METHODS
  The study was conducted at a Danish production site and employees with physically heavy work in the production line were included in the study. Work ability was assessed with the Work Ability Index (WAI), pain-related fear of movement with the Tampa Scale for Kinesiophobia and productivity and musculoskeletal pain by self-reported measures. Sickness absence records for construction of WAI were obtained from the workplace.
  
  
  RESULTS
  There was a 77% response rate with 350 employees included in the final analysis. Among employees with only moderate work ability, there was neither an association between pain and productivity nor between pain-related fear of movement and productivity. For employees with good work ability, higher levels of pain and higher levels of pain-related fear of movement both raised the odds of low productivity significantly.
  
  
  CONCLUSIONS
  Despite the fact that musculoskeletal pain increases the risk of reduced work ability significantly, musculoskeletal pain and pain-related fear of movement were associated with low productivity only among employees with good work ability.
authors.affiliation: Department of Environmental, Social and Spatial Change, Roskilde University, Universitetsvej 1, DK-4000 Roskilde, Denmark, leasell@gmail.com.
authors.forename: L
authors.initials: L
authors.lastname: Sell
authors.affiliation: Department of Environmental, Social and Spatial Change, Roskilde University, Universitetsvej 1, DK-4000 Roskilde, Denmark.
authors.forename: H L
authors.initials: HL
authors.lastname: Lund
authors.affiliation: National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen, Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Holtermann
authors.affiliation: Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, DK-5230 Odense, Denmark.
authors.forename: K
authors.initials: K
authors.lastname: Søgaard
mesh_terms: D000293:Adolescent; D000328:Adult; D003718:Denmark; D005239:Fear; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement; D059352:Musculoskeletal Pain / Q000523:psychology*; D009784:Occupational Diseases / Q000523:psychology*; D016273:Occupational Exposure / Q000009:adverse effects*; D057566:Self Report; D018582:Sick Leave; D013314:Stress, Mechanical; D014937:Work / Q000523:psychology*; D055815:Young Adult
keywords: Kinesiophobia; musculoskeletal pain; productivity; work ability