Being self-employed and shorter duration of sick leave due to lower back pain

A study coordinated by the Spanish Network of Researchers in Back Diseases (REIDE) has shown that Being self-employed is the only factor associated with a lower risk and duration of sick leave due to low back pain over the next 18 monthsand also a lower risk that, if it occurs, it will generate 30 or more days of sick leave during that period.

This work, which has been published in Occupational and Environmental Medicinethe magazine specialized in Occupational Medicine of the editorial group British Medical Journal, has analyzed 77 factors which previous studies had shown to be associated with the intensity of pain, the degree of disability and the evolution of both parameters.

Thus, they include sociodemographic aspects (such as age, sex and academic level), clinical (such as the intensity, duration and aggravation of pain and the existence of radiating pain), psychological (such as the use of anxiolytics and antidepressants, the intensity of catastrophic thoughts, and fear of losing a job), labor (such as being self-employed or salaried, the type and duration of the contract and the physical demands of the job) and economical (such as the level of income, the proportion of fixed and variable income and the impact of a possible sick leave on them).

Thus, some of the data obtained is that, for each additional year, the risk of sick leave due to low back pain increases by 3 percentand that this is 43 percent more common among those who have previously suffered episodes of low back pain lasting more than 14 days. Along with this, it has been confirmed that sick leave is 44 percent more likely among those who anticipate that they are likely to have it within the next year.

Everything in relation to low back pain, which is one of the main causes of disability and work absenteeism worldwideand whose appearance and evolution are influenced by biological, clinical, sociodemographic and psychosocial factors. Given this, this research has sought to develop predictive models that anticipate which workers are most likely to request sick leave and its duration, and identify those to whom preventive measures should be applied as a priority.

In this way, of all the variables studied, The only one that is associated with a lower risk of loss of employment is being self-employed.which could be explained, according to the authors of this study, because in the Social Security system, they face greater income instability and lower benefits during temporary disability (IT), compared to employed workers.

Data

Although 57 percent of the workers perceived some discomfort or lower back pain and 60 percent took medication for that reason.only 7.4 percent requested sick leave for this reason over the next 18 months. This situation suggests that low back pain is very common among the active population, but that it only motivates sick leave when it is disabling or other factors coexist.

This work, which has continued for 17 years, has been directed by researchers from the Institute of Biomedicine of the University of León (IBIOMED), the Clinical Biostatistics Unit of the Puerta de Hierro-Segovia Health Research Institute in Arana (Madrid), the Department of Nursing and Physiotherapy of the University of Salamanca and the Kovacs Back Unit of the Moncloa HLA University Hospital in the capital of Spain.

In this context, the member of IBIOMED and the University of the Basque Country and co-author of this study, Professor Jesús Seco, has highlighted “the enormous effort involved in collecting the data from more than 7,000 workers and follow their sick leave and their causes for 18 months“, as well as “the collaboration of many doctors from the National Health System (SNS) with private entities, such as labor insurance companies and large companies, without which this research would have been unviable.”

“It is striking that The vast majority of clinical parameters that have been shown to influence the evolution of pain or the degree of disability are irrelevant for predicting sick leave. or its duration,” said, for her part, the member of the Clinical Biostatistics Unit of the Puerta de Hierro-Segovia de Arana Health Research Institute and also co-author of this research, Dr. Ana Royuela, who added that “this reflects that asking for or maintaining a leave is a behavior in which the biological component is just one more aspect, and not the most determining one.”

Furthermore, the other co-author of this work, the member of the Kovacs Back Unit of the Moncloa University HLA Hospital and director of REIDE, Dr. Francisco Kovacs, has stressed that, “in practice, this study suggests that strategies to prevent low back pain and sick leave for this reason should be aimed at the entire active population, since it is impossible to predict who is at greater risk of suffering from them.”