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Do psychosocial work factors influence chronic low back pain (CLBP)?

Yes, according to this meta-analysis of 18 studies (N = 19,572 of pooled participants). Psychosocial work factors like workload, job control and social support were found to be significantly related to CLBP.

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ABSTRACT

Background

The aim of this review was to synthesize the evidence on the potential relationship between psychosocial work factors from the Areas of Worklife (AW) model (workload, job control, social support, reward, fairness, and values) and chronic low back pain (CLBP; unspecific pain in the lumbar region lasting 3 months or longer).

Methods

We conducted a systematic literature search of studies in Medline, PsycINFO, Web of Science, and CINAHL (1987 to 2018). Three authors independently assessed eligibility and quality of studies. In this meta-analysis, we pooled studies’ effect sizes using a random-effects model approach and report sample size weighted mean Odds Ratios (ORs).

Results

Data from 18 studies (N = 19,572) was included in the analyses. We found no studies investigating associations between fairness or values and CLBP. CLBP was significantly positively related to workload (OR = 1.32) and significantly negatively related to overall job control (OR = 0.81), decision authority (OR = 0.72), and two measures of social support (ORs = 0.75 to 0.78), even in prospective studies. Skill discretion and reward did not significantly relate to CLBP. Moderation analyses revealed several variables (e.g., exposure time, mean age and sex) affecting these relationships.

Conclusions

Our results support employees’ workload, job control, and social support as predictors of CLBP. In this line, these work factors should be considered when developing programs to prevent chronic low back pain. Future studies should apply measures of CLBP that are more precise, and investigate the full areas of work life (AW) factors in combination.

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From the full-text paper:

• Psychosocial job exposures were not only statistically associated with a higher risk for lower back pain but also whether that pain becomes chronic.
• High workload increases the risk but high job control reduces the risk of reported CLBP. Nevertheless, high job control in reducing CLBP risk was found only when combined with decision authority (people being able to make decisions about their working environment/conditions/tasks etc).
• High social support from colleagues and supervisors “also proved to be a resource that prevents or reduces the risks for CLBP” (p9). Job resources were also protective against CLPB, but only significant when combined with job control, decision authority and all social support measures (support from colleagues and supervisors); skill discretion and reward were not related.
• Age moderated the relationship between job control and CLPB, reducing risk. This may be partially explained by older workers having higher emotional competencies compared to younger workers to help them deal with workplace stressors.
• It’s noted that job crafting reduces risk since it allows “the active redesign of one’s own work by the employees themselves as a bottom-up process”, in contrast to conventional “top-down” concepts of work design.
• It’s said that these findings “are rather conservative estimates, undermining potential true effects” (p12).

Authors: Buruck, G., Tomaschek, A., Wendsche, J., Ochsmann, E., & Dörfel, D. (2019). BMC musculoskeletal disorders, 20(1), 1-16.

Study link: https://link.springer.com/article/10.1186/s12891-019-2826-3

Link to the LinkedIn article: https://www.linkedin.com/feed/update/urn:li:ugcPost:6922302478910717952?updateEntityUrn=urn%3Ali%3Afs_updateV2%3A%28urn%3Ali%3AugcPost%3A6922302478910717952%2CFEED_DETAIL%2CEMPTY%2CDEFAULT%2Cfalse%29