In Those With Persistent Pain, Beliefs About Pain Affect Early Workforce Exit

Personal beliefs about pain control and influence are significantly associated with risk for disability pension among eldercare workers with persistent pain, according to a prospective study published in The Journal of Pain.

Little is known about how pain perception affects premature exit from the labor market. Researchers therefore investigated the relationship between pain beliefs and risk for disability payment among eldercare workers in the Netherlands.

Investigators analyzed 11 years of follow-up data on 2257 eldercare workers (100% women), including nurses, health care assistants, therapists, and other caregivers, who

had experienced persistent lower-back or neck/shoulder pain. Data were from the Danish Register for Evaluation of Marginalization. Participants had completed questionnaires to rate pain intensity, control, and influence (defined as personal ability to affect and reduce pain). Cox proportional hazard models were used to assess the primary outcome of risk for disability pension according to reported levels of pain control and pain influence.

During the follow-up period, 426 cases of disability pension were registered. High pain levels were reported by 58% of those with neck/shoulder pain and by 44% of those with lower-back pain.

Increasing pain intensity ratings were associated with disability pension. In fully adjusted models, moderate and low pain control had hazard ratios (HR) of 1.30 and 2.09, respectively. Similarly, those with moderate and low pain influence had HRs of 1.43 and 2.10, respectively.  

Study limitations include potential recall bias and missing data resulting from reliance on questionnaire data, and the all-female study population, which may limit the generalizability of the study results.

“Pain control beliefs are associated with disability pension among eldercare workers with persistent pain,” the study authors concluded. “These results highlight the importance of evaluating not only bodily manifestations of pain, but also individual pain-related cognitions that may influence the experience of pain.”

This article originally appeared on Clinical Pain Advisor