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Musculoskeletal pain at multiple sites and its effects on work ability in a general working population
  1. Helena Miranda1,*,
  2. Leena Kaila-Kangas1,
  3. Markku Heliövaara2,
  4. Päivi Leino-Arjas1,
  5. Eija Haukka1,
  6. Juha Liira1,
  7. Eira Viikari-Juntura1
  1. 1 Finnish Institute of Occupational Health, Finland;
  2. 2 Finnish National Institute of Health and Welfare, Finland
  1. Correspondence to: Helena Miranda, Centre of Expertise for Health&Work Ability, Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, Helsinki, 00250, Finland; helena.miranda{at}


Objectives: Musculoskeletal pain often occurs at multiple sites concurrently. The aim of this study was to examine the associations between multi-site pain and self-rated work ability and retirement plans among actively working people.

Methods: A comprehensive health examination survey (The Health 2000 Survey) was carried out in 2000-2001 among a representative sample of the Finnish adults. Musculoskeletal pain during the preceding month in the low back, neck or shoulders, upper extremities, hips and lower extremities, as well as work ability and intentions to retire early were assessed with a face-to-face interview. The subjects were also clinically examined by a physician using standardized diagnostic criteria. Analyses were restricted to 30-64-year-old subjects actively working during the preceding 12 months and who provided information on the work ability outcomes (population-weighted number of subjects 4087). Log-binomial regression was used to estimate prevalence ratios of reduced work ability.

Results: Single-site pain was reported by 33% of the subjects, whereas 20%, 9% and 4% reported pain in 2, 3 and 4 sites, respectively. The prevalence of poor work ability varied from 8 to 15%. Every fifth had thought about retiring early. Age- and gender-adjusted risks of poor physical work ability and own prognosis of poor future work ability increased from 2 for single-site pain to 8 for pain at 4 sites. Risks remained considerably elevated after adjustment for various covariates, even for clinical musculoskeletal disorders and functional capacity. Poor current work ability was most affected by multi-site pain at older age (50-64 years), and intentions to retire early at age 40-49 years.

Conclusions: Co-occurring pain per se poses a considerable threat to work ability. Workers with multi-site pain may benefit from targeted preventive measures to sustain their work ability. Future studies should also consider multi-site pain as an important risk factor for reduced work ability.

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