Abstract
The purpose of this review was to summarize current knowledge concerning the role of psychological workplace variables in back pain. To this end the literature on psychological factors and back pain was systematically searched and analyzed. Psychological and medical databases and cross-referencing were used to locate 975 studies. To be included in this review, studies had to have a prospective design, include a psychological predictor variable, report on back pain, and be published in English. Twenty-one studies fulfilled the criteria for psychological workplace factors. The results showed a clear association between psychological variables and future back pain. There was strong evidence that job satisfaction, monotonous tasks, work relations, demands, stress, and perceived ability to work were related to future back pain problems. Further, moderate evidence was established for work pace, control, emotional effort at work, and the belief that work is dangerous. There was inconclusive evidence about work content. The attributable fraction indicated that substantial reductions in the number of cases of back pain could be achieved if the exposure to the psychological risk factor was eliminated. Although the methodological quality of the studies varied, they were deemed to provide “best evidence,” and the consistency of the findings suggests that they are relatively robust. It is concluded that psychological work factors play a significant role in future back pain problems. However, there is still a lack of knowledge concerning the mechanisms by which these operate. These results suggest that a change in the way we view and deal with back pain is needed. Applying knowledge about psychological factors at work might enhance prevention as well as rehabilitation.
Similar content being viewed by others
REFERENCES
Sauter SL, Murphy LR. Organizational risk factors for job stress. Washington DC: American Psychological Association, 1995.
Karasek R, Theorell T. Healthy work: Stress, productivity, and the reconstruction of working life. New York: Basic Books, 1990.
van Tulder MW, Assendelft WJJ, Koes BW, Bouter LM. Method guidelines for systemtaic reviews in the Cochrane collaboration back review group for spinal disorders. Spine 1997; 22(20): 2323-2330.
Hoogendoorn WE, van Poppel MNM, Bongers PM, KoesBW, Bouter LM. Systematic reviewof psychosocial factors at work and in the personal situation as risk factors for back pain. Spine 2000; 25(16): 2114-2125.
Bergenuud H, Nilsson B. Back pain in middle age: Occupational workload and psychologic factors: An epidemiologic survey. Spine 1988; 13: 58-60.
Biering-Sörensen F, Thomsen CE, Hilden J. Risk indicators for low back trouble. Scand J Rehab Med 1989; 21: 151-157.
Bigos SJ, Battié MC, Spengler DM, Fisher LD, Fordyce WE, Hansson TH, Nachemson AL, Wortley MD. A prospective study of work perceptions and psychosocial factors affecting the report of back injury. Spine 1991; 16(1): 1-6.
Hemingway H, Shipley MJ, Stansfeld S, Marmot M. Sickness absence from back pain, psychosocial work characteristics and employment grade among office workers. Scand J Work Environ Health 1997; 23(2): 121-129.
Leino PI, Hänninen V. Psychosocial factors at work in relation to back and limb disorders. Scand J Work, Environ Health 1995; 21(2): 134-42.
Papageorgiou AC, Macfarlane GJ, Thomas E, Croft PR, Jayson MIV, Silman AJ. Psychosocial factors in the workplace: Do they predict new episodes of low back pain? Spine 1997; 22(10): 1137-1142.
Ready AE, Boreskie SL, Law SA, Russell R. Fitness and lifestyle parameters fail to predict back injuries in nurses. Can J Appl Physiol 1993; 18(1): 80-90.
Riihimäki H, Wickström G, Hänninen K, Luopajärvi T. Predictors of sciatic pain among concrete reinforcement workers and house painters: A five year follow-up. Scand J Work Environ Health 1989; 15: 415-423.
Riihimäki H, ViikariJuntura E, Moneta G, Kuha J, Videman T, Tola S. Incidence of sciatic pain among men in machine operating, dynamic physical work, and sedentary work: A three year follow-up. Spine 1994; 19(2): 138-142.
van Poppel MNM, KoesBW, Devillé W, Smid T, Bouter LM. Risk factors for back pain incidence in industry: A prospective study. Pain 1998; 77: 81-86.
Rossignol M, Lortie M, Ledoux E. Comparison of spinal health indicators in predicting spinal status in a 1-year longitudinal study. Spine 1993; 18(1): 54-60.
Cats-Baril WL, Frymoyer JW. Identifying patients at risk of becoming disabled because of low-back pain: The Vermont Rehabilitation Engineering Center predictive model. Spine 1991; 16: 605-607.
Coste J, Delecoeuillerie G, Cohen de Lara A, Le Parc JM, Paolaggi JB. Clinical course and prognostic factors in acute low back pain: An inception cohort study in primary care practice. Br Med J 1994; 308: 577-580.
Hasenbring M, Marienfeld G, Kuhlendahl D, Soyka D. Risk factors of chronicity in lumbar disc patients. A prospective investigation of biologic, psychologic, and social predictors of therapy outcome. Spine 1994; 19(24): 2759-2765.
Hazard RG, Haugh LD, Reid S, Preble JB, MacDonald L. Early prediction of chronic disability after occupational low back injury. Spine 1996; 21(8): 945-951.
Hellsing AL, Linton SJ, Kälvemark M. A prospective study of patients with acute back and neck pain in Sweden. Phys Ther 1994; 74(2): 116-124; discussion 125-128.
Hurri H. The Swedish back school in chronic low back pain II. Factors predicting the outcome. Scand J Rehabil Med 1989; 21: 41-44.
Lancourt J, Kettelhut M. Predicting return to work for lower back pain patients receiving worker's compensation. Spine 1992; 17: 629-640.
Linton SJ, Halldén K. Can we screen for problematic back pain? A screening questionnaire for predicting outcome in acute and subacute back pain. Clin J Pain 1998; 14(3): 209-215.
van der Weide WE, Verbeek JHAM, Sallé HJA, van Dijk FJH. Prognostic factors for chronic disability from acute low-back pain in occupational health care. Scand J Work Environ Health 1999; 25: 50-56.
Fishbain DA, Cutler RB, Rosomoff HL, Khalil T, Steele-Rosomoff R. Impact of chronic pain patients' job perception variables on actual return to work. Spine 1997; 13: 197-206.
Weiser S, Cedraschi C. Psychosocial issues in the prevention of chronic low back pain-a literature review. Baillieres Clin Rheumatol 1992; 6(3): 657-684.
Bongers PM, deWinter CR, Kompier MA, Hildebrandt VH. Psychosocial factors atwork and musculoskeletal disease. Scand J Work Environ Health 1993; 19(5): 297-312.
Bernard BP. Work-related musculoskeletal disorders and psychosocial factors. In: Bernard BP, ed. Musculoskeletal disorders and workplace factors: A criticial review of epidemiologic evidence for workrelated musculoskeletal disorders of the neck, upper extremity, and low back. Washington, DC: U.S. Department of Health and Human Services, 1997, pp. 7-1;7-16.
Vingård E, Nachemson A.Work-related influences on neck and low back pain. In: Nachemson A, Jonsson E, eds. Neck and back pain: The scientific evidence of causes, diagnosis and treatment. Philadelphia: Limppincott, William & Wilkens, 2000, pp. 97-126.
Teasell RW, Bombardier C. Employment-related factors in chronic pain. Chronic pain initiative: Chronic pain expert advisory panel report. Toronto: Ontario Workplace Safety Insurance Board, 2000.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Linton, S.J. Occupational Psychological Factors Increase the Risk for Back Pain: A Systematic Review. J Occup Rehabil 11, 53–66 (2001). https://doi.org/10.1023/A:1016656225318
Issue Date:
DOI: https://doi.org/10.1023/A:1016656225318