Introduction For many, spinal pain first develops during adolescence. However, the extent to which adolescent spinal pain impacts work absenteeism later in life is largely unknown. We assessed the association of spinal pain in adolescence with work absenteeism in early adulthood, using a population-based cohort.

Methods Data from a sample of working people in the Western Australian Pregnancy Cohort (Raine) Study (n=476) were analysed. At 17 years of age, spinal pain (low-back or neck) with impact on work and/or study behaviour was self-reported. Six years later (at 23 years), participants replied to four quarterly text messages asking them about their work absenteeism, from which annual total and sickness absence were estimated. Negative binominal mixed-models were used to estimate the association between spinal pain and work absenteeism (Incidence Rate Ratios (IRR) with 95% confidence intervals (95% CI)).

Results Participants with adolescent spinal pain with impact at year 17 reported significantly higher (mean [SD]) total work absenteeism at year 23 (148.7[243.4] hours/year), compared to those without pain (43.7 [95.2] hours/year); with IRR [95% CI]: 3.9 [1.5 10.3]. Comparable findings were found for sickness absence (IRR: 3.6 [1.3 10.2], with 94.1 [201.5] and 29.3 [75.0] hours/year absence, respectively).

Conclusion Results of our study show a more than three-fold higher risk of work absenteeism in early adulthood among those with adolescent spinal pain with impact compared to those without spinal pain. These findings indicate that pain behaviour during adolescence can set a stage for work absenteeism later in life, underlining the importance of early pain prevention and management.