Factors promoting staying at work in people with chronic nonspecific musculoskeletal pain: A systematic review

Purpose: To identify determinants for staying at work (SAW) in workers with chronic musculoskeletal pain (CMP). Method: A systematic review of factors that promote SAW in workers with CMP. We searched the databases of PubMed, EMBASE, PsycInfo, CINAHL and the Cochrane Library. We included studies reporting on working subjects without present CMP-related sick leave. A quality assessment of GRADE criteria and evidence synthesis was performed. Results: We identified five cross-sectional studies and two qualitative studies reporting on factors associated with SAW in workers with CMP. Consistent association with SAW was found for low perceived physical disability and low emotional distress (low-level evidence). Duration of pain, catastrophizing, self-esteem and marital status were not associated with SAW (low-level evidence). Qualitative studies indicated that personal adjustments and workplace interventions are important determinants for SAW (evidence not graded). Conclusions: No high-level evidence for SAW determinants for workers with CMP was identified. Future interventions aimed at promoting SAW could consider reducing perceived physical disability and emotional distress, and promoting adjustment latitude at work, support from supervisors, and the workers’ motivation and self-management skills. Further research is required because knowledge of SAW in workers with CMP is scarce, and the relevance of the subject is high.

Implications for Rehabilitation

• When modifiable factors that promote staying at work can be identified, interventions can be developed to support the ability of workers with chronic nonspecific musculoskeletal pain to stay at work.

• Consistent evidence of promoting staying at work was found for low emotional distress and perceived physical disability, while duration of pain, catastrophizing, self-esteem and marital status were consistently not associated.

• Future interventions aimed at promoting staying at work should consider reducing perceived physical disability and emotional distress.