To what extent do current and past physical and psychosocial occupational factors explain care-seeking for low back pain in a working population? Results from the musculoskeletal intervention center-Norrtalje study

Study Design. A population-based case referent study. Objectives. To determine whether current and past physical and psychosocial occupational factors are associated with care-seeking for low back pain in working men and women. Summary of Background Data. The importance of physical and psychosocial wor kloads as causal factors of low back pain has mostly been investigated in s pecial occupational groups and with a crosssectioal design, which makes gen eralizability and interpretations more difficult. Methods. The study comprised 2118 working men and women 20 to 59 years old (695 cases, and 1423 referents). Cases were defined as persons seeking care by any caregiver for low back pain. The exposure assessments were made thr ough questionnaires and interviews about current and past physical and psyc hosocial loads during work and leisure time. Results. In a logistic regression analysis, physical load from forward bend ing in men (RR = 1.81 and high phys load, in general, in women (RR = 2.0) s howed increased relative risks. Psychosocial factors alone seemed to be of less importance in women, but "poor job satisfaction" and "mostly routine w ork without possibilities of learning" increased the risk in men. Combined current and past exposures further increased the risks. A combination of hi gh physical and psychosocial loads increased the risk substantially, but fe w were exposed to such loads. Adjustment for lifestyle and other loads outs ide work did not change the results. Conclusion. Current and past physical and psychosocial occupational factors , both separately and combined, seem to be gender-specific, and to have a m oderate impact on care-seeking for low back pain in a general working popul ation.