Occupational psychological factors increase the risk for back pain: A systematic review

The purpose of this review was to summarize current knowledge concerning th e role of psychological workplace variables in back pain. To this end the l iterature on psychological factors and back pain was systematically searche d and analyzed. Psychological and medical databases and cross-referencing w ere used to locate 975 studies. To be included in this review: studies had to have a prospective design, include a psychological predictor variable, r eport on back pain, and be published in English. Twenty-one studies fulfill ed the criteria for psychological workplace factors. Tile results showed a clear association between psychological variables and future back pain. The re was strong evidence that job satisfaction, monotonous tasks, work relati ons, demands, stress, and perceived ability to work were related to future back pain problems. Further, moderate evidence was established for work pac e, control, emotional effort at work, and the belief that work is dangerous . There,was inconclusive evidence about,work content. The attributable frac tion indicated that substantial reductions in the number of cases of back p ain 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 finding s suggests that they are relatively robust. it is concluded that psychologi cal work factors play a significant role in future back pain problems. Howe ver, there is still a lack of knowledge concerning the mechanisms by which these operate. These results suggest that a change in the way Mle view and deal with back pain is needed. Applying knowledge about psychological facto rs at work might enhance prevention as well as rehabilitation.