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Temporal relationships between job strain and low-back pain.

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Psychosocial working conditions like job strain may not causally impact long-term low-back pain. Time-invariant individual factors appear to explain the observed associations between job strain and back pain over several years.

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Area of Science:

  • Occupational Health
  • Epidemiology
  • Psychosomatic Medicine

Background:

  • Psychosocial working conditions, specifically job strain (high demands, low control), are suspected risk factors for low-back pain.
  • The causal nature of the association between job strain and low-back pain, particularly over time, remains unclear.
  • Longitudinal studies are needed to investigate lagged and bidirectional relationships while controlling for confounding factors.

Purpose of the Study:

  • To examine lagged and bidirectional associations between job strain and low-back pain.
  • To assess the impact of job strain on low-back pain severity and vice versa over time.
  • To control for unmeasured time-invariant confounding factors influencing the relationship.

Main Methods:

  • Utilized four biennial waves of data from the Swedish Longitudinal Occupational Survey of Health (SLOSH) with 3084 participants.
  • Employed cross-lagged structural equation modeling (SEM) to analyze job strain and low-back pain (any pain and severity).
  • Applied SEM with fixed effects (dynamic panel models) to account for time-invariant confounding.

Main Results:

  • Initial SEM models indicated statistically significant bidirectional associations between job strain and any low-back pain over a 2-year lag.
  • Job strain was also associated with increased low-back pain severity, and vice versa, in initial models.
  • However, SEM models controlling for time-invariant factors revealed no significant lagged relationships between job strain and low-back pain (any or severity).

Conclusions:

  • The observed long-term associations between job strain and low-back pain may be attributed to unmeasured, time-invariant individual characteristics (residual confounding).
  • The findings suggest that psychosocial working conditions might not be direct causal factors for low-back pain over extended periods.
  • Further research is recommended to explore potential short-term relationships between job strain and low-back pain.