Does neuropathic low back pain negatively influence work capacity? A cross-sectional study among Hungarian workers

Low back pain (LBP) is a leading cause of disability worldwide and neuropathic low back pain (NLBP) represents a subset of LBP that involves nerve injury or dysfunction. This condition has been shown to have significant impacts on physical, psychological, and social well-being. The aim of our study was to investigate the association of NLBP on Work Ability Index (WAI) among postal delivery workers taking many covariates into account. Demographic data, risk factors and concomitant diseases were included into our analysis as well as psychometric questionnaires of burnout (Mini Oldenburg Questionnaire-MOLBI), depression (Beck Depression Inventory-BDI) and insomnia (Athens Insomnia Scale-AIS). Low back pain categories (nociceptive, mixed or neuropathic) were assessed by the painDETECT questionnaire. Working capacity was measured by the Work Ability Index (WAI). This cross-sectional study was conducted between May 2021 and January 2022 among postal delivery workers in Hungary. Overall 1034 responders took part in our survey, 368 males (35.6%) and 666 females (64.4%). Based on the results of the WAI questionnaire, participants could be divided as having poor (3.8%, 39/1034), moderate (18.5%, 191/1034), good (43.8%, 453/1034) and excellent 33,9%, 351/1034) working ability. Due to the low number of participant in the poor WAI group after the setup of a logistic regression analysis we also employed LASSO (Least Absolute Shrinkage and Selection Operator) regression with tenfold cross-validation as well as we applied Firth's penalized likelihood regression, which reduces small-sample bias in logistic regression. In the final analysis poor WAI was associated with depression (aOR = 2.31, 95% CI: 1.89-2.82, p = 0.008), sleep disturbance (aOR = 1.85, 95% CI: 1.42-2.41, p = 0.012) and NLBP (aOR = 3.10, 95% CI: 2.95-3.98, p = 0.002). Targeted interventions addressing depression and sleep disturbance in individuals with NLBP may help preserve or improve work ability and overall functioning.