Self-reported pain on a digital workplace assessment: identifying the score that flags desk-based workers for earlier...

Musculoskeletal pain is common among desk-based workers and reduces productivity, increases healthcare use, and contributes to work disability. Digital workplace platforms now record self-reported pain at scale, offering a way to use a single score to flag workers for earlier review, yet evidence on the lowest score at which pain is consistently associated with functional impact across multiple domains is lacking. This study aimed to identify that point.

Retrospective cross-sectional analysis of de-identified data from 11,529 working adults reporting pain who completed digital desk-based musculoskeletal assessments between January and November 2025. Pain was self-reported on an 11-point scale (0-10) with defined verbal descriptors at each level (a descriptive pain scale). Five functional domains were examined: productivity impairment, healthcare-seeking, mental health impact, social participation, and work absenteeism. Logistic regression estimated odds ratios (ORs) with 95% confidence intervals, with a score of 1 as reference, adjusted for age and sex and with cluster-robust standard errors accounting for clustering of workers within employing organisations (116 organisations); generalised estimating equations were used as confirmation.

A pain score of 4 was the lowest level at which four of the five domains, productivity, healthcare-seeking, mental health, and social participation, were significantly associated with pain after adjustment and clustering (all p < 0.001; ORs: 3.5-5.3). Absenteeism showed an association of similar magnitude (OR: 2.0) but with a confidence interval that included once organisational clustering was accounted for, consistent with it being the rarest and most downstream outcome. Associations strengthened progressively at higher scores.

A self-reported pain score of 4 was the lowest level at which functional impact was consistently associated with pain across four independent domains, robust to age, sex, and organisational clustering. These cross-sectional associations may inform use of a score of 4 on this anchored scale to prompt earlier review; they do not establish that intervening changes outcomes, and the threshold is specific to this anchored scale. Prospective studies are required.