Reduction of pain-related disability in working populations: a randomized intervention study of the effects of an educational booklet addressing psychosocial risk factors and screening workplaces for physical health hazards

Spine (Phila Pa 1976). 2007 Aug 15;32(18):1949-54. doi: 10.1097/BRS.0b013e3181342659.


Study design: Cluster randomized controlled trial with 6 and 8 quarters of follow-up.

Objective: To test the effects of giving evidence-based information addressing psychosocial risk factors for pain-related disability and of screening workplaces for physical health hazards at work on reducing new episodes and duration of pain-related and general absence taking.

Summary of background data: The "flag strategy" for handling low back pain problems is recommended in many Western countries but, so far, randomized intervention studies addressing psychosocial risk factors for disability related to low back pain show mixed results.

Methods: We followed employees from 39 different work sites in western Denmark, who had received interventions consisting of either a carefully prepared booklet providing evidence-based information on common musculoskeletal pain problems alone or in combination with systematic workplace screening for physical work hazards. Absence due to pain for at least 7 days and the cumulative numbers of absence days were the main outcome measures. General absence taking was analyzed, too. Company registrations of sickness absence in combination with self-report on the cause of a given absence spell was used to inform absence spells.

Results: A total of 3808 of 4006 eligible employees provided information. Among 1063 participants in the control arm, 1458 in the information arm, and 1287 in the information and workplace screening arm, 4.6%, 6.9%, and 4.6%, respectively, experienced pain-related absence, and 27.8%, 27.2%, and 24.0%, respectively, experienced general absence taking during follow-up. No positive effect on the risk of the 2 measures of absence or on the cumulative duration of absence among cases was seen.

Conclusion: Results did not support population-based interventions addressing psychosocial risk factors for pain-related disability alone or in combination with workplace screening as effective in reducing the risk of pain-related absence taking or the duration of absence.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Musculoskeletal Diseases / epidemiology
  • Musculoskeletal Diseases / prevention & control
  • Musculoskeletal Diseases / psychology
  • Occupational Diseases / epidemiology
  • Occupational Diseases / prevention & control
  • Occupational Diseases / psychology*
  • Pain / epidemiology
  • Pain / prevention & control
  • Pain / psychology*
  • Pain Measurement / psychology
  • Pamphlets*
  • Patient Education as Topic / methods*
  • Prospective Studies
  • Psychology
  • Risk Factors
  • Workplace / psychology*