Objective The aim of this study was to identify prognostic factors for long-term sickness absence among employees with neck–shoulder or low-back pain.

Methods In 2000, a representative sample of Danish employees (N=5036) rated their average pain intensity in the neck–shoulder and low-back during the last three months on a 10-point scale; using a questionnaire, they also reported on physical and psychosocial work factors, health behavior, work ability and self-efficacy. Employees reporting pain intensity of ≥4 were considered to have musculoskeletal pain. As a result, we defined two populations to be included in our analyses: people with pain in the neck–shoulder (N=848) and low-back (N=676) regions. Data on long-term sickness absence of ≥3 weeks for the period 2001–2002 were attained from the Danish national register of social transfer payments.

Results One fifth of employees with neck–shoulder and low-back pain experienced long-term sickness absence during the two-year follow-up. Among employees with neck–shoulder and low-back pain, respectively, the main significant risk factors were (i) pain intensity [hazard ratio (HR)=1.12, 95% confidence interval (95% CI) 1.02–1.24 and HR=1.13, 95% CI 1.01–1.26] and (ii) heavy physical work (HR=1.68, 95% CI 1.21–2.33 and HR=1.41 95% CI 1.00–2.01).

Conclusion Preventive initiatives for long-term sickness absence should aim to reduce pain intensity and heavy physical work among employees with neck–shoulder and low-back pain.

Key terms chronic pain; employee; long-term sickness absence; low back; low-back pain; MSD; musculoskeletal disorder; musculoskeletal symptom; neck; neck–shoulder pain; pain; prognosis; prognostic factor; shoulder; sick leave; sickness absence