Trends in work-absenteeism and return-to-work among people with spine pain in middle income countries: A need for evidence.

Abstract

Background: Spine pain is a leading cause of functional disability and work absenteeism globally. Multiple prognostic factors influencing return-to-work(RTW) among people with spine pain are reported from high-income-countries. However, findings from high-income-countries with 16 percent world's population, cannot be extrapolated to low-middle-income countries (LMICs) which constitutes 84 percent world's population. Hence, paucity of evidence from LMICs motivated present literature review.

Objective: To study work absenteeism and RTW profile of people with spine pain in LMICs, including intrinsic and extrinsic factors influencing RTW and time taken to RTW.

Methods: Literature search in scientific databases: PubMed, Scopus, CINAHL, Cochrane and Google Scholar yielded 3 articles from middle-income countries; including 2 cohort studies and 1cross-sectional study. No study was identified from low-income countries.

Results: Review findings reported cessation of work or work absenteeism due to spine-pain; factors influencing RTW; proportion of people returning to work and period of RTW. Intrinsic factors which influenced work absenteeism and RTW included-age, gender, BMI, stage of spine pain and pain severity. Extrinsic factors were heavy physically demanding occupation, informal employment, compensatory leave and lack of access to rehabilitation services at primary and secondary healthcare levels.

Conclusions: Scarce evidence on work absenteeism and RTW among people with spine pain is available only from middle-income countries. Trends of work practice underpinned by pain-coping strategies among people with spine pain in LMICs with inadequate access to evidence-based spine-care, out-of-pocket health expenditure and lack of compensation guidelines warrant urgent research attention.