Work ability and well-being among sick-listed women with long-term pain in neck/shoulders or back who return to work and who remain on sick leave: A prospective study

Background: Sick leave due to long-term musculoskeletal pain is an increasing public health problem, particularly among women, in Western countries. Studies have shown that reduced work ability and well-being are common in this population, but do they really matter for return to work (RTW)? Purpose: The purpose of the present study was to compare work ability and well-being over time, among sick-listed women with long-term pain in neck/shoulders or back who had RTW and who remained on sick leave. Methods: A postal survey was sent to 600 women receiving time-loss benefits according to the Swedish Social Insurance registers. Inclusion criteria: (i) age between 18 and 65 years, (ii) Sick leave: ≥ 1 month of their ≥ 50% service, (iii) pain in neck/shoulders or back: ≥ 3 months, and (iv) understanding Swedish. Exclusion criteria: (i) rheumatoid arthritis, (ii) multiple sclerosis, (iii) stroke, (iv) cancer, (v) Parkinson, (vi) bipolar disease, (vii) schizophrenia, (viii) pregnancy. After 12 months, a follow-up survey was sent to the 208 women who answered the survey at baseline. At the follow-up, 64 women had RTW and 41 remained on sick leave. The Work Ability Index (WAI) and the Life Satisfaction questionnaire (LiSat) were used to assess work ability and well-being, respectively. To determine whether the groups (RTW and non-RTW) differed at baseline for WAI and LiSat, respectively, independent t-tests were performed. If significant differences were found, the baseline values were included as a covariate in univariate analysis of variance with change in WAI and LiSat, respectively, as outcome and groups as independent variable. The level of significance was set to p < 0.05. Results: For WAI, the groups differed at baseline (t= -7.54, p < 0.001). In the univariate analysis of covariance, the groups changed significantly over time (F= 28.47, p < 0.001) after adjusting for baseline values. The group that returned to work improved more than the group that remained o