Danish Ramazzini Centre, Aarhus, Denmark,
Int Arch Occup Environ Health. 2013 Oct;86(7):799-808. doi: 10.1007/s00420-012-0815-z. Epub 2012 Sep 16.
Musculoskeletal pain conditions remain a major cause of care-seeking in general practice. Not all patients with musculoskeletal pain (MP) seek care at their general practitioner (GP), but for those who do, the GP's knowledge of what work-related factors might have influenced the patient's decision to seek care could be important in order to give more well-founded advice to our patients. The objective of this study was to elucidate the effects of workloads on care-seeking for back pain or upper extremity pain during an eighteen-month follow-up period.
This is a prospective study with a baseline questionnaire and eighteen-month follow-up. Among the registered patients of 8 GPs, we identified 8,517 persons between 17 and 65 years of age, who all received the questionnaire. A total of 5,068 (59.5 %) persons answered. During the eighteen months of follow-up, we used the International Classification for Primary Care (ICPC) to identify all care-seekers with either back pain or upper extremity pain. Of these, all currently employed persons were included in our analysis, in all 4,325 persons. For analysis, we used Cox proportional hazards regression analysis. Analyses were stratified by gender.
High levels of heavy lifting, defined as the upper tertile on a categorical scale, were associated with care-seeking for back pain (HR 1.90 [95 % CI: 1.14-3.15]) and upper extremity pain (HR 2.09 [95 % CI: 1.30-3.38]) among males, but not in a statistically significant way among females. Repetitive work and psychosocial factors did not have any statistically significant impact on care-seeking for neither back pain nor upper extremity pain.
Work-related factors such as heavy lifting do, to some extent, contribute to care-seeking with MP. We suggest that asking the patient about physical workloads should be routinely included in consultations dealing with MP.
肌肉骨骼疼痛仍是全科医生就诊的主要原因。并非所有肌肉骨骼疼痛（MP）患者都会去看全科医生（GP），但对于那些确实去看医生的患者来说，GP 了解哪些与工作相关的因素可能影响了患者寻求治疗的决定，这对于向患者提供更有根据的建议非常重要。本研究的目的是阐明工作负荷对背痛或上肢疼痛在 18 个月随访期间寻求治疗的影响。
这是一项前瞻性研究，基线时使用问卷，18 个月后进行随访。在 8 名全科医生注册患者中，我们确定了年龄在 17 至 65 岁之间的 8517 人，他们都收到了问卷。共有 5068 人（59.5%）回答了问卷。在 18 个月的随访期间，我们使用初级保健国际分类（ICPC）来识别所有因背痛或上肢疼痛而寻求治疗的人。在这些人中，我们将所有在职人员都纳入我们的分析中，共 4325 人。我们使用 Cox 比例风险回归分析进行分析。分析按性别分层。
高水平的重体力劳动，定义为类别量表的上三分之一，与男性背痛（HR 1.90 [95%CI：1.14-3.15]）和上肢疼痛（HR 2.09 [95%CI：1.30-3.38]）的就诊有关，但在女性中没有统计学意义。重复性工作和心理社会因素对背痛和上肢疼痛的就诊没有任何统计学意义的影响。
工作相关因素，如重体力劳动，在一定程度上导致了肌肉骨骼疼痛的就诊。我们建议，在处理肌肉骨骼疼痛的咨询中，应常规询问患者的体力工作负荷。
