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Prevalence of low back pain and sickness absence: A ``borderline'' study in Norway and Sweden

Norwegian Back Pain Network, Research Unit, HALOS, University of Bergen, Bergen, Norway, Camilla.ihlebaek{at}psych.uib.no

Tommy H. Hansson

Department of Orthopaedics, Sahlgrenska University Hospital, Göteborg, Sweden

Even Lærum

Norwegian Back Pain Network, Communication Unit, Ullevål University Hospital, Oslo, Norway

Soren Brage

Section of Occupational Health and Social Insurance Medicine, Department of General Practice and Community Medicine, University of Oslo, Norway

Hege R. Eriksen

Norwegian Back Pain Network, Research Unit, HALOS, University of Bergen, Bergen, Norway, Department of Biological and Medical Psychology, University of Bergen, Norway

Sten H. Holm

Department of Experimental Surgery, Sahlgrenska University Hospital, Göteborg, Sweden

Rolf Svendsrød

Norwegian Gallup AS, Oslo, Norway

Aage Indahl

Hospital of Rehabilitation, Stavern, Norway

Aims: Low back pain (LBP) is a major public health problem in both Norway and Sweden. The aim of the study was to estimate the prevalence of LBP and sickness absence due to LBP in two neighbouring regions in Norway and Sweden. The two areas have similar socioeconomic status, but differ in health benefit systems. Methods: A representative sample of 1,988 adults in Norway and 2,006 in Sweden completed questionnaires concerning LBP during 1999 and 2000. For this study only individuals in part or full time jobs, (n=1,158 in Norway and n=1,129 in Sweden) were included. Results: In Norway the lifetime prevalence was 60.7% and in Sweden 69.6%, the one-year prevalence was 40.5% and 47.2%, and the point prevalence 13.4% and 18.2% respectively. There was a significantly higher risk of reporting LBP in Sweden, even after controlling for gender, age, education, and physical workload. There was no difference in risk of self-certificated short-term sickness absence (1—3 days), but it was a 40% lower risk of sickness absence with medical sickness certification in Sweden compared with Norway. Conclusion: The prevalence of LBP was higher in the Swedish area than in the Norwegian. The risk of self-certificated sickness absence, however, showed no differences and the risk of medically certificated sickness absence was lower in the Swedish area. This contradiction might partly be explained by the economical ``disincentives'' in the Swedish health compensation system.

Key Words: Economic incentives • geographical differences • LBP • low back pain • musculoskeletal pain • pain • sickness absence

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