Prevalence of and factors associated with long-term sick leave in working-age adults with chronic low back pain in Germany

Objective- There are little data on the impact of chronic low back pain (CLBP) on long-term sick leave. Thus, the aim was to investigate the prevalence of and the factors associated with long-term sick leave in working-age adults with CLBP in Germany. Methods- This retrospective study included adults aged 18–65 years diagnosed for the first time with CLBP in one of 1193 general practices in Germany between 2000 and 2019. CLBP was defined as the presence of two diagnoses of low back pain with > 90 days between them. Long-term sick leave was assessed in the year following the first diagnosis of low back pain, and was defined as > 42 days of absence from work for health-related reasons. In Germany, employees on sick leave lasting > 42 days are not paid by the employer anymore but by the health insurance fund. Finally, an adjusted logistic regression model was used to assess the association between predefined variables (e.g., age, sex, and comorbidities) and long-term sick leave. Results- A total of 59,269 working-age adults were included in this study [mean (SD) age 32.8 (11.5) years; 41.4% women]. The prevalence of long-term sick leave in the sample was 49.1%. Long-term sick leave was significantly associated with young age, male sex, and several physical and psychiatric comorbidities (e.g., reaction to severe stress and adjustment disorder, gastritis and duodenitis, and depression). Conclusions- Based on these results, public health measures are urgently needed to mitigate the deleterious effects of CLBP on work participation in Germany.