RESEARCH REPORT

Life events and the risk of low back and neck/shoulder pain of the kind people are seeking care for: results from the MUSIC-Norrtälje case–control study

Eva Skillgate^1,2, Eva Vingård^3,4, Malin Josephson^3,4, Töres Theorell⁵ and Lars Alfredsson^6,1

¹ Institute of Environmental Medicine, Division of Cardiovascular Epidemiology, Karolinska Institutet, Stockholm, Sweden
² Skandinaviska Naprapathögskolan, Stockholm, Sweden
³ Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala Universitet, Uppsala, Sweden
⁴ Section of Personal Injury Prevention, Karolinska Institutet, Stockholm, Sweden
⁵ Karolinska Institutet and National Institute for Psychosocial Factors and Health, Stockholm, Sweden
⁶ Stockholm Center for Public Health, Stockholm County Council, Stockholm, Sweden

Correspondence to:
Correspondence to:
MrsE Skillgate
Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden; eva.skillgate{at}ki.se

Objective: To expand the knowledge about the occurrence of life events, and how they affect the risk of low back and neck/shoulder pain.

Design: A population-based case–control study.

Setting: Men and women 20–59-years old, living in and not working outside the municipality of Norrtälje, Sweden, from November 1993 to November 1997.

Participants: Cases (n = 1 148) were defined as all subjects from the study base who sought healthcare for a new episode of low back and/or neck/shoulder pain by any of the care givers in the municipality. Controls (n = 1 700) were selected as a stratified random sample from the study base, considering sex and age. Study subjects were interviewed about life events and critical life changes. Critical life changes were defined as events that brought about a marked psychosocial change. Odds ratios (ORs) associated with different numbers of life events or critical life changes were calculated.

Results: Having experienced at least two life events during the preceding 5 years was associated with an increased risk of neck/shoulder pain (OR = 1.6, 95% CI 1.1 to 2.4). At least two critical life changes were associated with an increased risk of neck/shoulder pain (OR = 1.9, 95% CI 1.3 to 2.7). In general, no associations were observed in relation to risk of low back pain.

Conclusion: Life events and critical life changes are of importance for the risk of neck/shoulder pain of the kind that people are seeking care for. The study provides useful information for clinical practice and for future aetiological research on neck/shoulder pain.

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