Predictors of musculoskeletal pain in men: A twenty-year follow up from examination at enlistment

Study Design. Prospective study with follow-up by a postal questionnaire to 6626 men nearly 40 years of age who had been examined for the first time at the age of 18. Objectives. To study the predictability of frequent musculoskeletal problems, health, lifestyle, and work situation from the examination 20 years earlier. Background. Those who enlisted for military duty during 6 months in 1979–1980 answered a questionnaire focusing on back pain, smoking, and physical work exposure. As these men enter the biologic age when back pain is most frequent, a follow-up was of interest. Methods. A new questionnaire was sent to those from the enlistment group who could be identified in the population register, and the answers were compared with those given at enlistment. Results. The prevalence of low back pain increased from 38% to 74% during the 20-year period. Neck or shoulder problems were nearly as common as back problems. The number of those with a body mass index more than 25 had increased from 9% to 50%, and smoking had decreased from 29% to 14%. The odds ratio for frequent back/neck/shoulder problems at follow-up evaluation was 8.7 (95% CI: 3.78–20.10) if the person had experienced back pain that greatly affected everyday life at enlistment, 3.0 (95% CI: 2.33–3.93) if he had been off work or school because of that pain, and 2.2 (95% CI 1.57–3.24) if he had been doing heavy work already at the time of enlistment. Conclusion. Early back pain causing absence from work, reduced activity levels because of the pain, and heavy work loads showed a significantly increased risk for frequent pain problems at follow-up examination.