Conflict at work and incident chronic low back pain: a retrospective cohort of more than 101,000 adults from Germany.

Purpose: Little is known about the relationship between conflict at work and incident chronic low back pain (CLBP). Thus, this retrospective cohort study analyzed the association between conflict at work and the five-year incidence of CLBP in adults living in Germany.

Methods: This study included individuals aged 18-65 years reporting conflict at work for the first time in one of 1,293 general practices in Germany between 2005 and 2022 (index date). Patients not reporting conflict at work were matched (5:1) to those reporting conflict at work using a propensity score based on multiple demographic and clinical variables. In people not reporting conflict at work, the index date was a randomly selected consultation in 2005-2022. CLBP corresponded to two diagnoses of LBP at least three months apart. The relationship between conflict at work and incident CLBP was studied using Cox regression models.

Results: There were 16,925 patients reporting (mean [SD] age 39.5 [13.0] years; 63% women) and 84,625 patients not reporting conflict at work (mean [SD] age 39.6 [12.9] years; 64% women). Conflict at work was not associated with incident CLBP in the overall population (HR = 1.07, 95% CI = 0.99-1.14). However, there was a positive and significant association for CLBP without sciatica, individuals aged 18-30 years, and those with no history of low back pain before the index date.

Conclusion: Conflict at work may be a predisposing factor for CLBP without sciatica, highlighting the need to prevent conflict in the workplace. Further research is warranted to corroborate these results in other countries.