Sick leave in osteoarthritis and other muskuloskeletal disorders

Abstract: Osteoarthritis (OA) is one of the most common causes of pain and disability in the musculoskeletal system. Even though the prevalence of OA increases rapidly with age, OA also impacts the working age population. The overall aim of this thesis was to increase the knowledge on sick leave and disability pension in OA and other musculoskeletal disorders (MSDs). Specific aims were to study patients experiences of sick leave due to MSDs, to study the risk of sick leave and disability pension in patients with knee OA, to give a descriptive overview of sick leave patterns in different diseases within the group of MSDs and to investigate the association between occupation and risk for sick leave and disability pension due to knee and hip OA. The first study of the thesis is a qualitative paper where I study patients’ experiences of sick leave due to MSDs. The other three studies are population based cohort studies where I use data from the Swedish Social Insurance Agency, the Skåne Healthcare Register and Statistics Sweden to study sick leave and disability pension in hip and knee OA. I also use data from a smaller part of the region where I retrieve information on sick leave from medical health care records to study sick leave patterns in different diseases within the group of MSDs. In paper I the patients’ experiences illustrate how rehabilitation is often not about “curing” people, but rather about creating premises for life and work despite remaining limitations. In paper II I find that patients with knee OA have an almost two-fold increased risk of sick leave and about 40 to 50% increased risk of disability pension compared to the general population. In paper III I present comparable estimates of sick leave in other diseases within the group of MSDs. I show that duration, age and sex distribution of sick leave varies considerably between different MSDs. In paper IV I find that women in health care, child care and cleaning and men in construction and metal work have an increased risk of sick leave and disability pension due to knee OA and of disability pension due to hip OA, as compared to women and men working in business and administration. I also find that in health care and child care, the risk of sick leave and disability pension due to knee OA is increased also in occupations with higher educational requirements, like specialist nursing and pre-primary teaching professions.