Chronic Musculoskeletal Pain Linked to Earlier Retirement

Nils Georg Niederstrasser, PhD

Credit: University of Portsmouth

Chronic musculoskeletal pain not only causes discomfort but is linked to quitting a job or retiring early, a new study found.¹

“It is remarkable that pain predicts earlier retirement and work cessation to a similar extent or even more strongly than other variables, such as job satisfaction or specific job demands,” said investigators, led by Nils Georg Niederstrasser, PhD, from the University of Portsmouth in the United Kingdom.² “It shows just how much impact pain can have on all aspects of people's lives.”

Approximately 42% of people with chronic pain cannot work, and for those who do work, chronic pain puts a toll on individuals.¹ People with chronic pain are more likely to call out or struggle to function at an average working capacity, both of which can result in a reduced income.

Investigators conducted a study of 1156 participants aged ≥ 50 in England, pulled from the English Longitudinal Study of Ageing, to assess the effects of chronic pain on the employment status of older adults. They followed participants over waves of 2-year intervals for 14 years. The study assessed data from wave 2 (2004/2005) through wave 9 (2018 – 2019).

Participants from the English Longitudinal Study of Ageing originally came from the Health Survey for English in the years 1998, 1999, and 2001. Due to the participants’ age, the English Longitudinal Study of Ageing used new participants in waves 3, 4, 6, 7, and 9. Participants were included if they had available data for waves 2 through 9, had not yet retired, and were working at wave 2.

Participants self-reported their job status, selecting either retired, semi-retired, employed, self-employed, unemployed, permanently sick or disabled, looking after home or family, or other. The team considered participants retired if they selected either “retired” or “semi-retired.” Additionally, participants self-reported other predictors of retirement, including job satisfaction, depressive symptoms, self-perceived social status, frequent musculoskeletal pain, age, sex, wealth quintile, working conditions, and marital status.

After 14 years, marking the end of the study, 1073 participants retired.

Earlier retirement was linked to work dissatisfaction (hazard ratio [HR], 95% confidence interval [CI], 1.03 – 1.62 and higher self-perceived social status (HR, 1.01; 95% CI, 1.00 – 1.01). Female participants had a 1.27-increased risk of early retirement compared to male participants (95% CI, 1.13 – 1.44).

“It is perhaps unsurprising that being female [is] associated with leaving the workforce earlier, given that the UK state pension age was lower for females than males during the study period, being equalized in 2018,” investigators wrote. “Mandatory retirement has been abolished in the UK since 2011 which, at least notionally, means workers can choose when to retire.”

Later retirement was linked to receiving recognition at work (HR, 0.78; 95% CI, 0.66 – 0.91) and older age at baseline (HR, 0.89; 95% CI, 0.88 – 0.91) although this could have been due to using a statistical approach of using years, thus age, to assess age at retirement.

The team found participants who complained more about musculoskeletal pain tended to retire earlier than participants without pain (hazard ratio [HR], 1.30; 95% confidence interval [CI], 1.12 – 1.49). Not only that, but participants with chronic musculoskeletal pain were 1.25 times more likely to stop working, even if they did not describe themselves as retired (95% CI, 1.10 – 1.43). Chronic musculoskeletal pain was a significant predictor of early retirement or leaving work at a younger age, even after controlling for several variables, including job satisfaction, depressive symptoms, self-perceived social status, sex, and working conditions.

Additionally, after 14 years, 1196 participants reported ceasing work at an earlier age. Other than suffering from musculoskeletal pain, other reasons for quitting included work dissatisfaction (HR, 1.30; 95% CI, 1.04 – 1.62) and higher perceived social status (HR, 1.01; 95% CI, 1.0 – 1.01). Like with early retirement, females were more likely to report work cessation at an early age compared to males (HR, 1.28; 95% CI, 1.14 – 1.43).

The study did not identify reasons why participants left the workplace. Investigators theorized people could have left their jobs or retired because the pain made it impossible to continue working, they believed their job would increase their pain in the future, or they were pushed out by employers due to lowered productivity.

“Further research should establish the mechanisms and decision making involved in leaving the workforce in people with frequent [musculoskeletal] pain,” investigators concluded.

^References

1. ^{Niederstrasser NG, Wainwright E, Stevens MJ. Musculoskeletal pain affects the age of retirement and the risk of work cessation among older people. 2024. PLoS ONE 19(3): e0297155. https://doi.org/10.1371/journal.pone.0297155}
2. ^{Earlier Retirement for People with Chronic Musculoskeletal Pain. EurekAlert! March 20, 2024. https://www.eurekalert.org/news-releases/1037645. Accessed March 20, 2024.}