Conflict at Work and Incident Chronic Low Back Pain: a Retrospective Cohort of More than 101,000 Adults from Germany

Abstract

Purpose: Little is known about the relationship between conflict at work and incident chronic low back pain (CLBP). This retrospective cohort study analyzed the association between workplace conflict and the 5-year incidence of CLBP in adults in Germany. Methods: Adults aged 18–65 who first reported conflict at work in one of 1,293 German general practices (2005–2022) were matched 5:1 with those who did not report conflict, based on demographic and clinical variables. CLBP was defined as having two diagnoses of low back pain at least three months apart. Cox regression was used to evaluate associations. Results: The analysis included 16,925 individuals reporting workplace conflict (mean age ~39.5?±?13.0?years; 63% women) and 84,625 without (mean age ~39.6?±?12.9?years; 64% women). Overall, workplace conflict was not significantly associated with incident CLBP (HR = 1.07, 95% CI = 0.99–1.14). However, significant positive associations were observed for (1) CLBP without sciatica, (2) individuals aged 18–30 years, and (3) those with no prior history of low back pain Conclusion: Workplace conflict may predispose certain subgroups—especially younger adults without prior back pain—to develop CLBP without sciatica. These findings support implementing conflict prevention strategies in occupational health.