“The results of this meta-analysis may be obvious to you; if you have MS and suffer from MS-related pain you are more likely to be unemployed. This analysis doesn’t answer the chicken or egg question; are MSers unemployed because of the pain, or are unemployed MSer more likely to suffer pain? I suspect the latter. 50% of MSers are unemployed at EDSS 3.5, a level of impairment that is not associated with much disability or pain. As the EDSS increases and the incidence of MS-related pain increases the unemployment rate rises. I suspect this study is simply telling us that pain is a symptom associated with disability and this drives unemployment. However, the early drivers of unemployment tend to be hidden symptoms; cognitive impairment, anxiety, depression and fatigue.”
Shahrbanian et al. Does pain in individuals with multiple sclerosis affect employment? A systematic review and meta-analysis. Pain Res Manag. 2013 September/October;18(5):e94-e100.
BACKGROUND: MSers experience some of the highest unemployment rates among all groups of chronic illnesses. Pain has been found to be a common reason for sick leave or early retirement in healthy populations or other groups with chronic illness; however, there is little awareness regarding the effect of pain on the work status of MSers.
METHODS: An extensive systematic review of the scientific literature was performed within the framework of the Cochrane Collaboration to identify studies focusing on the effect of pain on employment in MSers. The following databases were searched: PubMed, EMBASE, PsychInfo, Web of Science, MD Consult and Elsevier, and Science Direct. The methodological quality of studies was assessed using the McMaster Critical Review Form.
RESULTS: Ten articles met the inclusion criteria and were included in the systematic review. Of these studies, five that exhibited clinical, methodological and statistical homogeneity were included in the meta-analysis. The between-groups (pain + versus pain -) pooled random OR of being employed was 0.7 (strong), and was significantly different from unity (95% CI 0.5 to 0.9; P=0.001).
CONCLUSIONS: The results of the present study indicated that MSers who experience pain were significantly more likely to report a decreased employment rate than MSers who were pain free