Adverse psychosocial working conditions have been identified as closely connected to musculoskeletal pain in previous studies (Bongers et al. 2002, 2006). There is some research suggesting that such adverse working conditions are related to musculoskeletal pain through their effects on perceived stress, that is, work stressors such as high job demands are hypothesized to cause high job stress, which in turn cause musculoskeletal pain through, for example, an increased muscle tension (Stewart et al. 2003a, b). Potential implications

for the interpretation of our results (the absence of a relationship QNZ between stress and reduced work ability/work performance, but a clear relationship between musculoskeletal pain and reduced work ability and work performance) may therefore be that participants in this study who report frequent musculoskeletal pain might have been exposed to a higher and more prolonged exposure to work-related stressors and that exposure to a high PF-3084014 datasheet job stress is more harmful when it is manifested also in HDAC inhibitor physical symptoms. Both clinical experience and the scientific literature

in the field indicate that exposure to adverse psychosocial working conditions often first expresses itself as physical sensations (Holte et al. 2003; Wahlstrom et al. 2003) and that these sensations may be the first “signs” of prolonged exposure to stress

Ribonuclease T1 and sometimes precede more severe stress-related mental conditions like exhaustion disorder/clinical burnout or depression, which often lead to sickness absence. Our findings therefore indicate the possibility that frequent musculoskeletal pain with or without long-standing stress as a contributing cause is associated with decreased work ability and work performance, while the perception of stress, not accompanied by pain (although other physical sensations or symptoms may exist), suggests an earlier and less severe stage in relation to these adverse outcomes. Work ability has been measured in many different ways in the literature sometimes by using the whole WAI (Ilmarinen 2007) and sometimes by using single questions (van den Berg et al. 2011). Moreover, in some studies, sick leave has been used as a measure of work ability, for example, in terms of not being on long-term sick leave or categorized by the amount of sick leave days in the preceding 12-month period (Lindberg et al. 2006). In this study, we chose to use the single item question included in the WAI that requests the responder to estimate the current perceived work ability compared to his/her best perceived work ability ever.