Alcohol intake and patterns of multi-site musculoskeletal pain in the British Whitehall II study

Abstract Background Patterns of multi-site musculoskeletal (MSK) pain and its relationship with alcohol drinking among white-collar employees and retirees remain unclear compared to blue-collar workers. This study aimed to examine the relationship between alcohol drinking and MSK pain through latent class analysis (LCA) in current and retired white-collar employees. Methods We used the data from the 7th phase (2000-2002, n = 6,967, response rate 71.6%) of the British Whitehall II study, chosen for its availability of MSK items and approximately 1:1 ratio of employees to retirees, allowing for an evaluation of the relationship between alcohol drinking and MSK pain by employment status. LCA was used to distinguish patterns of multi-site MSK pain. A multinomial logistic regression model was used to examine the association between alcohol drinking and the identified pain patterns, with analyses conducted separately for employees and retirees. Results We identified five latent classes for pain (back/cervical: 7.1%, cervical: 28.9%, upper limb: 29.4%, combined LBP/upper limb/cervical: 13.2%, and LBP alone: 21.5%). Increased alcohol intake might be associated with elevated odds of upper limb pain in current drinkers, but this could not be statistically confirmed (OR: 1.04, 95% CI: 0.99-1.09). Employment status may modify the association with a significant interaction found between alcohol intake and retirement (p-value: 0.043). Every 7-unit increase in alcohol intake is associated with 18% and 12% higher odds of pain in LBP/UBP/cervical and upper limbs, respectively (95% CI: 1.02-1.37; 1.02-1.23). Conclusions Increased alcohol intake was associated with pain patterns only among retired white-collar employees but not the current ones. Interventions on alcohol consumption could help confirm if, reducing alcohol intake or avoiding hazardous drinking, for white-collar retirees prevents not only upper limb pain but also more complex pain patterns. Key messages • Musculoskeletal pain in white-collar employees and retirees contributes to the cervical and upper extremities, differing from low back/neck pain studies among general or blue-collar workers. • The association between alcohol drinking and pain patterns may differ across employment status. Reducing alcohol intake might be advised to retired drinkers for preventing multi-site pain.