Return to work of injured worker following comprehensive pain management

Return to work of injured worker following comprehensive pain management

A FOLLOW-UP STUDY OF COMPENSATION AND EMPLOYMENT STATUS IN CHRONIC PAIN. D.S. Handlin*,*R.H. Dworkin, D.M Richlin, L. Brand*, and M.K. Parides , Depar...

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A FOLLOW-UP STUDY OF COMPENSATION AND EMPLOYMENT STATUS IN CHRONIC PAIN. D.S. Handlin*,*R.H. Dworkin, D.M Richlin, L. Brand*, and M.K. Parides , Department Anesthesiology, College of Physicians and Surgeons, University, New York, N.Y. 10032, USA Although it has often been suggested that chronic pain Aim of Investigation: patients who are receiving workmen’s compensati~ are less likely to benefit from ireatment, the results of pain clinic outcome studies of this question have been In previous research we found evidence of poorer short-term outcome inconsistent. in compensation patients and in patients who were not working at the beginning of treatment; however, multiple regression analyses indicated that when compensation and employment status were simultaneously used to predict outcome, the effect of employment was significant whereas compensation was not. The present study was conducted to determine whether this pattern of results would also be found in langterm follow-up of a sample of the original series of patients. Methods: Telephone interviews of a random sample of 82 chronic pain patients treated by a multimodalilty pain service were conducted an average of I8 months (range: 4 to 34 months) after the beginning of treatment. Patients were asked to rate improvement in their pain since treatment. Patients who were working at the beginning of treatment reported Results: Patients who were signXGZiy greater levels of improvement at follow-up. did not differ significantly from receiving compensation during treatment noncompensation patients in levels of improvement at follow-up. The data indicate that employment status is an important Conclusions: predictor of outcome in chronic pain patients and provide further support for our hypothesis that poorer outcome in compensation patients moy be due to the fact that these patients are less likely to be working.

RETURN TO WORK OF INJURED WORKER FOLLOWING COMPREHENSIVE PAIN MANAGEMENT. S. G. Fe *, T. E. Williamson-Kirkland*, and Rita M. Frangione '*N: W. E. Fordyce), Section of Physical Medicine and Rehabilitation, The Mason Clinic, Seattle. WA 98111. USA. Aim of Investigation: Workman's Compensation cases make up a large proportion of those patients referred for ~reatillent co chronic Pain Treatment A p&portion of these disabled patients return to work after facilities. This study examines the postpain treatment return xo workstatus treatment. of Worker's Compensation cases immediately after discharge and on follow-up, Their preinjury vocational and medical status was also examined. Methods: Fifty-five worker's compensation cases with chronic pain (mean durm.93 years for males, 4.09 years for females} were treated with colliprehensive pain nianageRient and rehabilitation. Treatment consisted of 3-4 weeks of conlprehensive physical rehabilitation, drug detoxification (if needed), psychological and vocational counseling. Results: Seventy-five percent of the cases demonstrated objective evidence of successful pain treatment with reversal of disability. Of these, 28% of the females returned immediately to work and 50% of the males returned to work. Forty-two percent of females and 21% of males were classified as uneniployed bur; not disabled. Preinjury data revealed that work injuries tended to be minor, pri~rily involving lifting, and did not require emergency care. Forty-eight percent of females and 50% of males had no objective physical findings of injury or defect at time of admission. Conclusion: That objective finding of pain, disability or injury have little predictive value in eventual return to work for injured workers. Economic, gender, and vocational-psychological issues seemed to be more predictive with females being much less liable to reenter the work force even though no disability remained.