Workers' compensation and litigation status influence the functional outcome of patients with neck pain

The purpose of this study was to determine if workers' compensation (WC) and litigation status were associated with long-term functional limitation in patients with neck pain. Understanding what physical and psychologic variables are related to long-term functional limitation is an important aspect of clinical decision-making and understanding illness behavior in patients with neck pain.

Seventy-nine patients reporting neck pain participated in this study. Of these, 27 had either a WC case or had injury-related litigation (WC=9, motor vehicle accident litigant=14, and personal injury litigant=4). Upon initial presentation to physical therapy and 12 weeks later, the patient's functional status was evaluated using the Neck Disability Index (NDI). An NDI score of 15 or more at 12-weeks was operationally defined as long-term functional limitation.

Mean NDI scores at initial presentation and at 12-weeks were significantly higher for those with WC/litigation involvement (mean=18.9, SD=9.7) than for those without (mean=9.4, SD=7.3). Those with WC/litigation involvement also had a higher percentage of long-term functional limitation than those who did not have WC/litigation involvement, 70.4% and 19.2%, respectively. The odds for developing long-term functional limitation were 9.5 times greater for those with WC/litigation involvement than for those without.

Results from this study suggest that patients with WC/litigation involvement exhibit more long-term functional limitation than patients who do not have WC/litigation involvement. These results underscore a need for future research in this area.