Psychological profile and work status of a predominantly Hispanic worker's compensation population with chronic limb...

The purposes of this study were to describe the psychosocial profile and to measure function (posttreatment work status) after surgical and non-surgical treatment in a predominantly Hispanic worker's compensation population with chronic limb pain. We conducted an archival review of records from 91 patients treated for neuropathic pain in a specialty clinic over a 10-year period who had extreme difficulty accepting or managing pain. Medical records from individuals with proven nerve dysfunction experiencing pain >3 months and whose record contained a full psychological evaluation were included. All patients received patient-centered care, a prescription to return to work, periodic pain assessment, and clinical evaluation of sensory and motor function plus pharmacologic pain management. Surgery was determined by the degree of sensory-motor abnormalities in the absence of untreated psychological distress regardless of pain level or worker's compensation status. The majority of patients returned to work after treatment of nerve injury. No differences were noted between surgical/non-surgical treatment groups on initial pain level (p = 0.2), litigation status (p > 0.5), and posttreatment work status (p > 0.05). However, individuals expecting surgery also expected total relief of pain with surgical intervention. Psychosocial assessment, support, and adequate pain treatment seem to mediate the ability of an individual with chronic limb pain to return to work regardless of surgical/non-surgical treatment. Patients' expectations of surgery may be unrealistic and are best addressed prior to treatment.