Abnormal Pain Response After a Compensable Shoulder Injury

The Orthopaedic Journal of Sports Medicine, 2017 · DOI: 10.1177/2325967117739851 · Published: November 1, 2017

Occupational Health Pain Management Orthopedics

Simple Explanation

This study investigates abnormal pain responses (APRs) in workers with shoulder injuries who have active workers' compensation claims. APRs are exaggerated pain behaviors during a clinical examination, such as facial grimacing or non-anatomical pain distribution. The study compares workers with APRs to those without, looking for differences in disability, psychological problems, and work limitations. The goal is to understand if APRs can help identify workers who might need additional psychological support to improve their recovery. The findings suggest that workers with APRs report higher levels of disability and psychological distress, and they are more likely to be off work or performing limited duties. This highlights the importance of considering psychological factors in the treatment of shoulder injuries in workers' compensation cases.

Study Duration

Not specified

Participants

1000 workers with shoulder injuries

Evidence Level

Level 3, Cross-sectional study

Key Findings

1
The prevalence of APRs in workers with compensable shoulder injuries was 9%.
2
Workers with APRs reported significantly higher levels of disability and psychological problems compared to those without APRs (P < .0001).
3
Workers with APRs were more likely to be off work or performing modified duties compared to those without APRs (P = .02).

Research Summary

This study examined the prevalence and characteristics of abnormal pain responses (APRs) in workers with compensable shoulder injuries. The researchers reviewed data from 1000 workers and identified 86 (9%) who exhibited APRs. The study found that workers with APRs reported higher levels of disability and psychological problems. They also presented with more inconsistency in range of motion and had more limitations at work. The authors conclude that the presence of APRs in workers with shoulder injuries is associated with negative outcomes, suggesting that clinicians should consider psychological factors in the management of these patients.

Practical Implications

Early Identification

Clinicians should be aware of APRs and assess injured workers for these behaviors to identify those at risk for prolonged disability.

Integrated Treatment

Treatment plans for workers with shoulder injuries should integrate psychological care with physical rehabilitation to address both physical and emotional aspects of recovery.

Return-to-Work Strategies

Return-to-work strategies should be tailored to address the specific needs of workers with APRs, including addressing psychological barriers and limitations at work.

Study Limitations

1
The cross-sectional design prevents establishing a cause-and-effect relationship between APRs and negative outcomes.
2
The subjective nature of APR assessment is influenced by the patient's pain experience and the examiner's biases.
3
The study did not compare group differences in work-related physical demands, which may have influenced the results.

Your Feedback

Was this summary helpful?

Back to Occupational Health