Perception of traumatic onset, compensation status, and physical findings: Impact on pain severity, emotional distress, and disability in chronic pain patients

Abstract

The primary purposes of the present study were to investigate the roles of physical findings, financial compensation, and types of pain onset (i.e., trauma vs. insidious onset) on adaptation by chronic pain patients. Comparisons between patients who were receiving or seeking compensation and those who were not revealed that, despite comparable degrees of physical findings, the compensation status was associated with reports of (a) more severe pain, (b) greater disability, (c) higher levels of emotional distress, and (d) greater life interference. The compensation status of 74% of the patients was correctly classified by combination of pain severity, perceived disability, and life interference. Objective indices of physical findings did not significantly improve classification accuracy. In order to eliminate the possible confound of compensation, analyses of the relationship between the types of onset and chronic pain were conducted only for a subset of patients who were not receiving or actively seeking compensation. The results indicated that the patients who attributed their pain to a specific trauma reported significantly higher levels of emotional distress, life interference, and higher levels of pain severity than did the patients who indicated that their pain had an insidious or spontaneous onset, regardless of the extent of objective physical findings.

Pain experience of Iraq and Afghanistan Veterans with comorbid chronic pain and posttraumatic stress

“…Previous literature has demonstrated associations between PTSD and intensified pain severity, disability, and interference [45][46][47]; however, at least one study did not corroborate this finding [4]. Results from the current study contribute further evidence to support the relationship between PTSD comorbidity and intensified pain features.…”

Types and effectiveness of treatments used by people with chronic pain associated with spinal cord injuries: influence of pain and psychosocial characteristics

“…25 In the present study we assessed aspects related to type of pain and to psychosocial and behavioral impact of chronic pain in order to determine if these were predictive of using PM, NPM, or NPhT. Use of NPM and NPhT was not strongly associated with any of the assessed pain characteristics or to psychosocial and behavioral impact of chronic pain.…”

“…Preliminary data indicate that how patients present to physicians will influence the pain management interventions they receive. 25,26 Moreover, people's decisions about the use of self-initiated efforts to control symptoms are also likely to be influenced by their attitudes and beliefs. 27 Little is known about the use of both prescribed and self-initiated pain management interventions by people who have pain secondary to SCIs.…”

Pain management in the context of workers compensation: a case study

“…It is too simplistic to attribute negative outcomes in the work injury arena solely to the potential for financial gain [3,15], although a scheme that places the term "compensation" in its title (as opposed to say a "workers rehabilitation scheme" or "workers recovery scheme") is arguably placing emphasis where it is least helpful.…”

“…Not surprisingly, given the points raised above, patients in the workers compensation system tend to be more psychologically distressed, more severely disabled and less active than non-compensation patients [15]. From these basic clinical standpoints, rehabilitation and recovery are always going to be more problematic with this patient group.…”