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The association between pain and disability.

Authors
Turner-JA; Franklin-G; Heagerty-PJ; Wu-R; Egan-K; Fulton-Kehoe-D; Gluck-JV; Wickizer-TM
Source
Pain 2004 Dec; 112(3):307-314
NIOSHTIC No.
20029417
Abstract
A clearer understanding of how pain intensity relates to disability could have important implications for pain treatment goals and definitions of treatment success. The objectives of this study were to determine the optimal pain intensity rating (0-10 scale) cutpoints for discriminating disability levels among individuals with work-related carpal tunnel syndrome (CTS) and low back (LB) injuries, whether these cutpoints differed for these conditions and for different disability measures, and whether the relationship between pain intensity and disability was linear in each injury group. Approximately 3 weeks after filing work injury claims, 2183 workers (1059 CTS; 1124 LB) who still had pain completed pain and disability measures. In the LB group, pain intensity rating categories of 1-4, 5-6, and 7-10 optimally discriminated disability levels for all four disability measures examined. In the CTS group, no pain intensity rating categorization scheme proved superior across all disability measures. For all disability measures examined, the relationship between pain intensity and disability level was linear in the CTS group, but nonlinear in the LB group. Among study participants with work-related back injuries, when pain level was 1-4, a decrease in pain of more than 1-point corresponded to clinically meaningful improvement in functioning, but when pain was rated as 5-10, a 2-point decrease was necessary for clinically meaningful improvement in functioning. The findings indicate that classifying numerical pain ratings into categories corresponding to levels of disability may be useful in establishing treatment goals, but that classification schemes must be validated separately for different pain conditions.
Keywords
Scanning-techniques; Tissue-disorders; Microscopic-analysis; Pain-tolerance; Disabled-workers; Behavioral-testing; Musculoskeletal-system-disorders; Cumulative-trauma-disorders
Contact
Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98195-6560
CODEN
PAINDB
Publication Date
20041201
Document Type
Journal Article
Email Address
jturner@u.washington.edu
Funding Type
Grant
Fiscal Year
2005
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R01-OH-004069
Issue of Publication
3
ISSN
0304-3959
Source Name
Pain
State
WA
Performing Organization
University of Washington
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