Js. Himmelstein et al., WORK-RELATED UPPER-EXTREMITY DISORDERS AND WORK DISABILITY - CLINICALAND PSYCHOSOCIAL PRESENTATION, Journal of occupational and environmental medicine, 37(11), 1995, pp. 1278-1286
Work-related upper-extremity disorders (WRUEDs) are an increasingly co
mmon cause of work-related symptoms and disability. Although most uppe
r-extremity disorders are acute and self-limited, a small percentage o
f workers with symptoms go on to permanent disability and account for
the majority of costs associated with these conditions. Little is know
n, however, about this progression from symptoms to disability and how
it might be prevented, In this study, we evaluate the demographic, vo
cational, medical, and psychosocial characteristics of patients with W
RUEDs and examine several hypotheses regarding the differences between
working- and work-disabled patients. One hundred twenty-four consecut
ive patients were evaluated in a clinic specializing in occupational u
pper-extremity disorders. Patients currently working (n = 55) and work
-disabled patients (n = 59) were similar with regard to age, gender, a
nd reported job demands. The work-disabled group reported less time on
the job, more surgeries, a higher frequency of acute antecedent traum
a, and more commonly had ''indeterminate'' musculoskeletal diagnoses.
They also reported higher pain levels, more anger with their employer,
and a greater Psychological response or reactivity to pain. These fin
dings, though cross-sectional in nature, suggest that, in addition to
medical management, more aggressive approaches to pain control, preven
tion of unnecessary surgery, directed efforts to improve patients' abi
lities to manage residual pain and distress, and attention to employer
-employee conflicts may be important in preventing the development of
prolonged work disability in this population.