Chronic pain is complex, costly and widespread – especially for injured workers. In fact, workers’ compensation patients in the U.S. generally experience poorer outcomes compared to those not covered by workers’ comp.
Not to mention the economic impact of chronic pain: direct and indirect costs total about $650 billion. This has prompted clinical practice guidelines and the U.S. Federal Pain Research Strategy to prioritize research on reducing the public health impact of low back pain (LBP) – and physical medicine researchers have begun to analyze the predictors of chronic pain in response. The goal: prevent acute pain from becoming chronic.
In this WorkersCompensation.com article, MedRisk’s VP of Clinical Services & Provider Management Brian Peers discusses key takeaways from a mapping review of 20 studies that have investigated the acute-to-chronic LBP transition. From this review, the authors described a standardized predictive framework to improve prediction of chronic LBP.
The structure used five predictor domains, adding elements in some areas that emerging evidence has revealed impactful on chronic pain:
- Demographics: income, marital status, household size and living arrangements
- Pain
- Health status
- Psychosocial: negative mood and copying styles, and positive coping skills like self-efficacy
- Individual context: perceptions of receiving care, expectations and treatment preferences
“There’s a lot to unpack in this research and much work left to be done. However, this analysis and previous studies have told us a lot,” said Peers. “Early and accurate prediction of the development of chronic pain can guide claims representatives in securing the appropriate physical and behavioral healthcare services in the beginning of the claim.”
Among other key takeaways, Peers pinpointed the importance of patient education in accelerating recovery, addressing psychosocial factors and treating chronic LBP. This is pertinent as psychosocial factors can delay recovery and return to work – and potentially lead to the development of chronic pain. Ultimately, this research supports a rising theme from the past couple of years: early physical therapy (including initial consult and education) produces better outcomes for all patients – but especially workers’ compensation patients.
To read more about the framework for predicting chronic pain, click here – or review the full study here.
