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Rehabilitation of Workers with Musculoskeletal Injury and Chronic Pain
Lyn Guy
School of Public Health, Griffith University, Meadowbrook, Queensland
Stephanie D. Short
School of Public Health, Griffith University, Meadowbrook, Queensland
Abstract
The aim of this study was to examine the relevance of type of work and socio-economic status on the experiences of pain rehabilitation for workers with musculo-skeletal injuries. The paper reports results of a study conducted with patients (n=20) and treating professionals (n=40).
The findings of this study provide insight into how patients with chronic musculo-skeletal pain and treating professionals determined success and also what they saw as barriers to success. Emergent themes and rich descriptions that supported the study, showed that patients' experiences were shaped significantly by social factors, and that type of work and socio-economic status were key determinants of success in terms of patients regaining their sense of independence and control over their lives - as opposed to losing control, remaining helpless and dependent on others, or becoming intent on revenge and validation of their pain and suffering.
Keywords
blue-collar work, socio-economic status, chronic pain, musculoskeletal injury, rehabilitation
Article Text
Despite significant advances across the world in medicine and technological treatment of disease, chronic pain has 'remained an enigma that health care professionals often manage poorly' (Jacobson and Mariano 2001: 241). Scientific evidence shows that despite a range of medical, therapeutic and multimodal biopsychosocial approaches, successful outcomes and long term benefits of treatment and management of chronic pain remain inconclusive, and the results of clinical trials are often contradictory (Smith 2000). Conclusions from an extensive review of the empirical research in relation to chronic pain arising from work-related musculoskeletal injury were that:
despite the progress that has been made in recent years, there continue to be a large number of individuals who are not adequately treated, and show quality of life is adversely affected by the various conditions collectively referred to under the rubric 'chronic pain'. It is now clear that the Cartesian mind-body dualism that has characterised earlier efforts to understand pain is no longer tenable, and will not advance our knowledge of pain.…Chronic pain is a multidimensional problem that requires a multidimensional solution (Smith 2000: 36).
This mind-body dualism has been inherent in the medical model of treatment that characterises much of clinical practice in treating chronic pain (Bonica 1990). The biopsychosocial model was designed to overcome its limitations and is a recommended alternate strategy for more successfully managing the multiple dimensions that are associated with chronic pain (Bonica and Loeser 2001, Engel 1977a, 1977b, IASP 1993, Jacobson and Mariano 2001, Loeser and Turk 2001, Melzack and Wall 1996, Turk and Okifuji 1999, Smith 2000, Wall 1999). Just how the integration of this model has influenced thinking amongst practitioners, however, is largely unknown.
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