Journal of occupational rehabilitation
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This study assessed the prevalence rates of psychopathology in acute carpal tunnel syndrome (CTS) and acute low back pain (LBP) patients. Psychopathology was assessed with the Structured Clinical Interview for the DSM-III-R (SCID). ⋯ In regard to other types of psychopathology, such as depression, current substance abuse, and somatoform pain disorders, CTS patients had similar rates as the LBP patients. It was concluded that anxiety disorders may be a concomitant of carpal tunnel syndrome, and that treating psychological problems along with physical aspects of the syndrome may increase the patient's chance of a successful therapeutic outcome.
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Studies indicate that work disabled chronic back pain patients out of work for longer than three months have a reduced probability of returning to work. The escalating personal and economic costs (indemnity and health care) associated with such long term disability have facilitated efforts at multiple levels to prevent and more effectively manage work disability. Multidisciplinary rehabilitation (MDR) targeted at return to work represents one such approach. ⋯ Research on predictors of return to work outcome following MDR were identified and included variables in five categories: demographics, medical history, physical findings, pain and psychological characteristics. The literature provides support for the use of integrated approaches that target the medical, physical, ergonomic and psychosocial factors that can exacerbate and/or maintain work disability. Future research should address current methodological limitations in the literature and focus on: 1) identifying critical treatment components of such approaches, 2) developing innovative screening methods to identify high risk cases to facilitate earlier more targeted efforts to assist such individuals, and 3) consider variations in the staging of various combinations of interventions in an effort to develop more cost-effective variations in the multidisciplinary approach.