Journal of psychosomatic research
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Comparative Study
Effects of time-limited vs unlimited compensation on pain behavior and treatment outcome in low back pain patients.
A common theme in the pain literature is that worker's compensation reinforces pain behavior and adversely influences treatment outcome of chronic pain patients. This study compared 110 chronic low back pain males divided into three groups: 44 receiving no compensation, 27 receiving time-limited worker's compensation, and 39 receiving unlimited social security disability benefits. All patients participated in a multimodal treatment program (e.g. nerve blocks, transcutaneous electrical nerve stimulation, relaxation training, biofeedback). ⋯ In general, however, more worker's compensation and non-compensation patients who were initially not working had returned to work at the time of follow-up compared with the disability patients. These results suggest that time-limited compensation may not affect treatment outcome or interfere with return-to-work chances while unlimited compensation may adversely influence the probability that patients will return to work. These findings support the notion that worker's compensation patients receiving time-limited financial benefits do not necessarily represent a 'problem' subgroup of chronic pain patients.
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The assumption of a specific migraine-related psychophysiological response stereotype under conditions of stress, recovery and relaxation was examined in 37 migraineurs (non-headache state) and 44 normal controls. Two stressors were presented, industrial noise and a 'social discomfort' situation, each was followed by a recovery period. Relaxation was induced by verbal instructions accompanied by soft music. ⋯ The hypothesis of a specific vasomotor stress response stereotype in migraineurs could not be corroborated. The observed differences in relaxation and recovery were hypothesized. But the overall results are not easily explained on the grounds of a coherent model (e.g. elevated sympathetic arousal level).