Cited by 191Musculoskeletal pain and rehabilitationWorkplace Health and Well-beingMedical Practices and Rehabilitation

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Chronic pain, work performance and litigation

Blyth, Fiona M, March, Lyn M, Nicholas, Michael K, Cousins, Michael J·2003·Pain

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Abstract

The overall population impact of chronic pain on work performance has been underestimated as it has often been described in terms of work-related absence, excluding more subtle effects that chronic pain may have on the ability to work effectively. Additionally, most studies have focussed on occupational and/or patient cohorts and treatment seeking, rather than sampling from the general population. We undertook a population-based random digit dialling computer-assisted telephone survey with participants randomly selected within households in order to measure the impact of chronic pain on work performance. In addition, we measured the association between pain-related disability and litigation. The study took place in Northern Sydney Health Area, a geographically defined urban area of New South Wales, Australia, and included 484 adults aged 18 or over with chronic pain. The response rate was 73.4%. Working with pain was more common (on an average 83.8 days in 6 months) than lost work days due to pain (4.5 days) among chronic pain participants in full-time or part-time employment. When both lost work days and reduced-effectiveness work days were summed, an average of 16.4 lost work day equivalents occurred in a 6-month period, approximately three times the average number of lost work days. In multiple logistic regression modelling with pain-related disability as the dependent variable, past or present pain-related litigation had the strongest association (odds ratio (OR)=3.59, P=0.001). In conclusion, chronic pain had a larger impact on work performance than has previously been recognised, related to reduced performance while working with pain. A significant proportion were able to work effectively with pain, suggesting that complete relief of pain may not be an essential therapeutic target. Litigation (principally work-related) for chronic pain was strongly associated with higher levels of pain-related disability, even after taking into account other factors associated with poor functional outcomes.

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Landers, M. R., Cheung, W. L., Miller, D., Summons, T., Wallmann, H. W., McWhorter, J. W., & Druse, T. (2007) · Clinical Journal of Pain · doi:10.1097/ajp.0b013e31813d110e · Cited by 23
“Patients with chronic pain have been shown to have greater amounts of pain-related disability, medication use, and healthcare service use if they were involved in financial litigation.(16) In another study, a group of litigants recorded no significant improvement in pain, depression, or functional disability until aft…”
Background
The relationship between anger and pain
Fernández, E. (2005) · Current Pain and Headache Reports · doi:10.1007/s11916-005-0046-z · Cited by 22
“Legal claims are made for workers compensation, social security disability benefits, insurance settlements [ 20 ,21], and medical malpractice.”
Background
Multidimensional screening for predicting pain problems in adults: a systematic review of screening tools and validation studies
Veirman, E., Ryckeghem, D. M. L. V., Paepe, A. L. D., Kirtley, O. J., & Crombez, G. (2019) · PAIN Reports · doi:10.1097/pr9.0000000000000775 · Cited by 22
“Chronic pain is a commonexperience,with a prevalence of between 10% and 20% in the general adult population.(6,7,34,95,114) Often, chronic pain is disabling and notoriously difficult to treat.”
Background
Perceived Injustice Predicts Intention to Litigate: Findings from a Spinal Cord Injury Sample
Trost, Z., Monden, K. R., Buelow, M., Boals, A., & Scott, W. (2016) · Psychological Injury and Law · doi:10.1007/s12207-015-9245-z · Cited by 20
The Pain Medicine Curriculum Framework-structured integration of pain medicine education into the medical curriculum
Shipton, E. E., Steketee, C., & Visser, E. (2023) · Frontiers in Pain Research · doi:10.3389/fpain.2022.1057114 · Cited by 25
What Challenges Manual Workers’ Ability to Cope with Back Pain at Work, and What Influences Their Decision to Call in Sick?
Frederiksen, P., Karsten, M. M. V., Indahl, A., & Bendix, T. (2015) · Journal of Occupational Rehabilitation · doi:10.1007/s10926-015-9578-1 · Cited by 19
Use of Attorneys and Appeal Filing in the Washington State Workers??? Compensation Program: Does Patient Satisfaction Matter?
Wickizer, T. M., Franklin, G. M., Turner, J. A., Fulton‐Kehoe, D., Mootz, R. D., & Smith‐Weller, T. (2004) · Journal of Occupational and Environmental Medicine · doi:10.1097/01.jom.0000121130.79868.e6 · Cited by 19
Pain, Perceived Injustice, and Pain Catastrophizing in Chronic Pain Patients in Ireland
Margiotta, F., Hannigan, A., Imran, A., & Harmon, D. C. (2016) · Pain Practice · doi:10.1111/papr.12501 · Cited by 18
The Interactive Effects of Chronic Pain, Guilt, and Perfectionism on Work Outcomes
Hochwarter, W. A., & Byrne, Z. S. (2010) · Journal of Applied Social Psychology · doi:10.1111/j.1559-1816.2009.00564.x · Cited by 19
Prevalence of chronic pain in patients attending primary healthcare facilities in south-west Tshwane
Rauf, W., Meyer, H., Marcus, T., & Becker, P. (2013) · South African Family Practice · doi:10.1080/20786204.2013.10874308 · Cited by 18
The construct validity of the Short Form-36 Health Survey for patients with nonspecific chronic neck pain
de Vries, G. E., Jorritsma, W., Dijkstra, P. U., Geertzen, J. H. B., & Reneman, M. F. (2015) · International Journal of Rehabilitation Research · doi:10.1097/mrr.0000000000000102 · Cited by 17
“…or who were receiving workers compensation (vs. no workers compensation) because of their neck problems (hypotheses 7a, 7b, 8a and 8b) (Jenkinson et al., 1993; Rainville et al., 1997; Riddle and Stratford, 1998; Teasell, 2001; Hee et al., 2002; Blyth et al., 2003; McCarthy et al., 2007).”
BackgroundMethodInfluential
Expectation influences the interruptive function of pain: Behavioural and neural findings
Sinke, C., Schmidt, K., Forkmann, K., & Bingel, U. (2016) · European Journal of Pain · doi:10.1002/ejp.928 · Cited by 17
“associated with decreased work productivity (Blyth et al., 2003).”
Background
An observational study of two rehabilitation strategies for patients with chronic pain, focusing on sick leave at one-year follow-up
Merrick, D., Sundelin, G., & Stålnacke, B. (2013) · Journal of Rehabilitation Medicine · doi:10.2340/16501977-1218 · Cited by 16
Disease and Economic Burden Associated with Recurrent Pericarditis in a Privately Insured United States Population
Lin, D., Laliberté, F., Majeski, C., Magestro, M., Lejeune, D., Duh, M. S., Lim-Watson, M. Z., & Paolini, J. F. (2021) · Advances in Therapy · doi:10.1007/s12325-021-01868-7 · Cited by 15
“While the indirect costs of pericarditis have not been assessed in the literature, HRQoL can be severely affected by frequent recurrences and associated chest pain [9, 28], which may lead to pain-related disability and work loss [29].”
Background
Finger joint pain in relation to radiographic osteoarthritis and joint location a study of middle-aged female dentists and teachers
Ding, H., Solovieva, S. A., Vehmas, T., Riihimäki, H., & Leino‐Arjas, P. (2007) · Lara D. Veeken · doi:10.1093/rheumatology/kem185 · Cited by 15
Does Standing Up Enhance Performance on the Stroop Task in Healthy Young Adults? A Systematic Review and Meta-Analysis
Šömen, M. M., Peskar, M., Wollesen, B., Gramann, K., & Marušič, U. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20032319 · Cited by 13
Is the relationship between chronic pain and mortality causal? A propensity score analysis
Ryan, E., Grol-Prokopczyk, H., Dennison, C. R., Zajacova, A., & Zimmer, Z. (2024) · Pain · doi:10.1097/j.pain.0000000000003336 · Cited by 14
Determinants associated with deprivation in multimorbid patients in primary care—A cross-sectional study in Switzerland
Leiser, S., Déruaz‐Luyet, A., N’Goran, A. A., Pasquier, J., Streit, S., Neuner‐Jehle, S., Zeller, A., Haller, D. M., Herzig, L., & Bodenmann, P. (2017) · PLoS ONE · doi:10.1371/journal.pone.0181534 · Cited by 13
Negative Life Events (NLEs) Contributing to Psychological Distress, Pain, and Disability in a U.S. Military Sample
Moreno, J. L., Nabity, P. S., Kanzler, K. E., Bryan, C. J., McGeary, C. A., & McGeary, D. D. (2018) · Military Medicine · doi:10.1093/milmed/usy259 · Cited by 13
Low Back Pain and Everyday Functioning of Students
Kędra, A., Kolwicz, A., Sitarski, D., Ewertowska, P., & Czaprowski, D. (2016) · Ortopedia Traumatologia Rehabilitacja · doi:10.5604/15093492.1198840 · Cited by 12
Chronic abacterial prostatitis: Living with a troublesome disease affecting many aspects of life
Jönsson, K., & Hedelin, H. H. (2008) · Scandinavian Journal of Urology and Nephrology · doi:10.1080/00365590802223585 · Cited by 12
“Even more short-term ‘‘boring’’ situations can result in physical symptoms being experienced more intensely [18,22].”
Background
No moderating impact of a medically unexplained etiology on the relationship between psychological profile and chronic pain
McNaughton, D. T., Hush, J. M., Beath, A. P., Dear, B. F., & Jones, M. P. (2018) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2018.10.017 · Cited by 11
Pain management programme for Chinese patients: a 10-year outcome review
Chu, M., Law, R. K. Y., Cheung, L. C. C., Marlene, L., Tse, E. Y., Wong, T. C. M., & Chen, P. (2015) · Hong Kong Medical Journal · doi:10.12809/hkmj144350 · Cited by 11
Evaluating the Psychometric Properties of a Clinical Vocational Rehabilitation Outcome Measurement: The Assessment of Work Performance (AWP)
Fan, C. W., Taylor, R. R., Ekbladh, E., Hemmingsson, H., & Sandqvist, J. L. (2013) · OTJR Occupational Therapy Journal of Research · doi:10.3928/15394492-20130614-01 · Cited by 11
Helping workers help themselves: empowering physiotherapy clients to manage musculoskeletal problems at work
Johnston, V., & Shaw, W. S. (2013) · Physical Therapy Reviews · doi:10.1179/1743288x13y.0000000087 · Cited by 11
Lifetime prevalence of and factors associated with non-traumatic musculoskeletal pains amongst surgeons and patients
Bernstein, D. N., Sood, A., Mellema, J. J., Li, Y., & Ring, D. (2016) · International Orthopaedics · doi:10.1007/s00264-016-3338-5 · Cited by 11
A Descriptive Longitudinal Study of Chronic Pain Outcomes and Gender Differences in a Multidisciplinary Pain Management Centre
Tay, T. G., Willcocks, A. L., Chen, J. F., Jastrzab, G., & Khor, K. E. (2014) · Pain Studies and Treatment · doi:10.4236/pst.2014.22010 · Cited by 11
“Chronic pain often causes psychological distress such as depression, anxiety, poor self-efficacy and health-related quality of life and has negative social ramifications such as unemployment, loss of working days and reduced job effectiveness [3] [4].”
Background
An exploratory clinical trial on acceptance and commitment therapy as an adjunct to psychoeducational relaxation therapy for chronic pain.
Roslyakova, T., Falco, M.-A., & Gauchet, A. (2021) · Psychology & Health · doi:10.1080/08870446.2020.1856844 · Cited by 10
“CP can seriously affect the patient’s daily activities, cause social and family repercussions (i.e. abandonment of leisure activities, detachment from family), and have repercussions in the workplace (Blyth et al., 2003).”
Background
Signature Informed Consent for Long-Term Opioid Therapy in Patients With Cancer: Perspectives of Patients and Providers
Giannitrapani, K. F., Fereydooni, S., Azarfar, A., Silveira, M. J., Glassman, P. A., Midboe, A. M., Bohnert, A. S. B., Zenoni, M., Kerns, R. D., Pearlman, R. A., et al. (2019) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2019.08.020 · Cited by 10
Pain Severity Cut‐Points and Analgesic Use by Community‐Dwelling People for Chronic Pain
Brown, K. E., Swift, I., & Spark, M. J. (2012) · Journal of Pharmacy Practice and Research · doi:10.1002/j.2055-2335.2012.tb00169.x · Cited by 10
Adverse effects of obesity on overall health, quality of life, and related physical health metrics: A cross‐sectional and longitudinal study from the All of Us Research Program
Yao, Z., Tchang, B. G., Chae, K., Albert, M. H., Clark, J. M., & Blaha, M. J. (2025) · Journal of Internal Medicine · doi:10.1111/joim.20083 · Cited by 11
An observational study of pain self-management strategies and outcomes: does type of pain, age, or gender, matter?
Slack, M. K., Chavez, R., Trinh, D., de Dios, D. V., & Lee, J. K. (2018) · Scandinavian Journal of Pain · doi:10.1515/sjpain-2018-0070 · Cited by 9

Authors: Blyth, F. M., March, L. M., Nicholas, M. K., & Cousins, M. J.
Affiliations: The University of Sydney (AU)
Corresponding author: Blyth, Fiona M
ORCID: Blyth, Fiona M
March, Lyn M
Nicholas, Michael K
Venue: Pain
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2003-05
Volume: 103
Issue: 1
Pages: 41-47
ISSN: 0304-3959 (ISSN-L)
DOI: 10.1016/s0304-3959(02)00380-9
OpenAlex: W2017538611
Cited by: 191
References: 30
Citations by year: 2026: 2 · 2025: 5 · 2024: 2 · 2023: 6 · 2022: 5 · 2021: 6 · 2020: 3 · 2019: 12 · 2018: 13 · 2017: 5 · 2016: 11 · 2015: 9 · 2014: 11 · 2013: 13 · 2012: 11
FWCI: 5.14
Type: journal article
Language: en
Open access: closed
Locations: Pain (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Workplace Health and Well-being
Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
Keywords: chronic pain, employee performance, pain-related disability, litigation, absenteeism, population survey, employment, functional outcome
MeSH terms: Australia, Chronic Disease, Disability Evaluation, Female, Health Surveys, Humans, Jurisprudence, Male, Middle Aged, Pain, Pain Measurement, Sex Factors, Work, Work Capacity Evaluation, Workers' Compensation, Prevalence, Age Distribution

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Chronic pain, work performance and litigation

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