Workstyle As a Predictor of Pain and Restricted Work Associated With Upper Extremity Disorders: A Prospective Study

Purpose A patient's reaction to a perceived increase in work demand may be related to his or her upper limb symptoms. The purpose of this study was to determine whether a brief measure of a patient's perception of how they respond to perceived increases in demands at work predicts pain levels and work status 6 months after an initial consultation with a hand surgeon. Methods Working patients with diverse upper extremity diagnoses completed a measure of response to job stress at their first clinic visit and were followed for 6 months during their prescribed treatment course. Controlling for age, gender, job type, diagnosis, patient perceptions of work-relatedness, baseline pain, grip strength, and treatment (surgery vs no surgery) analyses were conducted to determine whether self-reported response to perceived job stress was associated with pain and work status 6 months after the initial consultation. Results Higher scores on the patient-reported job stress measure predicted higher levels of pain at 6 months. The measure was also a modest but significant predictor of work status at 6 months. Conclusions Evaluation of a working patient's self-reported cognitive and behavioral response to perceived increases in work demands, or what has been referred to as workstyle, predicts subsequent levels of upper extremity pain and work status. Generalization to other practice settings requires further study. This measure provides a brief evaluation of reaction to job stress that can be an important factor in certain patients with upper extremity symptoms. Future controlled studies addressing this aspect of the clinical picture are indicated. (J Hand Surg 2009;34A:724-731. (c) 2009 Published by Elsevier Inc. on behalf of the American Society for Surgery of the Hand.)