Ergonomic and psychosocial factors affect daily function in workers' compensation claimants with persistent upper extremity disorders.

Abstract

Pain and other symptoms associated with work-related upper extremity disorders (WRUEDs) can lead to significant distress, lost function, and disability. Identifying factors associated with decreased upper extremity function may lead to the development of more effective interventions. In this study, participants were 165 government employees (127 female, 38 male) with an accepted workers' compensation claim (< 90 days from claim filing) for a WRUED who were unable to perform their normal work. Participants completed baseline measures of upper extremity functional limitation, symptoms, general health status, problem solving orientation, pain coping, and workplace factors. After controlling for pain and gender in a multiple regression analysis, greater functional limitation was further explained by: (1) upper extremity symptoms other than pain (e.g., sleep disturbance, numbness and tingling), (2) symptoms in one or both hands, (3) feeling overwhelmed by pain, (4) low confidence in problem solving abilities, and (5) higher ergonomic risk factor exposures at work. The final model accounted for 47.4% of the variance in upper extremity function, F(7157) = 4.33, P < 0.05. Mental health status was related to functional limitation in univariate, but not multivariate analyses. These results suggest that improving function in this population may require: (1) pain coping techniques and active problem solving to overcome functional barriers, and (2) reduction of workplace ergonomic risk exposure.