Summary

Musculoskeletal disorders (MSDs) affect more than 45,000 Québec workers every year in all activity sectors. In a biopsychosocial model of MSDs, the issue of the beliefs held by the main stakeholders about disability and pain is central to the rehabilitation process. Many health professionals, employers, and insurers believe that injured employees should not return to work until they have completely recovered from their injury. Paradoxically, others believe that only a tenuous relationship exists between work absence and pain. To the best of our knowledge, little work has focused to date on the correlation between perceived pain and work status. This study sought to fill that gap.

The aim of the study was to gain a better understanding of the correlation between the evolution of pain intensity perceived by an individual with an MSD and his  work status and reintegration into his usual activities. Two specific questions were addressed: (1) what are the profiles of pain intensity evolution in workers with MSDs, and (2) what are the differences in the profiles of pain intensity evolution when sociodemographic variables (age, gender, pathology, number of weeks of work absence), work status, and reintegration into usual activities are taken into account.

A retrospective study was done using data collected between 1997 and 2009 in the clinical unit of the Centre d’action en prévention et réadaptation de l’incapacité au travail (CAPRIT, or Centre for Action in Work Disability Prevention and Rehabilitation). This study drew on a database containing clinical information on workers who had participated in the PRÉVICAP rehabilitation program, as well as information gathered in the follow-ups performed at one and three years post-program. Hierarchical cluster analyses, k-means cluster analyses, and statistical correlation measures (chi-square and ANOVA) were used for the data analysis.

Cluster analyses by profile of pain intensity evolution were performed using data on 107 workers who had taken part in the PRÉVICAP program and in the one- and three-year follow-ups. Significant correlations were observed between work status at one and three years post-program, reintegration into usual activities, and profiles of pain intensity evolution. The workers who experienced a decrease in their pain intensity had a higher rate of employment and of reintegration into their usual activities at the three-year follow-up than those whose pain increased over time. It would appear therefore that the evolution of perceived pain intensity is related to work status.