Chronic Pain Syndromes and Occupational Health Professionals
By: Steven Babitsky, Esq.

When are injured workers likely to develop chronic pain syndromes and what can occupational health professionals do about it?

When Will They Develop It?

Dr. Roger Choo, in his 2010 JAMA article Will This Patient Develop Persistent Disabling Low Back Pain? concluded:

The most helpful components for prediction persistent disabling back pain were maladaptive pain coping behaviors, nonorganic signs, functional impairment, general health status, and presence of psychiatric comorbidities.

What to Do About It

The authors of the March 2012 article in Transitional Behavior Medicine entitled Pain Management in the Context of Workers; Compensation: A Case Study concluded:

The clinical management of chronic pain is a biopsychosocial challenge in itself; however, when the pain occurs in the context of workers compensation, there is even greater clinical complexity. A review of the literature shows that patients being treated for chronic pain under workers compensation are generally more distressed and have poorer outcomes both clinically and vocationally than non-compensated patients. A range of factors is identified to explain these differences, including operation of the system itself.


Practice: Cognitive behavioral pain management programs for injured workers with chronic pain can achieve positive vocational outcomes when the strategies for managing pain specifically target regaining work fitness and address issues of returning to employment despite ongoing pain.

Policy: Resources for the rehabilitation of injured workers with chronic pain should be directed towards providing early delivery, functionally based interventions, so that the problems associated with excessive pain medication use and reliance upon passive treatments do not become entrenched.

Research: Research efforts should be directed towards elucidating the reasons for the consistently poorer treatment outcomes for patients in receipt of workers compensation payments when compared to outcomes for non-compensable patients.

Dr. Leon Ensalada will offer the latest findings on this topic when he presents Psychological and Behavioral Factors in Chronic Pain Syndromes: What Occupational Health Professionals Can Do at the SEAK 33rd Annual National Workers’ Compensation and Occupational Medicine Conference to be held on July16-18, 2013 on Cape Cod, MA.

Dr. Ensalada will explain how to devise and execute a strategy to mitigate the adverse effects of psychological and behavioral factors in chronic pain syndromes. He will discuss the factors that drive the syndromes and will differentiate between appropriate and inappropriate illness behavior. He will offer practical suggestions for facilitating early recognition and intervention targeting the root causes of chronic pain syndromes.

Leon Ensalada, MD, MPH received his BA from the University of Washington in Seattle, his MD from Dartmouth Medical School, and his MPH from the Medical College of Wisconsin. He has written and lectured extensively on chronic pain, illness behavior, and disability management. He was editor and contributor to the AMA Guides 6th
Edition and casebook. After 9/11, at age 53, he reenlisted in the military and served 3 combat tours in Afghanistan, in addition to tours in Pakistan and Africa. Dr. Ensalada was born in Brooklyn, NY.

For additional information about the SEAK National Workers’ Compensation and Occupational Medicine Conference click here.

Steven Babitsky, Esq. is the conference leader.