Outcomes Comparison of Treatment for Chronic Disabling Work-Related Upper-Extremity Disorders and Spinal Disorders

Since 1986, the percentage of upper-extremity musculoskeletal disorders (UEMSDs) has increased from 1% to 4% of all occupational injury claims, while the average total medical and compensation cost is 80% higher than the average of all other claims. Because chronic disability leads to the highest co...

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Bibliographic Details
Published in:Journal of occupational and environmental medicine 1999-09, Vol.41 (9), p.761-770
Main Authors: Mayer, Tom G, Gatchel, Robert J, Polatin, Peter B, Evans, Trent H
Format: Article
Language:English
Subjects:
Adult
Arm
Biological and medical sciences
Chronic Disease
Chronic illnesses
Cost of Illness
disabilities
Disability Evaluation
Female
Humans
Injuries of the limb. Injuries of the spine
Logistic Models
Male
Medical disorders
Medical sciences
Musculoskeletal Diseases - rehabilitation
musculoskeletal system
Occupational accidents
Occupational Diseases - rehabilitation
Occupational hazards
Outcome Assessment (Health Care)
Prospective Studies
Spinal Diseases - rehabilitation
Spine
Traumas. Diseases due to physical agents
United States
Workers' Compensation
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Summary:Since 1986, the percentage of upper-extremity musculoskeletal disorders (UEMSDs) has increased from 1% to 4% of all occupational injury claims, while the average total medical and compensation cost is 80% higher than the average of all other claims. Because chronic disability leads to the highest cost, systematic evaluation of this growing occupational condition is needed. We performed a prospective case-series cohort study of patients (n = 163) with UEMSDs, compared with a matched group of spinal disorder (SD) patients (n = 163) treated with the same protocol. UEMSD patients were subclassified as those with one or more neuropathic diagnoses or those with non-neuropathic diagnoses. The neuropathic UEMSD subgroup had the poorest outcomes, with significantly higher surgery rates, higher health care utilization rates, and lower work retention when compared with the SD group. Rehabilitation outcomes for UEMSDs are similar to those for SDs. However, neuropathic-diagnosis patients are at risk for high-cost injuries and/or poorer prognoses.
ISSN:1076-2752
1536-5948
DOI:10.1097/00043764-199909000-00008