What affects return to work for graduates of a pain management program with chronic upper limb pain?

Chronic upper limb pain often causes work loss, and return to work after pain management is disappointingly low. This study aimed to identify patient characteristics and beliefs contributing to return to work or nonreturn. A total of 103 (66%) ex-patients with CULP, who had completed a pain management program, agreed to telephone interview. Participants were predominantly female and in middle years; 53.4% were working part- or full-time. Their responses were related to pre- and posttreatment psychological and disability variables. Those patients who had returned to work, compared to those who had not, were more likely to have been working shortly before treatment (chi 2 = 36.77, p < 0.00001). They were more psychologically robust and were more confident of managing pain (t = 4.55, p < 0.001), and catastrophized less (t = 2.21, p = 0.029). They were also more optimistic about being capable of work (u = 566, p < 0.0001) and of overcoming obstacles to work (u = 889, p = 0.0103). Workers and nonworkers were not differentiated by expectations of support from their immediate line manager, although nonworkers doubted support available from colleagues. Overall, despite generalization of pain management strategies in nonwork activity, return to work depended on specific beliefs concerning work-relevant strategies.