Depression and Pessimism Can Affect Recovery from Orthopedic Injuries

Psychological factors such as pessimism about recovery and depression may be major predictors of chronic pain in trauma patients, according to results of a study by Australian researchers published in The Journal of Pain.

The goal of the research was to examine the factors that contribute to the development of ongoing pain following the healing of acute injuries. Additionally, the team sought to determine if early identification of those at risk for ongoing pain could be valuable for returning injured workers to full productivity.

The researchers, from Monash University’s Accident Research Centre, evaluated 168 patients with a range of non-life threatening orthopedic injuries. Many of those interviewed has injuries that occurred at the workplace.

More than half of the respondents reported persistent pain six months following injury and 87% said reported that their pain interfered with normal work activities. Results demonstrated that there was a high prevalence of pain six months following injury and a significant contribution of psychological and mood factors for increasing risks for chronic pain. Results also demonstrated that high initial pain intensity was a major factor predicting development of chronic pain. The authors surmised that severe initial pain may initiate behaviors that lead to psychological distress.

It was found that those who reported high initial pain levels while hospitalized were more likely to have significant pain six months after discharge. Those who expected they would not recover soon were nearly four times more likely to report pain-related work disability after six months. Those that were injured at work were also found to develop symptoms consistent with post-traumatic stress disorder, initiate litigation, and blame others for their injuries.