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The biopsychosocial model provides a useful heuristic for conceptualizing CTS risk among injured workers.

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Low back pain is an increasingly prevalent and costly issue in the United States. It is a particularly relevant problem for Workers' Compensation patients, who typically experience worse surgical and functional outcomes than their non-compensated counterparts. Neuropsychologists often provide intervention and assessment services to compensated patients with back pain, and thus it is critical they possess a basic understanding of the factors that might predispose an injured worker to poor spine surgery outcomes. This paper will review the current literature regarding presurgical biopsychosocial factors which have been implicated in poor back surgery outcomes among injured workers. We provide some tentative guidelines for neuropsychologists to utilize in providing services to injured workers with back pain.

PurposeThe prevalence of radiofrequency zygapophyseal joint neurotomy (RFN) has increased substantially across the past decade. Limited research exists that has examined pre-procedure predictors of RFN outcomes, particularly within workers’ compensation populations. The purpose of this study was to determine if pre-procedure biopsychosocial variables are predictive of outcomes in a cohort of compensated Utah patients who have undergone RFN.Patients and methodsThis was a retrospective cohort study consisting of a review of pre-procedure medical records and a telephone outcome survey. The sample consisted of 101 compensated workers from Utah who had undergone RFN. Fifty-six patients (55%) responded to the outcome survey. Patients were an average of 46 months post-neurotomy at the time of follow-up. Outcome measures included patient satisfaction, disability status, Roland–Morris Disability Questionnaire, Stauffer–Coventry Index, and Short-Form Health Survey-36 (v.2). Statistical techniques utilized included frequencies, mean comparisons, and logistic and multiple regressions.ResultsForty percent of patients were totally disabled at the time of follow-up. Lawyer involvement, older age, and a positive history of depression were predictors of poor outcomes in logistic and multiple regression equations.ConclusionPresurgical biopsychosocial variables were predictive of multidimensional patient outcomes, and a high rate of total disability was observed. Additional research on the effectiveness of RFN for workers’ compensation patients is recommended.