An important discovery was made in the field of chronic pain and rehabilitation medicine by a group of investigators collaborating from the Productive Rehabilitation Institute of Dallas for Ergonomics (PRIDE) and researchers at University of Texas Southwestern Medical Center and University of Texas at Arlington. The investigators assessed the efficacy of Functional Restoration Programs (FRP) in the resolution of chronic disabling occupational musculoskeletal disorders (CDOMDs) in patients with fibromyalgia (FM). The results of their investigative study were published recently in the August 2014 issue of Spine.
FM is a chronic condition associated with widespread pain in muscles and joints. FM affects approximately 2% to 5% of the U.S. population; however, its prevalence is significantly higher (23 % to 41%) in patients diagnosed with a chronic pain condition such as a CDOMD. CDOMDs are a group of painful disorders, with an occupational cause, that affect muscles, tendons, and nerves. Disorders such as Carpal tunnel syndrome, tendonitis, and tension neck syndrome are just a few examples. According to the Bureau of Labor Statistics, 387,820 musculoskeletal disorders accounted for 33% of all worker injury and illness cases in 2011. This is associated with high costs to employers such as absenteeism; lost productivity; and increased health care, disability, and worker’s compensation costs. Many employers are using programs such as FRP to mitigate these costs, help their employees increase their physical functioning ability, improve patient’s pain coping skills, and accelerate their return to work. FRP is an interdisciplinary approach to pain management and rehabilitation that uses physical therapy; as well as, educational, psychological, and supportive philosophies to treat patients.
The study evaluated a cohort of patients that were taking part in PRIDE’s FRP who had a primary diagnosis of CDOMD and also had a comorbid FM diagnosis. Those patients who met diagnostic criteria for FM at treatment admission were divided into two groups: those who lost and those who retained the FM diagnosis at the end of the FRP. These two groups were then compared to a group of patients with chronic regional lumbar pain only (no fibromyalgia or widespread pain) on psychosocial self-report measures and relevant socioeconomic outcomes (including work return and work retention) one year after treatment discharge.
The study results showed that the comorbid FM diagnosis resolved in nearly half of all patients who initially were presented with FM and successful completion of functional restoration physical and psychosocial rehabilitation. One year after discharge, fewer patients from both FM groups (those who had lost and those who had retained the fibromyalgia diagnosis at discharge) were working than those in the lumbar only group, indicating that a comorbid FM diagnosis at admission, whether resolution occurs, is predictive of poorer work outcomes.
The results of this study add to the body of knowledge that indicates the effectiveness of FRPs to reduce the pain, disability, and depressive symptoms that are associated with a comorbidity such as FM in CDOMD patients.
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