Chronic pain disability in the workplace

Chronic pain disorders have been associated with increasing disability expenditures in Western industrialized countries. The reason for this increase is not known. Many chronic pain disorders have been characterized by a lack of readily demonstrable pathology, resistance to treatment, and associated psychosocial difficulties. The difficulties inherent in the diagnosis and treatment of chronic pain disorders are compounded by problems in determining disability and entitlement to compensation. Recent attempts to label chronic pain disorders as solely psychosocial issues to the exclusion of biological issues appear to be misguided, particularly in the light of recent evidence supporting an organic etiology in several chronic pain conditions. Such an approach will disproportionately affect those in lower socioeconomic groups in an effort to contain costs. The long-term cost to society of targeting a highly vulnerable group with such an approach remains to be determined.