Pain responses in patients with upper-extremity disorders

The purpose of this study was to evaluate the relationship between pain response factors and upper-extremity disorders associated with work-related compensable disorders. In this retrospective study, the charts of 113 patients were examined. Compensation was not found to have any statistically significant association with pain levels. The degree of functional overlay in these patients, indicated by pain questionnaire scores, differed only slightly between compensated and noncompensated patients and indicated no significant difference between the 2 groups, except that the compensated group used a higher number of descriptors to describe their pain (p = .0143). These results indicate that compensation affects the verbalization of pain but does not affect the degree of pain experienced. Working status was found to be significantly correlated with a better ability to cope with stress at home, suggesting that employment status may be a more important factor than compensation status in the presentation of these patients.

Long-term follow-up evaluation of cold sensitivity following nerve injury

This article reports the long-term follow-up evaluation (mean, 10 years) findings of 50 patients with upper-extremity peripheral nerve injuries. The most common persistent symptom was cold sensitivity (n = 38), and 33 of 38 patients rated its intensity as moderate or severe. Cold sensitivity typically developed within months after initial injury and resolved in only 2 patients. No significant difference in the incidence of cold sensitivity was found between patients with subjectively normal hand sensation (7 of 11) and those who reported abnormal hand sensibility (31 of 37). A cold sensitivity severity score (CSSS) was determined; a significant relationship was found between the CSSS and the patient's subjective rating of cold sensitivity intensity and change in job status or occupation due to injury (p < or = .02). No significant relationships were found between incidence of cold sensitivity and age, mechanism of injury, smoking, or level of nerve injury. A significant relationship was found between cold sensitivity and digital amputation injuries (p < or = .05). Thus, cold sensitivity is a common sequela following nerve injury and does not decrease over time.