It Hurts Too Much for Me to Work

07 February 2013 / California Workers Compensation, How To, Impairment Physical Exam, Medical History / Comments Off on It Hurts Too Much for Me to Work

“It hurts too much for me to work” is a common complaint in the clinic.

In this situation be sure you have clearly reviewed the physical exam findings, objective imaging (x-ray, MRI, consultant opinions, etc.). Inform the patient that the pain is not dangerous, but does require activity modification during the healing process.

Movement is essential for soft tissue recovery, as is strengthening and following conservative treatment measures. If the worker is still having difficulty tolerating work one of two things can be additionally done.

The first is to shorten the work day.

I reserve this for situations where there has been a reasonable change in condition, and the subjective findings are at least in part supported by objective findings i.e. increased muscle tension, guarding with distraction on exam, and good compliance with therapy attendance etc. I will often shorten the shift by a maximum of 1-3 hours.

“Still hurts too much”.

At this point I will revisit my work restrictions and see if they can be further limited with regards to weight bearing, bending, and lifting. In general I do not place anyone on a work shift less than 4 hours, and preclude lifting less than 10 pounds, or bending less than 10 x per hour.

The reality is that these are the basic minimal required functions for activity of daily living i.e. dressing, shopping, preparing food and self hygiene etc. I also point this out to the patient.

Back to top