Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Pain, Chronic


Related Terms

  • Chronic Pain Syndrome
  • Unresolved Pain

Differential Diagnosis

Specialists

  • Anesthesiologist
  • Clinical Psychologist
  • Dentist
  • Neurologist
  • Pain Medicine Physician/Pain Specialist
  • Physiatrist (Physical Medicine and Rehabilitation Specialist)
  • Psychiatrist

Comorbid Conditions

Factors Influencing Duration

Although persons with chronic pain syndrome may have no objective medical impairment, their self-perception of incapacity depends on many variables, including character traits, personality, ethnic and cultural background, the presence of support systems, motivation and prior job satisfaction.

Medical Codes

ICD-9-CM:
338.2 - Chronic Pain
338.21 - Chronic Pain Due to Trauma
338.22 - Chronic Post-thoracotomy Pain
338.28 - Chronic Postoperative Pain, Other
338.29 - Chronic Pain, Other
338.3 - Neoplasm Related Pain (Acute) (Chronic)
338.4 - Chronic Pain Syndrome; Chronic Pain Associated with Significant Psychosocial Dysfunction

Overview

Chronic pain generally refers to persistent, non-acute, sometimes disabling pain in the extremities or other areas of the body. The pain can be associated with a known cause such as a major or minor injury, or it can be a symptom of a painful chronic condition such as fibromyalgia. It can just as often be of unknown origin. Considerable controversy continues to surround the cause (etiology), definition, diagnosis, and treatment of chronic pain.

The term "chronic pain" is not used consistently. The term can refer to pain that has been present for an arbitrarily defined period, for example, longer than 6 months. Alternatively, the term "chronic pain" is often used as a synonym for the term "chronic pain syndrome," a descriptive term used to indicate persistent pain, subjective symptoms in excess of objective findings, associated dysfunctional pain behaviors, and self limitation in activities of daily living. Chronic pain syndrome is the presentation of combined physical and psychological changes due to chronic pain. It is not to be confused with “Complex regional pain syndrome” (CRPS), also called reflex sympathy dystrophy, which also involves chronic pain but is defined and diagnosed using an established set of clinical criteria.

Chronic pain syndrome is not the same as acute pain or recurrent acute pain. Acute pain is due to actual or pending tissue damage. Its duration is short and its psychosocial consequences are minimal. A person's perception of acute pain and behavior following the onset of acute pain are commensurate with the inciting event. Acute pain resolves as healing occurs. Acute pain is common, occurring for example with fractured bones, skin lacerations, sprains and other similar events. Recurrent, acute pain refers to episodic pain associated with chronic conditions such as trigeminal neuralgia or cluster migraine headaches.

Although chronic pain differs from acute pain, the current understanding of neurophysiologic mechanisms involved in the development and persistence of pain recognizes that transmission of pain (nociceptive signals) from peripheral sites results in changes at all levels of the central nervous system (CNS). Genetic and environmental factors along with increases in innate (endogenous) CNS excitatory controls and decreases in inhibitory controls are also believed to contribute to the evolution of chronic pain (Marchand). Evidence-based research suggests that when acute pain does not resolve within a few months, continued activation of nerves that transmit pain (nociceptors) may result in changes in the spinal cord and brain (CNS changes) that can eventually lead to the development of chronic pain (Apkarian; Jayson). This knowledge of CNS changes due to prolonged pain may help to explain the disproportionate and non-dermatomal presentation of chronic pain and may help in the diagnosis and treatment of the individual.

Chronic pain syndrome refers to persistent pain that usually has no identifiable source and is associated with abnormal illness behaviors, including expressions of pain (moaning, groaning, gasping, or grimacing) that are grossly disproportional to any underlying cause, substance abuse involving prescription drugs, non-prescription drugs and alcohol; self-imposed prolonged excessive disuse; self-limitation of social and recreational activities; and a self-perception of total occupational disability.

Chronic pain syndrome is complex and involves multiple factors, but should be considered if a person does not respond to appropriate medical care within a reasonable time frame or if the person's pain behavior greatly exceeds the usual response to a specific disorder.

Incidence and Prevalence: It is estimated that about 35% of the American population has some degree of chronic pain, and up to 50 million Americans are partially or totally disabled due to chronic pain (Singh). Pain is the most frequent complaint leading individuals to seek medical care. Because pain is considered a symptom rather than a diagnosis, there are no valid incidence figures available for chronic pain itself.

Source: Medical Disability Advisor






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