It is well known that psychologic distress after severe injuries can have profound effects on recovery. When physical activities are restricted by injury, chronic disability can develop. Such conditions can have both personal as well as social implications. For example, only one out of every two patients goes back to work after severe leg injuries. Function limited by pain and psychologic distress are considered the main problem.
This was demonstrated in a recent study of 327 adults with a severe leg injury. The group was studied to see the effects of pain, anxiety, and depression on physical function at home, at work, and at play. Measures for each effect were taken at regular intervals up to two years after the injury.
Most of the patients were men between the ages of 26 and 45 who had either broken a leg and/or damaged the soft tissues in a motor vehicle accident. The goal of the study was to gain a better understanding of the psychological factors affecting function in complex injuries like your father’s.
After analyzing all of the data collected on these patients, they found that pain and psychologic/emotional distress both decreased patients’ function. The effects are most noticeable during that first year after the injury.
Once the physical body has recovered as much as it can, then the effects of psychologic and emotional distress take on a more significant (and obvious) role in long-term recovery. As might be expected, the higher the psychologic distress, the lower the physical function. It appears that pain and negative mood affect level of function rather than the other way around (low function results in increased pain and negative mood).
What does all this mean for someone like your father? A comprehensive program to address all postinjury needs is required. Physical and emotional pain must both be treated in order to maximize function. Loss of control leads to anxiety and anxiety is linked with fear of pain. The end result is a self-imposed limitation on any movements or activities that might produce pain. This, in turn, reduces physical function and contributes to long-term chronic impairments or disability.
If there is any way you can encourage him to get some counseling that might be the best first step. It may be that he would be willing to see a rehab counselor as a way to get back to a productive work status. Usually emotional and psychologic needs are addressed at the time of the return-to-work assessment. It’s worth at least asking a few questions and making the suggestion.