A. Pain Reinforcing Factors:
Secondary gain: Support system allows passive / inactive role for patient via catering to needs and hence fostering dependency
Environmental: Inadequate opportunity or skills to compete in the professional community
Physician knowledge deficit: In areas of diagnosis and appropriate treatment, can prolong symptoms and validate pain behavior
Worker’s compensation: Laws have become counterproductive-- financial compensation or open claim may discourage desire for return work and impede recovery
Litigation: Anticipation of large financial settlement can reinforce pain behavior and develop into learned pain behavior