Sources of injustice among individuals with persistent pain following musculoskeletal injury

Evidence supports the negative impact of perceived injustice on recovery following injury. However, little is known about sources that contribute to injustice perceptions in this context. Therefore, this study systematically investigated sources of injustice following painful musculoskeletal injury. Following completion of the Injustice Experiences Questionnaire (IEQ) and measures of pain, depression, and disability, participants completed a semi-structured interview to discuss reasons underlying their IEQ responses. On average, the sample was experiencing moderate levels of pain, depression, and disability, and clinically meaningful levels of perceived injustice. Participants frequently identified employers/colleagues, other drivers, insurers, healthcare providers, family, significant others, friends, and society as sources of injustice. Common reasons for identifying these sources included their contribution to the injury, inadequate assessment or treatment of pain, and punitive responses toward participants’ pain expression. Sex- and injury-related differences emerged in the identification of injustice sources. Potential strategies for preventing perceived injustice following painful injury are discussed.