The functional limitations will be directly related to the location of the pain. Low back pain, which is very frequent with vocational rehabilitation clients, will produce the following limitations:

• Strength

• Pushing, pulling, pressing

• Climbing

• Standing

• Walking

• Stooping, bending

• Lifting

• Sitting

• Kneeling

• Turning, twisting

• Carrying

• Crawling

• Driving

• Cold, sudden changes in temperature

Persons who experience chronic pain frequently have been out of work for long periods before they become involved with vocational rehabilitation. In these situations, it is important to look at the reinforcers present in the client's environment. Long periods of reduced activity may be an impediment in and of itself. Employers are reluctant to employ persons who have chronic pain and have been unemployed for extensive periods (Fordyce, 1982).

Yelin, Meenan, Nevitt, & Epstein (1980) found that they could predict work outcomes 80 percent of the time by examining the severity of the disability along with social and work factors. Physical limitations by themselves were not sufficient to predict if the person would return to work. The most accurate predictor was what Yelin et al. labeled autonomy, which they defined as the capacity to self-pace, and the ability to choose activities on the job.