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Digital EditionUnderstanding Chronic Pain in the Workplace: How Employers Can Better Promote Employee Wellbeing
Chronic pain is an epidemic all its own.
In 2021, the CDC estimated 51.6 million adults experienced chronic pain (pain lasting more than three months) in the United States, equating to 21 percent of the population. Seven percent of adults experience high-impact chronic pain (HICP), according to the National Institutes of Health (NIH).
Chronic pain can be debilitating, affecting all aspects of daily life and routine. The inability to participate in work or activities due to pain has even been linked to depression, Alzheimer’s, higher risk of suicide, and substance abuse.
Injured workers are no exception to the mental and physical toll that chronic pain can cause. It’s imperative for employers to understand its impact on their workforce, workplace safety, and productivity to prevent disruptions to their operations and their employees’ lives.
Chronic Pain Can Damage Productivity and Safety
Michelle Despres, vice president of product management, One Call
Unresolved chronic pain can have serious consequences for injured workers and their employer. For example, pain that keeps workers at home can lead to higher levels of absenteeism — something that can have downstream effects for both productivity and the remaining workforce.
One study, which followed people experiencing chronic pain, found that within a three-month period, 16 days required “usual activities” to be curtailed, four days amounted to missed work, and there was at least one visit to the physician or a clinical nurse.
“If someone doesn’t show up due to chronic pain, their work must be redistributed, putting additional strain and risk on co-workers,” explained Michelle Despres, VP of product management, physical therapy at One Call.
This can lead to a decrease in productivity, quality, and safety, because the remaining workforce is being tasked with extra work. It can also add up to extra costs for the employer, who is responsible for both paid leave for the absent employee and any overtime pay for those picking up the slack.
Replacing absent workers can add up as well, due to time spent hiring, onboarding, and training a new employee.
On the other hand, employees facing chronic pain may still come to work even if they are not feeling well. This presenteeism, where the employee is present but working sub-optimally due to pain, also takes a toll.
“Productivity, quality of work, time management, and interpersonal relationships suffer. Overburdened co-workers can become resentful of both the employee in pain and leadership for not addressing the situation, ultimately deteriorating workplace culture,” Despres said.
Keeping Employee Mental Health Top of Mind
For the employee who feels like they have no other choice, living with chronic pain can seriously impact their wellbeing and ability to earn a living.
According to NIH data, 74 percent of HICP adults are unemployed. Chronic pain costs a staggering $635 billion each year, due to medical treatments, disability and lost productivity. An added $7,726 is spent on annual health care expenditures for someone with chronic pain.
With such high costs, coupled with debilitating pain and potential job insecurity, it is no wonder adults with chronic pain are four times more likely to have depression or anxiety. To make matters worse, they are twice as likely to commit suicide.
“There is a scientific link between chronic pain and depression, as they share neurotransmitters and biological pathways. Someone with chronic pain is 41 percent more likely to receive a mental health diagnosis, including drug use disorder, depression, and anxiety,” Despres stated.
While overall dispensing rates are declining, opioids are still a top drug of choice for pain management. Unresolved chronic pain that leads to mental health concerns could ultimately result in opioid abuse, as well as opioids interacting with other medications.
“Chronic pain is commonly diagnosed alongside other pain conditions, such as back pain, headaches, and neuropathy, which can lead to taking additional medications that interact dangerously with opioids,” said Despres. “In fact, 61 percent of opioid deaths are linked to chronic pain, even though research has shown opioids are often not effective for treating chronic pain long-term,” she continued.
Strategies to Combat Chronic Pain
Employers need not feel like they’re looking at a bleak future; there are several ways to get ahead of chronic pain’s impact on employees and the bottom line.
“Physical therapy should be the first place anyone starts if they have chronic pain,” said Despres. “As movement experts, physical therapists are the ideal resource to uncover problems and provide tailored solutions. Instead of constantly asking about pain levels – which reinforces the idea of pain – we ask what activities are painful or being avoided due to pain. This allows us to identify areas where movement strategies can be improved.” Physical therapy intervention includes exercises and education proven to effectively reduce chronic pain intensity and/or frequency. A psychologically informed approach will help mitigate fear-avoidance behaviors that commonly present with chronic pain.
The American Physical Therapy Association offers many publicly available clinical practice guidelines and current concepts, like the “Clinical Guidance to Optimize Work Participation After Injury or Illness: The Role of Physical Therapists,” which provides a wealth of great information on what should be done.
Keeping employees free of opioids should be the first line of defense against chronic pain. Other post-injury opioid alternatives include massage therapy, acupuncture, and chiropractic treatments.
Focusing on Prevention
Perhaps most importantly, employers should invest in programs that prevent injury and chronic pain in the first place. During an ergonomic assessment, for example, an employee’s job requirements, physical demands, and capabilities are assessed to help ensure the work environment fits the worker.
“Chronic pain is often exacerbated by improper movement – ergonomic assessments can pinpoint where movement patterns are suboptimal, leading to solutions,” said Despres. “And there are many possible solutions to a problem, taking into account an employer’s budget, structure, and work processes.”
“With the right resources, training, and supportive environment, chronic pain can be both prevented and effectively managed in the workplace.” &
