Chronic pain is more prevalent than many people think. The latest government figures say more than 15 percent of currently employed adults have pain nearly every single day, and when non-working adults are added in, the rate rises to almost 20 percent. That translates to at least one in six employees suffering through the workday with pain.
We can only guess at the implications to the workplace on productivity, morale, absenteeism, safety, health care costs and the list goes on. While we can’t say specifically why all these people are in pain, we have the scientific evidence to understand enough about it to develop strategies that may help.
Chronic vs. Acute Pain
Chronic pain is the overriding symptom among injured workers with delayed recoveries. Many if not most of these employees have psychosocial risk factors that create or at least exacerbate the pain, and these must be properly addressed for the person to return to function and work.
This type of pain is different from acute pain, which is a reaction to a physical stimulus perceived as a threat to the body. In those situations, the brain sends a pain signal to the affected area that serves as a warning and activates the fight-flight-freeze response. This “good pain” protects us against harm.
But chronic pain may be present long after the damaged tissues that caused the acute pain have healed. It doesn’t help us survive, as acute pain can. Without the tools to stop the pain cycle, chronic pain can snowball and worsen, leading to a multitude of physical and psychological side effects.
Pain consists of our thoughts, emotions, and environmental factors, in addition to physical stimuli. When the pain signal first gets to the brain, it goes to the primal and emotional areas and then to the thinking part. Ideally, the thinking area of our brain takes over and sends the signal that decides if the threat to the body is real or not. But this is not always the case.
Some people cannot simply turn off the alarm signals from the primal and emotional brains. These areas of the brain start to grow and take up more space. Modern medical imaging technology enables us to see actual changes to the brain caused by chronic pain. This “bad pain” has no redeeming value to our wellbeing.
Psychosocial Risk Factors
There are many reasons some people develop chronic pain while others do not. But at least some core psychosocial risk factors are usually present.
Adverse childhood experiences, depression/anxiety, lack of attachment to work, and lifestyles may play a role. Catastrophic thinking, where the person has irrational thoughts of worst-case outcomes, is often present.
Australian researchers recently published a study that identifies two common traits in chronic pain patients:
Harm-avoidance behavior, which refers to the tendency to be fearful and pessimistic. People with this trait typically avoid doing much, if any, physical activity for fear of causing themselves more pain and bodily harm.
Lower levels of self-directedness, which causes difficulty in defining and setting meaningful goals. It also includes low motivation and problems with adaptive coping.
Understanding the psychosocial risk factors that are present greatly benefits the recovery process for injured workers in chronic pain. There are proven techniques that help the person change his thought patterns and help him manage and cope with his pain.
Cognitive behavioral therapy (CBT) is considered the gold star treatment method for injured workers with delayed recoveries. It is a short term, goal-oriented, activity-based concept in which the injured worker ultimately gains control and takes responsibility for his own health and wellbeing. It may include a variety of activities, such as yoga, mindfulness meditation and exercise.
Workers who have not sustained occupational injuries but have chronic pain can be helped through these same techniques.
Employers can offer information and education about CBT and other strategies to their employees, so those who are in chronic pain realize they have options. Incorporating the information into wellness programs could greatly benefit the workforce.
At least one in six employees in any given company is in chronic pain on a daily or nearly daily basis, according to the government. These figures point to a compelling need for employers to take action. Educating workers about their potential risk factors and available treatments may be a good place to start.
IMCS – Integrated Medical Case Solutions – is the premier behavioral medicine network for pain and trauma response with evidence-based outcomes and a proven track record for transforming workers’ compensation cases. IMCS makes intervention efficient with a national network of 1,000+ psychologists and psychiatrists in all 50 states