Chronic pain is correlated with unemployment and negative occupational outcomes. Returning to work is a process that takes place after a time period of sickness absence. Work is an important part of one’s identity and sense of purpose; work provides financial support and therefore being off of work for an extended period of time impacts the quality of life. Rehabilitation plans often incorporate a return to work/“stay at work” goal to motivate clients and promote wellness.
There are a number of obstacles to maintaining health and wellness in the work environment. Millions of people work with chronic pain. It is not easy to wake up, experience intense pain and fatigue, and find the motivation and energy to work despite the pain. It is normal to experience fear and anxiety prior to returning to work after a period of being off due to illness or injury. Dealing with pain fluctuations at work, being worried about causing further pain, or being unsure about how to communicate difficulties to colleagues and employers may be barriers to work. This post will provide some considerations and tips to promote proactive chronic pain management in the workplace.
The Physical Work Environment
Modifications to the design of your job or the physical work environment are crucial for pain management. Consider requesting an ergonomic assessment through your insurer or place of work. Ensure that your workstation is properly designed. Request assistive devices such as lifts, trolleys, and handles if needed. If you are comfortable requesting support from colleagues for tasks involving increased physical demands, utilize your resources appropriately. Sit-to-stand desks can increase movement, take pressure off of certain joints, and allow for changing positions throughout the workday.
For individuals working desk jobs, ergonomic keyboards, back cushions, and modifications to computer screen settings can be beneficial depending on diagnosis and pain (e.g. if chronic headaches/migraines are a concern, adjusting the brightness of the screen to limit blue-light settings may be beneficial). If typing or writing has led to issues such as carpal tunnel syndrome, considering having a note-taker/scribe or speech-to-text software can be beneficial.
Workplace Accommodations
If available, work with a return to work specialist, occupational health nurse, your primary healthcare provider, or an Occupational Therapist to explore appropriate workplace accommodations. There are a wide variety of accommodations that may be applicable in your work setting, which requires careful assessment and clinical considerations to be justified accordingly. Please note: these accommodations are of course not always feasible in every work role.
Workplace accommodations can include modifications to hours as well as duties. If you are off work due to illness/injury for a period of time, there should be a strong consideration for a graduated return to work schedule (e.g. working only a few hours per week to start then slowly increasing work hours and days over a period of 8-10 weeks).
Other accommodations to hours could include working from home, reduced hours, and time off permitted for essential healthcare appointments. Job sharing options and having flexible work hours can be supportive of a successful stay-at-work plan (e.g. having the flexibility to work mornings at home and afternoons at the worksite if the individual has more pain in the morning).
Scheduling regular rest breaks/stretch breaks, and even arranging to have a private room that can be used for exercise, relaxation, and mindfulness can be helpful.
Behavioral Interventions
Adjustments to the work demands, your workstation, and hours can promote workplace wellness, however, there are also a number of behavioral strategies that are effective. Seek support to learn stretches that are best for your pain and schedule a stretching routine throughout the workday. Set vibrating alarms or reminders on your phone to help you remember to engage in these exercises at least once per hour. Change positions frequently. Try chair yoga, or bring a theraband/resistance band and engage in exercises at your desk. Go for a walk at lunchtime.
Make sure medications and pain self-care items are available if that is part of your care plan. Check-in with your self-care: eat regularly, get movement, engage in relaxation and stress management, drink water, and sleep properly. Prepare in advance the strategies that are supportive of your workplace wellness.
Pace yourself. If you feel as though your pain is minimal one day, do not push yourself to do everything that day. Why? This leads to what we call a boom-bust pattern of activity, which essentially means that if you push yourself too hard one day, the next day, or the following few days you may experience exhaustion and increased pain. To avoid this pattern, explore strategies for healthy pacing with your healthcare provider. There are specific calculations and tracking activities to help with pacing.
Cognitive Interventions
Re-frame your thinking around work and pain. Use techniques such as meditation, mindfulness, and breathing to work through the pain. Seek support from counselors and use Cognitive Behavioural Techniques and apply these to the workplace. Use distractions when the pain intensifies. Do a word search, listen to music, have a healthy snack in a mindful way, talk with a colleague, or step outside for a break. Engage in positive self-talk such as reminding yourself that things could be worse and that you can get through them. See previous blog posts for a number of excellent cognitive interventions that can be adapted for the workplace.
Learn to Communicate Pain Effectively
You have a right to your confidential health information. You do not need to disclose your health condition to anyone. There are benefits and drawbacks of engaging in different levels of disclosure in the workplace. Chronic pain is challenging for a number of reasons, however in particular it can be difficult for others to understand and empathize with because it is often an invisible illness. Experiment with different forms of disclosure to see which fits best for your needs and your work environment.
Disclosure to your employer could allow the employer to make more reasonable adjustments to your work demands. Colleagues may have a better idea of how they can support you if they are aware of your pain. Consider your work culture, your work goals, and your relationship with your employer prior to making a decision around disclosure.
A Final Note
Working with pain is sometimes not possible. Taking time off work to recover and learn strategies to cope with pain may be needed in some cases. Using proactive pain management strategies, accessing workplace accommodations, and seeking support from professionals can decrease negative work-related outcomes. If you do need to take time off work, remember that paid work is not the only form of productivity.
Productivity can include activities such as volunteering, childcare, cleaning, and even paying bills. Finding creative ways to manage pain at work and engage in productive occupations at home and in the community will support a healthy recovery process.
Precision Pain Care and Rehabilitation has four convenient locations in Richmond Hill – Queens and New Hyde Park, Lindenhurst, and Valley Stream – Long Island. Call the Queens office at (718) 215-1888, or (516) 419-4480 for the Long Island offices, to arrange an appointment with our Interventional Pain Management Specialist, Dr. Jeffrey Chacko.
