Pain vs. the U.S. Workforce

Chronic pain, at its core, is a conflict, pitting what you want to do against what your body will allow you to do. This internal struggle seeps into every part of life, but nowhere is it more pervasive than when it comes to work. Pain’s impact on the workplace is costly, both in terms of lost productivity and the psychological changes that accompany it. Only with a multifaceted approach can individuals start to reclaim what they’ve lost and begin to accept the changes that life has brought.

Workplace Costs

In 2010 dollars, the lost productivity stemming from pain conditions in the U.S. cost the country an estimated $297 billion to $336 billion ($11.6 billion to $12.7 billion for missed work days, $95.2 billion to $96.5 billion for lost work hours and $190.6 billion to $226.3 billion for lower wages).[1] Surprisingly, while work absences account for a portion of that lost productivity, the majority of it is due to reduced performance while at work.

According to a large-scale study in the Journal of the American Medical Association, about 13% of the U.S. workforce experienced a loss in productive time over a 2-week period due to a common pain condition.[2] Those with back pain and arthritis, for instance, lost 5.2 hours of productive time each week. Across all common pain conditions, the average lost productivity amounted to roughly 4.6 hours per week.

In addition, a large portion of those in pain aren’t able to work at all. According to a nationwide survey of American adults, about 20% of chronic pain sufferers have had to take a disability leave from work due to their pain levels.[3]

Personal Costs

Often, an individual’s degree of productivity on any given day, the amount they are able to accomplish, feeds into their feelings of self-worth.[4] Those in pain who are unable to work not only miss out on the income and healthcare benefits of employment, but also the sense of meaning, purposefulness and belongingness that one can gain from a job. Even for those still able to work but experiencing lost productivity, their sense of self can suffer.

The thwarted belongingness that comes from no longer having that community of coworkers and the perceived burdensomeness of relegating more and more tasks to coworkers can bode ill for your mental health. A recent study regarding the interpersonal theory of suicide found that both factors are independent predictors of suicidal ideation.[5]  The study concluded that thoughts of suicide “may be most likely to arise among people with longstanding pain who are depressed, but especially if they feel alienated from valued social groups and believe that they have become a burden to others.”

Multimodal Treatment Approach

There is no single treatment that can make working comfortable – or even feasible – for everyone, but by incorporating various treatments and strategies, it may be possible to achieve the relief needed to return to work or increase productivity or even find meaning and peace outside of the workplace if full employment isn’t possible.

In a study conducted on people who stay at work despite chronic pain, one key factor came to light: “Participants … were willing to change in order to reach their goal: staying at work.”[6] This change manifested in various ways, from taking a rest when needed and learning to ask co-workers for help to moving closer to work, retraining for a more suitable position, finding a new job with less strain and even seeking help.

Help in the form of pain management interventions is crucial. The longer an individual waits before seeking treatment, the more detrimental pain’s effects become. Pairing interventions with a behavioral health component is also an important step, allowing patients to address the perceived burdensomeness and isolation, while also helping them come to terms with the changes that chronic pain has brought to their lives.

References

[1] Institute of Medicine of the National Academies. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. Washington, D.C.: National Academies Press, 2011.

[2] Stewart, Walter F., Judith A. Ricci, Elsbeth Chee, David Morganstein, and Richard Lipton. “Lost Productive Time and Cost Due to Common Pain Conditions in the US Workforce.” The Journal of the American Medical Association 290, no. 18 (November 12, 2003): 2443-454.

[3] Peter D. Hart Research Associates. “Americans Talk About Pain.” (August 2003). Accessed March 28, 2016. http://www.researchamerica.org/sites/default/files/uploads/poll2003pain.pdf

[4] Penney Cowan. “Pain in the Workplace.” American Chronic Pain Association Chronicle (March 2011):1-9. Accessed March 28, 2016. https://theacpa.org/uploads/chronicle_march2011_ONLINE_030211.pdf

[5] Wilson, Keith, John Kowal, Peter Henderson, Lachlan Mcwilliams, and Katherine Peloquin. “Chronic Pain and the Interpersonal Theory of Suicide.” The Journal of Pain 14, no. 4 (February 2013): 111-15.

[6] Vries, Haitze J De, Sandra Brouwer, Johan W. Groothoff, Jan Hb Geertzen, and Michiel F. Reneman. “Staying at Work with Chronic Nonspecific Musculoskeletal Pain: A Qualitative Study of Workers’ Experiences.” BMC Musculoskeletal Disorders 12, no. 1 (June 2011): 126.