Pain is the top cause of adult disability in the United States, costing the workforce as much as $334 billion each year in lost productivity costs, according to a 2012 study in the Journal of Pain. While the musculoskeletal “pain points,” such as back pain and carpal tunnel, are well known and their direct costs well-documented, there has been less emphasis on—or awareness of—the secondary or mental health effects of pain: anxiety, depression, unclear thinking and memory loss.
Even what someone might consider mild discomfort or irritation can cause these secondary effects and can affect everything from sleep to diet to exercise. As a result, these conditions can—and often do—impinge on the workplace, with symptoms manifesting themselves in form of diminished employee morale, focus and performance.
There is also a “compounding effect”—the more pain persists, the more of an impact it can have. It may become a vicious cycle, as discomfort in one area causes problems in another. Employees who are suffering and unable to work miss out not only on the income, but also the sense of meaning, purposefulness and belonging that can be gained from a job. Initial distress may lead to chronic anxiety and even depression.
Those who are able to work may only be there in body, unable to focus and perform as expected. This is known as presenteeism and it can be an even greater drag on productivity than absenteeism. In fact, according to a Global Corporate Challenge report, the cost of presenteeism to businesses is 10 times higher than that of absenteeism and amounts to as much as 57.5 days lost per employee each year.
Four Pillars of Pain Management
In order to effectively address chronic pain, employers need to take a systematic, evidence-based approach, including pain assessment, education, worksite therapy and training. The “four pillars of pain management” are:
- Develop a system of employee-centered integrated pain management practices based on a model of care that offers access to the full spectrum of pain treatment options. Evidence-based pain management is founded on a proactive and holistic approach that is pegged to outcomes, such as absenteeism, presenteeism, morale and worker satisfaction. It is based on preventing, managing and eliminating musculoskeletal discomfort, and continuously analyzing outcome data to see what is or is not working. A holistic approach addresses body, behavior and environment in an employee-centric pain mitigation model. This focuses on stretching, posture, body mechanics, coaching and training. It also incorporates technology that promotes healthy behaviors and creates a more “user-friendly” ergonomic office environment for sitting, standing, pushing, pulling and lifting. An employee-centric solution should involve onsite pain relief therapy before the issue becomes chronic, and before the pain starts creating or heightening the secondary effects. It should also include educational reinforcements and ongoing monitoring. Early interventions can pre-empt the need for doctor’s visits or more involved physical therapy, reducing medical and workers compensation claims.
- Take steps to eliminate barriers to pain care and improve the quality of care. The two biggest barriers to improving care are access and the stigma that attaches to those who seek it. Providing onsite treatment enables employees to more readily seek out and receive counseling and treatment. This can be augmented by making resources available online and by providing each employee with a self-treatment and pain management plan. Organizations can help reduce the perceived stigma by promoting the importance of awareness and early intervention pre- and post-treatment, and making employees aware of the costs to the company when chronic discomfort or pain compromises performance. Since pain does not stop at the executive suite, leadership can also play a key role in this effort by actively championing and participating in the program.
- Develop methods and metrics to monitor and improve the prevention and management of pain. Pain exists on a continuum of intensity. People will generally start with no noticeable pain or discomfort at all, then eventually start to notice some mild discomfort from sitting at their desk, standing on the floor for too long, or performing any number of repetitive everyday tasks. While it is difficult to quantify pain, businesses can quantify it in terms of costs with respect to absenteeism, presenteeism and reduced productivity, as well as workers compensation and health care costs. An “evidence-based” pain management approach begins with a workforce assessment, enabling organizations to get a firm handle on the prevalence and associated costs of musculoskeletal pain, and gauge the effectiveness of the solutions in place.
- Increase organizational awareness of pain and knowledge of treatment options. The first step in raising workforce awareness around this issue is to educate senior management. Several recent studies indicate that support from supervisors and co-workers had a positive effect on workers with chronic pain based on self-reported health-related quality of life. Their ongoing promotion and reinforcement of that commitment, combined with visible participation, will demonstrate that employee health and wellness is one of the company’s core values.
Total Worker Health
While employers increasingly understand the connections between wellness, safety and absence management, pain mitigation has historically been viewed as a risk management strategy. A pain program based on the four pillars, however, also fits the traditional wellness framework, which shifts the focus from risk to measures of productivity.
The Centers for Disease Control and Prevention addresses this connection to productivity in its total worker health (TWH) model, which is defined as “policies, programs and practices that integrate protection from work-related safety and health hazards with promotion of injury and illness prevention efforts to advance worker well-being.” TWH links risk and wellness and, in the case of pain mitigation, helps organizations maximize their value. By integrating occupational health and safety initiatives with workplace wellness programs, organizations can improve employee health and morale, reduce medical plan costs, reduce the frequency and severity of workers compensation claims, and increase productivity.
In a 2016 DORN survey of nearly 3,000 employees and their employers, 50% of employees who participated in a workplace pain management program reported an increase in productivity and 59% reported missing fewer days due to musculoskeletal pain and discomfort. Almost all employees (99%) reported an improvement in overall morale and a more positive view of their organization.
A holistic pain management program, delivered via a total worker health framework, can ultimately provide employees and employers alike with a systematic solution for alleviating the primary and secondary effects of pain, making for happier, healthier and more productive workplaces.