When Pain Keeps Injured Workers from Going Back to Work
Taken from the article written by: Robert W. Seltzer Jr., President and Steven A. Stramara, Senior Vice President – The Seltzer Group
Managing pain is a critical when it comes to musculoskeletal injuries such as a lower back injury. Finding ways to deal with it can often be elusive. Pain management for these injuries is particularly important since such conditions account for a high percentage of job-related injuries and Worker’s Compensation costs. Sometimes these cases can lead to legal action, substantial settlement, loss of a job and employers needing to replace valuable workers.
It is important to point out that pain is both real and imagined. There may be times when employers feel that their employees are “faking it” or using pain to “milk the system”. The role of pain and controlling it in work-related disabilities is attracting more attention. Generally, pain control has not been fully realized. In a study documented in the Journal of Occupational Rehabilitation (December 2005) it is explained that in some cases there are both internal and external psychological factors influencing how the injured individual reacts to pain. In this article, “Integrating Psychological and Behavioral Interventions to Achieve Optimal Rehabilitation Outcomes”, it is suggested that many musculoskeletal disabilities are often 10% pain driven and 90% psychological. This would indicate that acknowledging the role of psychological factors is important in an employer’s injury management program. The question is not the reality of the pain, but rather how it’s treated.
– Pain Preoccupation: Anyone who has had “back trouble” knows how all-encompassing this condition can be. Pain can become all the injured person thinks about.
– Fear of Re-injury: No one wants to go through a painful experience a second time. It is the same principle as a child who burns themselves on the stove- they tend to avoid it for a long period of time. As a result the disability can become worse than the pain itself.
– Perceived Disability: When someone has been away from the job for an extended period of time, it’s not uncommon that they may feeling uncomfortable or embarrassed resulting in a hesitancy to return to work.
All of these points lead to the conclusion that the way we think about our injury and pain is directly related to our healing ability and therefore the return to work outcomes. Fear and apprehension to re-injure or face peers can become more disabling than the injury itself.
– The psychological implications of the work environment. The amount of job stress and co-worker support impacts the length of the disability. The employer’s attitude toward the disability can influence the employee’s return to the job.
– Preventing acute injuries from becoming chronic disabilities.
– Public education should not be ignored. Educating employees about the psychological issues associated with a workplace injury can help change attitudes toward a job-related disability.
– Primary physicians can play a valuable role in terms of what the researchers call “medical reassurance.” If physicians emphasize the role of activity and encourage their patients to return to an active lifestyle, addressing the fear of re- injury, they are helping the injured worker avoid a “disability mindset”.
– Combining , behavioral and psychological approaches. A study was done with a group a back pain patients who were off the job for less than six months. Some were taught problem solving skills, the others were not. Those receiving training had better return to work that those who received no training.
– Customized approaches to specific psychological factors. One study suggests that disabilities can result from the development of high levels of pain-related fears. Focusing on the fear and overcoming it can be instrumental in recovery.
Addressing and managing pain- both physical and psychological is instrumental in a successful recovery and return to work. Without an understanding of the psychological implications of injury and injury may become a long-term disability.
The Seltzer Group with locations in Schuylkill Haven, Orwigsburg, and Pottsville, Pennsylvania, serves businesses and individuals locally, regionally, and on the national level. The Seltzer Group is a proud member of the Keystone Insurers Group.
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