Pain Service - Chronic Pain and Work: A 5 Minute Guide for Employers

What is chronic pain?

• Chronic pain is a long-term health condition recognised by the World Health Organisation[1]
• It can affect people of all ages and abilities and can reduce participation in leisure and work activities
• Medicines have limited benefit and currently there is no medical cure
• Chronic pain is caused by hypersensitivity of the nervous system, so that pain continues in the absence of ongoing tissue damage or disease
• The Global Burden of Disease Study (2016) highlighted pain as one of the most prominent causes of disability worldwide [2]
• Primary chronic pain is now deemed to be a specific condition in its own right. [3]
• It is estimated that 43% of adults (approximately 28 million people) currently live with a degree of chronic pain in the UK. [4]

References

1. Gureje, O., Von Korff, M., Simon, G. E., & Gater, R. (1998). Persistent pain and well-being: a World Health Organization study in primary care. Jama, 280(2), 147-151.
2. Vos et al, Global, regional and national incidence, prevalence and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016:a systematic analysis for the Global burden of disease Study 2016. Lancet. 2017; 390: 1211-1259
3. (ICD-11 International Classification of Diseases 2023. Available at https://www.who.int/standards/classifications/classification-of- diseases)
4. Fayaz et al, Prevalence of chronic pain in the UK: a systematic review and meta-analysis of population studies. BMJ Open 2016

Common myths about chronic pain

Myth 1
Pain is imaginary or caused by psychological factors.

Fact 1
The pain you feel is very real and the research shows there are changes in the nervous system that happen which can lead to persistent pain being present. We recognise that persistent pain can be influenced by psychological factors, but we know psychological factors do not cause pain.

Myth 2
The pain is a sign of serious structural damage.

Fact 2
While some chronic pain conditions are linked to identifiable tissue damage, many are not, and pain can persist even after the initial injury has healed. Scans may not always reveal a clear cause for chronic pain.

Myth 3
Activity should be avoided completely, and prolonged rest is helpful.

Fact 3
While rest is important during acute pain episodes, prolonged inactivity can weaken muscles, increase pain, and hinder recovery.
 

Myth 4
The person can only return to work when they are 100% pain free.

Fact 4
Returning to work is often a part of the recovery process, and gradual return with accommodations is often more beneficial than waiting for complete pain resolution.

Myth 5
If you have pain, you just need to ignore it and get on with it.

Fact 5
Chronic pain requires management and support. Ignoring the pain can lead to worsening symptoms and decreased quality of life.

Common concerns at work for people with chronic pain

• Prolonged activity including sitting, standing, or lifting can aggravate pain
• Stress can aggravate pain
• People worry about not being believed by others, especially if they have had to take time off
• Pain flare-ups, where pain intensifies for a brief period of time, are a normal part of a chronic pain condition. Employees worry that time off during pain flare-ups will lead to disciplinary action and/or the perception that they are lazy
• Chronic pain can have a negative impact on confidence. Employees may over-compensate for pain-related absences by overdoing which can lead to a flare-up and further absence

How can employers help?

Implementation of pain management strategies help people to stay in work, be more productive, and reduce sickness absence. As an employer, you can support this by:

• Arranging a meeting with the employee to discuss pain management strategies learned as part of rehabilitation
• Allowing the opportunity for regular brief breaks. This helps people to pace their activity levels and gives them the opportunity to do stretches or other exercises that will help
• Identifying ways to limit stress such as setting up a manageable workload or schedule. Simply showing that you are supportive to employees with long-term health conditions can help to reduce stress
• Considering flexible working options especially during a flare- up e.g. agreeing in advance a temporary change in hours or location of work if possible
• Agreeing sickness absence and return to work plan in advance of flare-ups. This may include ways to maintain contact during absence, recording chronic pain as disability absence separately from other sickness absence, and having a clear and achievable ‘return to work’ plan
• Making appropriate adjustments to the workspace or providing additional equipment to assist with tasks

Chronic Pain and the Equality Act 2010

Having a chronic pain condition is covered under the Equality Act 2010.

Employers have a duty to make reasonable adjustments to prevent employees with chronic pain/long term health conditions being substantially disadvantaged. Reasonable adjustments are changes that can be made to remove or reduce the effect of a disability, enabling people with chronic pain to do and apply for jobs.

This includes changes within the workplace environment and/or changes to the way things are done. Sometimes financial support may be available to employers to help adjustments to be made in the workplace, such as The Access To Work Scheme. For further information please refer to the Equality Act 2010 on the UK Government Website.

For more information

For more information about chronic pain, and links to useful websites and resources use QR code or the link below:

Manchester and Salford Pain Centre website www.northerncarealliance.nhs.uk/paincentre
Tel: 0161 206 4002

Pain management programme work goals

During pain management rehabilitation, people often identify minor changes they can make at work which may help them to manage pain more effectively.

NAME:

has identified the following potential changes which they would like to discuss with you to consider if they are feasible