The opioid crisis has made a significant impact on America’s culture and psyche. Lawmakers, the healthcare industry and other national and local leaders have responded appropriately to initiate new guidelines and regulations around opioid prescribing. But unfortunately, not enough people are discussing the elephant in the room: The real root of our opioid crisis is poor pain control for the 116 million Americans suffering from chronic pain.
Not addressing coordination of care and interdisciplinary access to pain management has not only been costly for our economy — it’s estimated that the nation is spending $183.5 billion annually in direct healthcare costs for musculoskeletal conditions — but also for employers. The costs of unsuccessful pain treatments can add up in the form of absenteeism, presenteeism, poor productivity on the job and higher medical costs.
But thankfully, employers can be part of the solution by offering affordable, evidence-based interventions that can help employees mitigate pain. Here are three important components of an evidence-supported pain management program that benefits administrators should consider when determining a strategy to deal with pain in the workplace.
Educate your employees about self-care options. Self-care education should be the foundation of any pain management program. At a basic level, a pain management campaign can include flyers, posters, newsletter articles, mailings to the home and on-site staff meetings. Poor understanding of pain and what it means leads to many poor decisions and high costs; accurate and targeted information can make a difference in the choices employees make about pain. Information should help educate employees on when and how to engage with their physician or other medical provider to understand the root causes of their pain, understand medications and the appropriate application of self-care treatments, such as heat vs. ice, and identify physical as well as psychological barriers to movement. Employees should be urged to obtain guidance on posture and body mechanics to learn how to move safely, and learn mental imagery and relaxation techniques.
For many employees with pain, self-care options such as mindful movement, relaxation training, exercise, and posture/body mechanics training can be very effective in helping to mitigate pain and prevent re-injury. Employee education and self-care training should always be considered a first line intervention for any pain management strategy.
Give employees access to conservative therapies. Some employees who suffer from acute and chronic pain conditions can resolve their pain completely or reduce it through first-line conservative interventions such as physical therapy, therapeutic massage, acupuncture and manual therapy, like spinal manipulation.
Reviews of these therapies and their success in managing musculoskeletal pain have been published by the American College of Physicians, the Agency for Healthcare Research and Quality and others. The other good news is that these therapies can be affordable for employees through employer-sponsored coverage offering access in a managed setting. Various health plans and specialty benefits administrators offer low-cost, employer-sponsored plans that cover chiropractic, therapeutic massage, acupuncture and other evidence-based therapies.
Address psychological factors around pain and healing. Employees who suffer from severe acute pain or on-going chronic pain may find that fear is a big impediment to healing. Fear and anxiety about moving or reinjuring the body can cause maladaptive coping strategies, such as movement avoidance, catastrophizing and depression. Using cognitive behavioral training (CBT) can help by changing patterns of thinking, beliefs or behavior related to perceptions about pain. Significant results from CBT studies include reductions in pain severity, pain catastrophizing, and depression. CBT also has been shown to reduce absenteeism due to pain-related disability. Pain management programs that include CBT can prove to be a cost-effective way of helping employees return to work as happier, more productive employees.
Benefits administrators should reach out to their benefits advisers and/or health insurance providers to learn more about their options in providing employee access to non-invasive, non-pharmacologic pain solutions. Armed with data about the high prevalence of musculoskeletal pain in America, the risks associated with opioid use, and the variety of evidence-based non-invasive interventions available, administrators can make an effective case for providing a pain management program at the workplace.
