Self-management tools for people with chronic or persistent pain tend to focus on symptom reporting, treatment programmes or exercise and do not address barriers to work, facilitators of work ability, or workplace pain self-management strategies. We developed the Pain at Work (PAW) toolkit, an evidence-based digital toolkit to provide advice on how employees can self-manage their pain at work. In a collaborative-participatory design, 4-step Agile methodology (N = 452) was used to co-create the toolkit with healthcare professionals, employers and people with chronic or persistent pain. Step 1: stakeholder consultation event (n = 27) established content and format; Step 2: online survey with employees who have persistent pain (n = 274) showed employees fear disclosing their condition, and commonly report discrimination and lack of line manager support. Step 3: online employer survey (n = 107) showed employers rarely provide self-management materials or education around managing pain at work, occupational health recommendations for reasonable adjustments are not always actioned, and pain-related stigma is common. Step 4: Toolkit development integrated findings and recommendations from Steps 1–3, and iterative expert peer review was conducted (n = 40). The PAW toolkit provides (a) evidence-based guidelines and signposting around work-capacity advice and support; (b) self-management strategies around working with chronic or persistent pain, (c) promotion of healthy lifestyles, and quality of life at work; (d) advice on adjustments to working environments and workplace solutions to facilitate work participation.
Reference
Blake, H.; Somerset, S.; Greaves, S. The Pain at Work Toolkit for Employees with Chronic or Persistent Pain: A Collaborative-Participatory Study. Healthcare 2022, 10, 56. https://doi.org/10.3390/healthcare10010056
“Inability to have flexible working to help me manage my health and still do my role, not everyone needs to be in the office every day”.
“I share a workspace, so the fact that I have to adjust the chair, computer etc every shift, rather than having a permanent set up, can be difficult”.
“Going to meetings when I can’t have the right support. I need back support and a footrest then I’m fine, but meeting rooms usually have awful chairs-no back support and impossible to reach the floor. I also couldn’t hot desk as I need too many personal accessories, like a back rest, special mouse and keyboard, footrest”.
“I got pain and swelling in my wrists which can make typing and scrolling on computers difficult. I often have to stop writing which delays my work”.
“Continuing to meet my daily obligations, no matter how much pain I am in that day or that week. Hard sometimes to keep up a cheery exterior”.
“Not having a work life balance-putting too much energy into work and not leaving energy for fun or anything else…trying not to show how hard I work to prove I can still do it”.
“The sporadic nature of living with a long-term health condition… I can have periods of months with few problems and then a flare up which requires hospital treatment”.
“Some days can be much worse in terms of pain and the impact is greater”.
“Each day is changeable. I might be having a good day and able to meet some of the more physical elements of my role one day, then the next be struggling even with less active tasks”.
“Others not understanding that because you don’t ‘look in pain’ you must be a whinger or making it up. Fear if you admit how much pain you are in, they will fire you or retire you or you won’t get promotions”.
“Having a suitable ergonomic desk and chair has made a massive difference, but it has been challenging when colleagues have not appreciated how necessary or important these items are to me”.
“I work in large open plan office and if you ask for adjustments the other people in the office will complain and senior management will blame me for it”.
“I feel I have to apologise for being in pain. My job does not get adapted and I feel that if I make too much of an issue I will lose my employment, especially in these times”.
“[there is a] lack of clarity around how pain related sick leave would be managed in line with current HR policy”.
“Sickness absence policy isn’t set up for people with chronic or persistent pain”.
“At work I have access to a standing desk and ergonomic chair. Since the pandemic hit, I’m working from home all the time, but I have no access to those”.
“Currently, I am on slightly reduced hours as I don’t have all my reasonable adjustments at home, but I am still completing the same work as I would in full-time hours”.
“Recent changes for COVID-19 mean I am now full time from home and coping extremely well”.
“My health has improved massively since lock down as I can start later and work later on days when pain and stiffness are too hard in the morning”.
“I work from home and do not work set hours, which means I can work around my pain, even working from bed when necessary”.
“The only thing which would make a work situation better is for there to be better understanding and training that chronic or persistent pain conditions are invisible and fluctuating. That would avoid some difficult conversations”.
“Educate people that not all disabilities are visible and that many of us live with conditions which are life limiting. It’s not our choice”.
“I have been provided with adapted workspace but was reminded of this repeatedly at staff meetings that it had eaten into budget”.
“Emotional support, reasonable adjustments, open environment to talk about it without me feeling embarrassed intimidated or uncomfortable or that I’m not pulling my weight or that I can’t do my job”.
“I am a medical doctor…before I had chronic or persistent pain it never occurred to me that there is so much ignorance and prejudice about chronic or persistent pain”.
“…Line managers ignoring the recommendations from the occupational health team…Delays in the approval and delivery of disability equipment”.
“‘anecdotal comments-Does she need a chair when a cushion will do?’ or ‘If she can’t drive long distances what’s wrong with stopping to stretch her legs?’”
“In a small company, the hardest thing is cover if someone is absent from work. People don’t tend to take sick days as they don’t want to let people down”.
“I thought we didn’t have anyone with chronic or persistent pain, but this did make me think about types of pain that are less visible, and as a leader it’s about being sensitive to that and knowing that people might be struggling but might not disclose it, in case they let you down. So, the biggest challenge is probably feeling safe to disclose health issues”.
This entry is adapted from the peer-reviewed paper 10.3390/healthcare10010056