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Information of interest to our Clients and for the industry

Understanding How Psychosocial Barriers to Pain Affect RTW Outcomes

Have you ever been for a routine chiropractic appointment and met with, ‘Oh wow, you’re back is really out of alignment’ before a click and a crack has you sorted? But then in another week or two your back starts to ache and you automatically think ‘my Chiropractor said my back is out and it’s hurting again so I obviously have a bad back.’ Think about it… have you actually always had a bad back and since your Chiropractor has pointed it out, you’re more sensitive to back pain? Or have you just been sitting for a long time and need to stretch out, or lifted a heavy box from an awkward position? Perhaps there are a range of other factors that are impacting your perception of pain…

The psychosocial approach to pain looks at the combined influences of factors – or barriers – within a social environment, and determines the effects they have on physical and mental wellness. Beliefs, values and behaviours are examples of these barriers which can impact on an individual’s pain threshold and perceived pain tolerance.

Pain threshold refers to the point at which a stimulus causes pain that can no longer be tolerated, whereas pain tolerance refers to putting up with pain day to day. In order to recover, an individual must tolerate pain in order to increase physical capabilities, which ultimately then increases pain threshold.

So how does this all relate to return to work outcomes? Often an injured person will tell themselves that they can’t do something, or they can’t function at full capacity, because of their injury. As a result, they start to move less in fear of making their injury worse, which is the opposite of what they need to do to make it better, slowing down their recovery time. Their thought process goes something like this:

Injury Management Specialists will tell you that a fast and efficient recovery and return to work is about increasing physical capabilities which will therefore increase pain threshold, and reduce reliance on passive treatment and medications, in order to gain a sense of empowerment and return to their pre-injury state.

Here’s how an Injury Management Specialist will assist an injured worker reduce the impact of psychosocial barriers, and get back to work sooner:

  • Provide rehabilitation services, recovery strategies and mediation between doctors and specialists to manage pain, with sustainable upgrades in capacity to increase function
  • Set personal goals for increases in self-efficacy, improved relationships, mood and reduction in pain through personal, domestic, work and community
  • Provide pain education and encourage shifting beliefs about pain:
    • Provide valuable and educational resources beyond Google
    • Listen to what the worker hears, rather than what they are told
    • Checks in to identify what they’ve learnt and put ideas into practice
  • Focus on reducing pain by encouraging the worker to reduce reliance on passive treatment, reduce pain medication and home help, and take control of their pain

Pain is a subjective experience; everyone has personal barriers when it comes to pain, which is often reflected in our actions. But what is important to understand is that psychosocial barriers to pain, and the fear of making an injury worse, can sometimes mean that pain gets worse anyway, or an individual develops chronic pain as a result. Defusion – changing the relationships with thoughts – and acceptance – turning off the struggle switch – are key factors in the psychosocial approach to pain and recovery. An Injury Management Specialist will use these tools, and others, to create a placebo affect, and shift pain beliefs by allowing increased confidence to function, the resolution of the cause of pain, and ultimately allow improvement in life and return to work as quickly as possible.

Consult an Injury Management Specialist or Return to Work Provider.

 

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