For the 16 million Americans liaving with chronic back pain, symptoms can impact every part of life – especially at work. Back pain in the workplace is the leading cause of disability worldwide. Even for those whose jobs don’t include any manual labor, pain can still be debilitating.

Pain that quickly resolves can be distracting enough. When pain lasts for more than three months, it becomes chronic. Chronic pain can have serious consequences for work performance, sleep quality, and even interpersonal relationships.

When thinking about how to support team members who experience pain, keep in mind the myriad ways pain can impact employees – and where your employee benefits strategy can help.

10 Ways Back Pain in the Workplace Impacts Employees

1. Back pain is the leading cause of workplace disability. Lower back pain can lead to more than just a few missed days of work. It’s the leading cause of disability worldwide. Disability claims related to back pain are a significant cost driver for employers – the average cost for a long-term disability claim for back pain is $35,000 per active claim, per year.

2. Back pain saps productivity. While chronic absenteeism – missing days of work – is typically more noticeable, its counterpart, presenteeism, may be more damaging to productivity. Presenteeism means that employees come in when they’re not feeling well, and get distracted by symptoms. In a survey of the most significant causes of presenteeism in the workplace, chronic back pain ranked first, contributing to 16.7 minutes per day of work lost to pain. That added up to $1.21 million in lost work for the company in question.

3. Pain makes it harder to make decisions. Research suggests that pain makes it more difficult to adapt to changing environments. That makes it harder to make decisions quickly, or make adjustments when projects get off track.

4. Pain decreases motivation. In a Stanford study, mice with chronic pain were less likely to work for a reward compared with mice that weren’t in pain. Ongoing pain can make it increasingly difficult to feel positive or optimistic about the future, which in turn makes it more difficult to work towards something.

5. Pain can lead to invasive, ineffective surgery. In a study following up after patients received spinal fusion surgery, 87%  were in pain two years after surgery – and 15% had more surgery. Surgery also makes up a significant percentage of healthcare spending related to back pain. 

6. Back pain is expensive. The costs from pain conditions don’t just impact employer healthcare plans. They can also lead to significant out-of-pocket costs for employees, too. Some insurance plans don’t cover physical therapy. For those that do, copays for physical therapy range from $20 to $55 per session. If employees have a deductible that hasn’t been met yet, that cost per session can be much higher. When it comes to surgery, an employee’s part of a surgery bill could be thousands of dollars. But costs don’t have to reach into the thousands for them to be a burden. Around half of Americans, regardless of socioeconomic status or health condition, say that they are either “very worried” or “somewhat worried” about being able to afford unexpected medical bills.

7. People in pain get less sleep. Those who experience chronic pain have an average sleep debt of 42 minutes. Those without pain on average don’t have sleep debt. Sleep loss weakens the immune system and can make it easier to catch a cold, the flu, and other viruses. More than twice as many people with chronic pain report that sleep problems interfere with their work, compared with those without pain.

8. Chronic pain is linked to depression. Major depression is four times higher in people with chronic low back pain. Chronic back pain can lead sufferers to stay at home more frequently, limiting both physical activity and socializing. Long-term pain can also lead sufferers to feel hopeless about their condition or powerless over their pain.

9. Pain affects interpersonal relationships. It’s frustrating if chronic pain keeps you from attending your favorite dance class. But if that dance class is also a significant source of social interaction, the impact is even greater. Pain has the most significant impact on quality of life when it negatively affects social relationships, research has found

10. Chronic lower back pain negatively impacts overall quality of life. Studies show chronic pain can make it more difficult to sleep, exercise, maintain relationships, and focus on work. In other words, pain creeps into every part of life and is associated with lower quality of life overall.

What are risk factors for back pain?

Sprains and strains for twisting or lifting something improperly, lifting something too heavy, or over stretching are all common causes of lower back pain. Jobs that require heavy lifting, pushing, or pulling are more likely to lead to workplace injuries and back pain. For those who sit at a desk, poor ergonomics or posture can lead to back pain.

Back pain also becomes more common with advancing age. Discs between vertebrae begin to lose fluid and flexibility with age. This decreases their ability to cushion the vertebrae. Vertebrae rubbing against each other can contribute to pain. Loss of bone strength from osteoporosis can also lead to fractures.

Back pain is also more common among people who are not physically fit, as weak back and abdominal muscles may not offer the spine enough support. Muscle elasticity and tone naturally decreases with age, and can weaken muscles in the back.

Being overweight or obese, or quickly gaining a significant amount of weight, can also put stress on the back and lead to low back pain. Some causes of back pain, such as ankylosing spondylitis, have a genetic component.

Chronic back pain – pain that lasts for three months or longer – is more complicated. In chronic lower back pain, the source of the pain is often unknown, or can’t be specifically identified. It may start with an injury, but continue after the injury has healed.

Nerve pathways that carry pain signals from nerve endings through the spinal cord and to the brain may become sensitized. These sensitized nerves may increase the intensity or frequency of pain, even in response to stimuli that didn’t used to be painful. Pain signals may also still be sent to the brain even after the original injury has healed.

Obesity is one risk factor for chronic back pain, as excess weight can strain the back. Post-traumatic stress disorder (PTSD) and depression are also risk factors, speaking to the connection between back pain and emotional distress.

What can help?

Chronic low back pain that isn’t the result of a particular injury has historically been a challenging condition to treat. That’s because back pain isn’t just physical – there’s a strong mental component to pain, as well.

For example, research shows that stress is a significant contributor to lower back pain. Work-related stress in particular takes a toll. One recent study found that heavy workloads, lack of control over one’s job, and lack of social support at work were all predictors of chronic low back pain.

One way to address back pain in the workplace is to introduce a musculoskeletal (MSK) solution as part of your benefits package. Some solutions, like Fern Health, address both the physical and psychological sides of pain with the goal of reducing symptoms and improving wellbeing.


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