Work should focus on safety and well-being for everyone, experts say

Work is frequently perceived as a risk factor rather than a source of well-being, life values, development, and health. A special issue of Work on work-related pain in collaboration with the Journal of Back and Musculoskeletal Rehabilitation aims to challenge this perception and addresses the pressing need to study the balance on the cutting edge of social and health research.

Work can in many ways be regarded as one of the primary human needs. It may provide a source of income, contribute to social contacts, and is for many an important life value, providing social and intellectual growth. In musculoskeletal rehabilitation, return to work is often identified as one of its main targets. However, there is much to overcome to make work a healthy place for everyone.

Guest Editor Karen Jacobs, OT, EdD, OTR, CPE, FAOTA, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, U.S., and Editor-in-Chief of Work, says, “It was a pleasure to have the opportunity for collaboration between the two journals on this important topic of work-related pain.

“We aim to raise awareness of the challenges we face and propose a call for action to make work a safe place for every individual, where they can evolve and build up a fair income to support their lives.”

Guest Editor Remko Soer, Ph.D., University of Groningen, University Medical Center Groningen, Department of Anesthesiology, Pain Center, Groningen, and mProve Hospitals, Zwolle, Netherlands, and Editor-in-Chief of the Journal of Back and Musculoskeletal Rehabilitation, adds, “We need to shift away from the vision of work as just a risk factor, and instead strive for a situation in which well-being, life values, development and health are the outcomes.

“We can learn so much from those enduring in work despite having musculoskeletal conditions and how employers actively support people with disabilities, minority backgrounds, or older age.”

Dr. Soer notes, “While we see that physically demanding work is a significant risk factor for musculoskeletal injury, safety at the workplace is a prerequisite for a healthy work environment. Especially within low- and middle-income countries, work circumstances can be considered poor in some industries.

“In Western society, with growing demands, a 24-online culture has been introduced, leading to a blurring of boundaries between private and professional life. Increasingly, people call absent from work because of continuous stress, leading to burnout, depression, fibromyalgia, or other chronic pain conditions.”

This special issue contains 15 insightful papers related to pain that focus on topics such as burnout, work ability, quality of life, occupational rehabilitation, return to work, and ergonomics.

One of the featured articles in this issue is “Efficacy of occupational rehabilitation in return to work for back pain: A systematic literature review,” by Linda Kalski, Laura Völkel, Sarah Häußler, and Bernd Wolfarth. The authors investigated the efficacy of occupational rehabilitation programs for workers with back pain, as there is no standard procedure for a return to work (RTW) rehabilitation program used by practitioners.

This evidence-based review concluded that a combination of activity, maintenance therapy, stretching, and manual therapy showed promising results in improving RTW. In addition, the relationship and mediation between employer/workplace and employee seem to be important aspects of RTW.

Notably, pain intensity, disability, and quality of life were enhanced with interventions that included a high proportion of physical activity. Also, the intervention programs differed widely, leading to the observation that the treatment effect of the intervention programs is not established yet.

The issue also acknowledges the growing recognition of the role of psychological and social factors in pain management. Strategies such as cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) are being used more frequently. This reflects the shift towards non-pharmacological approaches to managing pain in the wake of the opioid crisis.

Applications of new technologies are explored in this issue. These include the use of virtual reality (VR) and artificial intelligence (AI) for pain management and wearable devices to track physiological data in real-time, helping to determine pain intensity and the effectiveness of treatments. AI and machine learning are expected to facilitate more personalized treatment options.

Collectively, the articles in this issue show that work-related pain management requires an interdisciplinary approach integrating medical, psychological, and occupational therapies to prevent work-related illness, injury, and disability.

When prevention is not achievable, the focus should shift to designing person-centered interventions, rehabilitation, treatment, or controls. Disclosing a pain condition at work can be complicated due to stigma. The unpredictability of pain conditions or their progression can make managing work-related pain difficult.

Dr. Jacobs concludes “We sincerely encourage researchers, clinicians, employers, and policymakers to continue work on this important topic and continue to create awareness to improve work circumstances for all individuals across the globe.”