Abstract
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.
Highlights
Chronic or persistent pain affects between one-third and one-half of the population of the United Kingdom (UK), corresponding to just under 28 million adults [1]
COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and was declared a pandemic in the UK by the World Health Organization (WHO) in March 2020
There is no conclusive evidence to support any specific tertiary-level return to work intervention for workers with chronic pain who are already off sick [13], it has been raised that managing pain, managing work relationships and making workplace adjustments are essential areas of a successful return for those with pain-related absence [14]
Summary
Chronic or persistent pain affects between one-third and one-half of the population of the United Kingdom (UK), corresponding to just under 28 million adults [1]. There is unequivocal evidence that chronic pain reduces quality of life [2] This negative impact on quality of life for people living with pain has been exacerbated by the recent coronavirus disease (COVID-19) outbreak due to changes in work-related activities, and physical inactivity during periods of confinement [3]. COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and was declared a pandemic in the UK by the World Health Organization (WHO) in March 2020 This pandemic has generated additional healthcare concerns for people with chronic pain due to postponed or cancelled elective surgical procedures, outpatient procedures and patient visits (including pain management services), resulting in delayed treatments, lack of continuity of care, and concerns about access to healthcare services and pain medications [4,5]. There is no conclusive evidence to support any specific tertiary-level (remedial) return to work intervention for workers with chronic pain who are already off sick [13], it has been raised that managing pain, managing work relationships and making workplace adjustments are essential (but not straightforward) areas of a successful return for those with pain-related absence [14]
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