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Family Health Magazine
GROWING OLDER

CHRONIC PAIN SECTION

Back to Work
Returning to work with chronic pain

When are you returning to work? It seems a simple question when asked by your family, friends and coworkers. However, the answer can be complex, especially when you have chronic pain. Many factors come into play, including physical and mental readiness as well as work availability. The experience will be different for each person. If you are thinking about returning to work, advance planning can help make the transition successful.

Physical readiness

Are you physically ready to return to work? Do you have the strength, endurance, and pain tolerance to work productively?

If you are on disability benefits through your insurance company, a rehabilitation or work conditioning program may help you answer these questions. Rehab providers such as physiotherapists, occupational therapists or kinesiologists can work with you to assess your present level of fitness. They can design a program to help improve your abilities. You may access a work conditioning program on your own. However, there is usually a significant cost involved. If you are seeing a single provider such as a physiotherapist outside of a structured return to work program, they still may be able to provide you with assistance in determining your return to work readiness.

If you are not in such a program or are not seeing a rehab professional, do your own check. Think about the major physical demands of your occupation. Even if you have a job that mostly involves sitting (such as keyboarding), do not kid yourself. You still need a fair amount of muscle endurance to sit with proper posture. Factor this in.

Once you have an idea of the physical tasks of your job, try doing them at home. This gives you an idea of your physical ability to work and for how long. Pace yourself – overdoing it can make pain flare up.

Once you know your physical tolerance, you may feel ready to start the return to work process. It is time to talk with your family doctor, employer, and insurance company.

Mental and emotional readiness

For some people, returning to work can feel overwhelming. The amount of time spent away and the nature of workplace relationships make a difference. You might worry about being unable to sustain the return plan. You may also feel concerned about what coworkers think and whether you are letting your employer down. The longer you have been away from work, the greater these fears and concerns may be. As we know, increased stress often increases pain symptoms, another barrier to returning to work.

Address these fears and concerns, rather than ignoring them and assuming they will go away. Psychological barriers can be just as limiting as physical ones.
Monitor your thoughts, feelings, and beliefs about returning to work. Look for things that you can control to help reduce the fear. If you need help, talk with someone close to you. Seeing a professional like a psychologist or behavioural health consultant can provide you with coping tools. These strategies can reduce anxiety, help you take control, and improve communication with everyone involved in your return to work.

Work availability

Is there a job for you to return to? This is an important question to ask. Situations change over time, and your employer may or may not have a position for you. Organizational and employee changes may happen while you are away. Many employers will hold a position for an employee. However, the ability to do so will likely lessen over time and is affected by the importance of your role.

Stay in touch with your employer if you hope to eventually return to your job. Maintaining this relationship makes the transition back into the workplace much smoother. You will both have a better picture of your status and plans. If you are uncomfortable speaking with your employer, consider having your insurance disability case manager or union representative do this for you.

A gradual return to work

It is rare for anyone who has been off work due to chronic pain or illness to return immediately to full work hours and duties. You may have lost physical fitness or muscle tone. You may have more pain and less ability to stay active. Your workplace may have changed. All of these can make an immediate full return very difficult.
More often, a modified or gradual return to work is better. This type of return comes in all shapes and sizes, and should be tailored to fit each situation. Certain strategies can all be part of a modified return to work plan:

• Start with reduced hours and gradually increase them.
• Do alternate duties.
• Begin with a reduced amount of your regular duties.
• Add more demanding tasks slowly over time.

As mentioned before, modified return to work plans should be specific to each person. Your plan should benefit both you and your employer. You should be doing meaningful work, while your employer should see productive results.

Design a flexible plan that takes your varying symptoms into account. You may not always be able to progress in tidy regular intervals if pain flares up. Allow time for plateau periods as you learn to manage pain. Taking this into account when planning your return can smooth the transition.

Thinking ahead is a key part of gradually returning to work duties. A modified return plan can greatly increase your success in learning to work productively with chronic pain.