Pain and the Workers Compensation Patient

Pain is both a physical and emotional experience. It is made up of both sensation and perception. In other words, it is the way we feel, as well as how we interpret that feeling. For example, you may step on a tack and view this as a negative experience or receive a vaccine and view this as a positive experience, even if the pain is the same. This is an area in which the body and mind interact in a very real way to change someone’s experience.

Furthermore, our behavior in response to pain varies depending on the situation or circumstance, including how those around us respond to our expression of that pain. This is commonly referred to as pain behavior. Pain behavior is anything someone can outwardly observe that lets them know you are in pain. Everyone engages in pain behavior, but the way that it is expressed is an individual process.

As an example, imagine that you hit your finger while using a hammer. If you are alone, you may express a litany of curse words in response. However, if your preschooler is assisting you in the task, you may modify your reaction to exclude the foul language. It’s the same experience, but different behavior due to your perception of the consequences of cursing in front of your child.

Along with an injury and the resultant pain, a person may begin to experience emotional symptoms of irritability, depression, anxiety, frustration, and even anger. The pain experience is often worsened by these emotional factors, but can improve when you address the impact on mood and start to function more effectively. 

Sometimes the pain that people have after a work injury may extend beyond the expected time it would take to heal and may cause significant disruption in daily functioning. The better treatment you receive now, the more likely you are to have a shorter experience in the workers’ compensation system and the faster you will be able to return to as regular an activity level as you are able to achieve. It is important to communicate clearly with your case manager and to let him or her know the steps you are taking to make progress so they can support you in that endeavor.

When pain is treated in a comprehensive biopsychosocial manner, including a variety of disciplines, daily functioning is more likely to be restored. In other words, different disciplines can address different aspects of your pain. Therefore, you may work with physicians, psychologists, physical therapy, occupational therapy, vocational rehabilitation, or even massage therapy. Those providers may work together in a program or separately. It is essential that they are able to communicate with each other about how you are doing in order to optimize your results.

From the psychological perspective, Cognitive-Behavioral Therapy is an effective evidence-based intervention for pain management. CBT helps you to look at beliefs you may have about your injury or your pain experience. You can begin to understand how those beliefs have affected you emotionally and behaviorally. We can help you to test out and change beliefs that may not be accurate or helpful. We can also address ways in which you are expressing your pain and show you how to engage in healthy lifestyle changes that better assist in your rehabilitation.

Assertiveness training, pacing of activities, distraction, and sleep hygiene techniques are often used to manage pain more effectively.  Additionally, relaxation training, such as deep breathing and guided imagery, can be used in order to decrease stress and pain. It is also important to have realistic expectancies about life with pain. Everyone experiences pain at some point, as it is a naturally occurring part of the human experience.  There is no such thing as a pain-free existence, but we can certainly learn to manage it well when it does occur.

It is very important to get you back into activities you may have stopped due to avoidance of pain, as is appropriate. Not only is it important to return to work-related activities, but to those that are in the social and recreational realms. We want your life to be as fulfilling and similar as possible to that of your previous level of functioning.

Please feel free to ask questions and address any of these concerns when you come in for an appointment.