3 Non-Pharmaceutical Alternatives for Injured Worker Chronic Pain Management

Chronic pain, perceived or actual, can leave an injured worker unable to perform job duties, but it can also be debilitating enough to affect the essential functions of their daily lives. Work-related injuries, including burns, soft tissue injuries, musculoskeletal disorders and stress injuries, can all lead to the feeling of “everything hurts everywhere.” Where pharmaceuticals used to be the first line of defense in chronic pain treatment, recent studies have shown that treatments involving the psychosocial elements of an injury can have longer-lasting effects.

“Injured workers experiencing chronic pain are often left with more questions than answers when medications are not working, and physicians are unable to pinpoint the best course of treatment,” said Stacy Whalen, Senior Medical Manager at Safety National. “With the various treatment modalities available outside of opioids, and the need for an engaged provider with clear treatment goals and guidelines, it is likely that finding the most effective remedy will require some trial and error. It is critically important that the injured worker is engaged in their care, remaining empowered in the process and communicating effectively throughout rehabilitation to receive the most tailored road map to their recovery.”

These pain management alternatives provide an effective treatment option for injured workers on their path to recovery.

1. Physical Therapy

While the use of physical therapy is common, often accounting for a significant part of an injured worker’s treatment plan, early intervention can be the key differentiator in restoring function, improving mobility and relieving pain. Treatment plans are tailored specifically to injury type and limitations under the care of a physical therapist, who works closely with the injured worker’s occupational medical doctor to ensure continuity of care. While a physical therapist will continually measure progress, they will also provide the education and tools necessary for at-home exercises, further empowering the employee to participate in their recovery. While there are various treatments involved in physical therapy, some of the most effective options may include:

• Strengthening and flexibility – Working closely with a physical therapist, these exercises will help an injured worker move more efficiently with minimal discomfort. These treatment plans will typically include movements that are gradually increased according to the patient’s abilities.
• Massage – Known widely for its relaxation and stress-relief benefits, massage can also improve muscular blood flow and relieve tightness. Kneading the soft tissues involved with an injury can increase the range of motion and reduce pain.
• Pain neuroscience education (PNE) – This educational approach was introduced in 2002 and can help change a patient’s perception of their pain experience. Combined with physical exercises, it can increase pain thresholds and decrease fear related to specific movements.

2. Electrical Stimulation

This therapeutic modality uses a device to send an electrical current to nerves or muscles to decrease pain signals coming from the body to the brain. This treatment may include:

• Transcutaneous electrical stimulation (TENS) – This non-invasive, inexpensive option uses adhesive electrodes applied to the skin, which send a range of electrical pulses to an affected area to stop pain signals. It can release endorphins and other substances, acting as the body’s own pain relief.
• Spinal cord stimulation (SCS) – For the most severe patients suffering from unmitigated pain, SCS may provide relief. Consisting of electrodes placed between the spinal cord and vertebrae, this elective surgical procedure allows an injured worker to send electrical pulses to an area using a remote control. It can be used to treat a complex range of injuries, including back pain, spinal cord injuries, pain after amputation and nerve-related pain. This option is typically explored last due to its high cost and range of effectiveness.

3. Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) provides psychological treatment for chronic pain, altering the brain’s chemistry through sessions with a licensed specialist. It can identify key drivers of pain, digging into the individual’s past trauma and developing coping skills. Often patients can develop autonomy in their recovery through active engagement in this type of treatment. Many experts have noted success when CBT is employed as a first-line treatment in chronic back pain patients. Additional treatments to CBT, including mindfulness training, acceptance and commitment therapy, can help patients self-soothe, avoiding a passive mindset about their pain.