While some ‘minor’ workers’ compensation claims deteriorate into long term, expensive ordeals, there are also claims involving catastrophic injuries where the workers gets back to function and work. One of the major differences between the two is how the patient deals with pain.
Contrary to what many believe, pain is an experience — at least as much psychological as it is physical. Injured workers who understand this can learn skills that help them cope and function.
Rather than continuing to undergo multiple unsuccessful medical procedures and taking oft-dangerous medications, these injured workers become empowered and learned to manage their own pain. Having a better understanding and command of pain is key to helping injured workers who are at risk of, or have already developed a disability mindset.
Pain can be a good thing when it alerts our bodies to dangerous stimuli. But chronic pain causes unnecessary fears and stress, which can exacerbate the pain. The fear and stress can also cause sleepless nights — a major contributor to the pain experience.
Injured workers in chronic pain may be willing to try anything to mitigate the pain, especially opioids. As research has shown, this generally doesn’t work and instead can cause its own set of problems with abuse, misuse or addiction. What these injured workers are missing is a focus on the psychological part of the pain experience.
Behavioral interventions can help anyone with chronic pain, especially those with psychosocial risk factors for delayed recovery; catastrophic thinking, fear avoidance behavior, and histories of substance abuse, for example. The best predictor of outcomes in a pain program is early intervention with psychosocial factors, so the sooner in a claim these issues are addressed, the better.
The techniques needed to cope with pain are teachable and can be learned in a relatively short time period. Thinking and behavior patterns can be changed to focus on functional goals, through programs that take a practical approach.
Cognitive Behavioral Therapy is the basis for many treatments for chronic pain. It is short term and includes action plans to help patients become an integral part of their own treatment, giving them a sense of empowerment. In addition to talking with those trained in CBT, it can be enhanced with classes, videos and reading materials.
Other programs, such as mindfulness training and chronic pain self-management are similar to CBT and offer additional benefits, depending on the patient’s needs. Physical and occupational therapy, relaxation training, acupuncture or massage can also helpful, as long as they are used in conjunction with a therapy program that engages the patient. Every patient is different, so the specific treatment varies from one patient to another. But they all aim to teach mind-body practices that influence health independence and improve functionality.
‘Prehab’ is an emerging concept that teaches CBT basics to help prevent injuries, especially for patients prior to surgery or other medical procedures. It offers techniques to help patients with risk factors cope with their pain and stress later on, to prevent poor outcomes.
Integrated Medical Case Solutions (Ascellus) is a national network of Health Providers in Psychology that delivers cognitive behavioral therapy (CBT) for chronic pain, trauma and insomnia across the country for the workers’ compensation industry.
Ascellus bridges the gap between mental and physical health to accelerate recovery for our nation's workforce. By connecting the workers' compensation industry with our expert behavioral care and evidence-based treatments, we deliver high-quality outcomes, helping injured workers reemerge with increased strength, purpose and resilience in the workplace.