Other - Clinical Intervention: Pain Management Programs, Physiotherapy And Rehabilitation, including Multi- and Inter-Disciplinary Approaches

Pain & Work: Evidence Based Practice to Enhance Work Participation and Quality of Life

This course will provide participants with state-of-the-art evidence on the interplay between chronic pain and work. The leading paradigm will be the main message from the 2006 landmark study by Waddell and Burton: good work is good for health and well-being. We will present the evidence for this along with characteristics for ‘good’ work. We will present how leading biopsychosocial work-health integration models, their principles and supporting evidence, can be applied to clinical care. We will present successful examples of integration of pain care and work, including integrated workplace-based interventions to reduce pain and increase work participation, quality of life and productivity. Because we recognize that IASP draws an audience that is highly diverse, we will present a summary of best practices and principles that can be applied by the participants regardless of country-specific system characteristics. The refresher course will consist of multiple short presentations (5-10 minutes) by each of the 3 speakers, followed by interactive discussions and Q&A moderated by all presenters.

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Effectiveness of Risk Factor Screening Tools for Primary Prevention of Musculoskeletal Pain

Presentation of a recent systematic review looking at the effectiveness of risk factor screening tools for primary prevention of musculoskeletal pain. While pain at work is common, it is difficult to predict or prevent. Comprehensive workplace assessment of physical and mental health factors has been recommended.

Insight: Risk factor assessment may inform interventions to help prevent the onset of musculoskeletal pain at the workplace.

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Assessing Cognitive and Physical Demands of the Job a Biopsychosocial Approach to a Job Demands Analysis

Using a biopsychosocial approach grounded in the Sherbrook model, a job demands analysis assesses and quantifies specific job demands using a structured and systematic approach.

Insight: A comprehensive assessment of the cognitive, physical, sensory, and behavioral demands performed in a specific job is crucial to maximizing functioning at work and minimizing pain.

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Occupational Lifting and Back Pain: Thou Shalt Not Lift?

Presentation of the evidence for a causal relationship between (occupational) lifting and back pain based on the application of the Bradford Hill criteria; occupational lifting myths, alternative explanations for the widespread beliefs about the relation between lifting and back pain, including the unwanted negative role of health care practitioners. Discussion on the ‘safe lifting’ paradox.

Insight: Evidence for falsification of a one-dimensional causal relationship between lifting and back pain, biopsychosocial alternative approaches, focusing on the possible unwanted nocebic role of the health care practitioner and positive alternatives.

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Implementation of Behavioral Change Strategies for Return to Work

Interventions aimed at reducing pain intensity do not consistently lead to improved work participation. Since work participation is human behaviour, behavioural change interventions are likely more effective. Trials of motivational interviewing and health coaching have found long-term improvements in sustained work participation. Work ability assessment is also an integral part of several effective behavioral change interventions, including graded activity and functional restoration programs.

Insight: Behavioural change interventions (including some that integrate workability assessment) appear more effective for promoting work participation than treatments aimed at reducing pain intensity.

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Using ‘Occupation’ as the Focus for Therapy in Supporting Individuals at Work

‘Occupation’ represents any meaningful activity and includes the areas of self-care, productivity, and play/leisure. Evidence suggests activity engagement increases occupational involvement and decreases pain. An overview of the evidence for workplace interventions (ergonomic, exercise, and organizational) for pain reduction will be presented.

Insight: The central tenet of the intervention is activity management, activity analysis, goal setting, skill development, activity modification, and energy conservation.

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