Have you ever been at work and you’ve noticed that your neck or back pain is starting to become more and more intense? You might be doing more harm than good by coming in.
That’s the summary from several different articles I read this month on the topic of presenteeism. You might know what absenteeism is: when you call in sick to work because you are ill. However, if you are physically at work but you can’t concentrate on your work because you are in pain, have a Crohn’s disease flare up, or have a migraine headache, then you are an employee who is present but checked out. You are contributing to your company’s presenteeism.
Stiffness just as vexing as pain
My patients have come to my with complaints that don’t fit neatly in a back pain/neck pain box. They might have hints of pain in the form of stiffness, but that’s not really what is affecting them. They complain that the stiffness and borderline pain is affecting their mind share. They can’t concentrate fully on their work, and that bothers them. They are demanding more of themselves, and they want to concentrate fully on their task. But they can’t. Their neck stiffness gets in the way.
This is presenteeism in a mild form. If you are suffering from pain, it actually takes pretty severe pain for someone to call in sick to work. Im my experience, a patient of mine will have to be disabled to the point to not be able to travel to work in order to call in sick, they they could potentially be at work taking up residence at their desk with moderate to severe pain, but without the ability to produce quality work.
You might have been paid to suffer from pain
A 2000 study published in the Journal of Epidemiology and Community Health (J Epidemiol Community Health 2000;54:502-509) reports on surveys that the researchers did. In a survey of 3801 workers, they found that in a given year about a third of workers admitted that they should have stayed home on some of the days that they reported to work. They found that if you have neck and/or shoulder pain, then you will be most likely to suffer from presenteeism. You’ll be at work, but focusing to your pain.
Presenteeism causes productivity loss that is calculated to be three times greater than productivity loss by absenteeism (Harvard Business Review.) And it’s getting worse. A few years ago, the cost to business was about 230 billion dollars a year. To put this in perspective, All of the chiropractic clinics in the United States do about 3 billion dollars a year in business. The HBR article points to mental health days, an absentee approach that meters out your productivity, as a strategic way to reset your anxiety and even your musculoskeletal pain. Another idea is to design a comprehensive benefits package that includes mental health care and conservative musculoskeletal care a priority. I suggest that employers large and small team up with chiropractic clinics in the area to provide wellness care to prevent neck and back injuries.
Pain at work is the start of something disabling
Workers who suffer in silence with neck and back pain tend to bookend more acute and severe episodes of time off with extended periods of presenteeism. In other words, an employee may be suffering with neck pain or stiffness for months with loss of productivity, followed by an acute episode of severe pain that causes them to call in sick for a few days, followed by disabling neck stiffness for months again.
A review from 2009, Working With Musculoskeletal Pain, published in Reviews in Pain (Vol 3, No 1, June 2009) suggests that if you suffer from a cold, then it’s appropriate to call in sick. However, if you have neck pain or back pain you should strive to return to work as soon as possible, and you should use the professional help that you have available to you. You’ll have better back pain resolutions if you are back to work instead of staying at home sick from pain. An employee in pain is part of a complex system of moving parts to consider, according to the authors:
- Your mental health
- Your work culture
- Your biomechanics
- Factors at home
- Factors in the organization
They suggest that the real long-term solution is to put in place measures to help employees who are in pain.
Chiropractors as part of a multidisciplinary solution
I suggest chiropractic care be implemented by employers to be part of a multi-disciplinary team. Chiropractors can work really well to care for the large “bio” portion of the biopsychosocial theory of pain science. One of the most practical and immediately effective ways to help someone out of pain is to get them moving properly again, and this is where chiropractic care can shine. With presenteeism responsible for hundreds of billions of dollars of lost productivity per year, chiropractic care is surely a cost-effective approach whereby employers can help employees, as well as their bottom line.
– Dr. Todd Lloyd, DC