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. 2019 Oct 27;20(1):486.
doi: 10.1186/s12891-019-2877-5.

Obstacles to returning to work with chronic pain: in-depth interviews with people who are off work due to chronic pain and employers

Mary Grant  1 , Sophie Rees  2 , Martin Underwood  2   3 , Robert Froud  2   4
Affiliations

Obstacles to returning to work with chronic pain: in-depth interviews with people who are off work due to chronic pain and employers

Mary Grant et al. BMC Musculoskelet Disord. .

Abstract

Background: The global burden of chronic pain is growing with implications for both an ageing workforce and employers. Many obstacles are faced by people with chronic pain in finding employment and returning to work after a period of absence. Few studies have explored obstacles to return-to-work (RTW) from workers' and employers' perspectives. Here we explore views of both people in pain and employers about challenges to returning to work of people who are off work with chronic pain.

Methods: We did individual semi-structured interviews with people who were off work (unemployed or off sick) with chronic pain recruited from National Health Service (NHS) pain services and employment services, and employers from small, medium, and large public or private sector organisations. We analysed data using the Framework method.

Results: We interviewed 15 people off work with chronic pain and 10 employers. Obstacles to RTW for people with chronic pain spanned psychological, pain related, financial and economic, educational, and work-related domains. Employers were concerned about potential attitudinal obstacles, absence, ability of people with chronic pain to fulfil the job requirements, and the implications for workplace relationships. Views on disclosure of the pain condition were conflicting with more than half employers wanting early full disclosure and two-thirds of people with chronic pain declaring they would not disclose for fear of not getting a job or losing a job. Both employers and people with chronic pain thought that lack of confidence was an important obstacle. Changes to the job or work conditions (e.g. making reasonable adjustments, phased return, working from home or redeployment) were seen by both groups as facilitators. People with chronic pain wanted help in preparing to RTW, education for managers about pain and supportive working relationships.

Conclusions: People with chronic pain and employers may think differently in terms of perceptions of obstacles to RTW. Views appeared disparate in relation to disclosure of pain and when this needs to occur. They appeared to have more in common regarding opinions about how to facilitate successful RTW. Increased understanding of both perspectives may be used to inform the development of improved RTW interventions.

Keywords: Chronic pain; Qualitative interview; Return to work.

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Conflict of interest statement

MU was Chair of the NICE accreditation advisory committee until March 2017 for which he received a fee. He is chief investigator or co-investigator on multiple previous and current research grants from the UK National Institute for Health Research, Versus Arthritis and is a co-investigator on grants funded by the Australian NHMRC. He is an NIHR Senior Investigator. He has received travel expenses for speaking at conferences from the professional organisations hosting the conferences. He is a co-investigator on a study receiving support in kind from Orthospace Ltd. He has accepted an honorarium from CARTA. He is an editor of the NIHR journal series, and a member of the NIHR Journal Editors Group, for which he receives a fee. He has published multiple papers on chronic pain some of which are referenced in this paper.

RF and MU are directors and shareholders of Clinvivo Ltd. that provides electronic data collection for health services research. RF and MU are part of an academic partnership with Serco Ltd. related to return to work initiatives.

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