Pain impairments include acute pain, which is categorised as lasting under 12 weeks, and chronic pain, which encompasses a longer-standing pain impairment, either following or unrelated to a trauma or operation in the part of the body affected. A recent study suggests that up to 28 million adults in the UK may have some degree of chronic pain.
What are the types of pain impairment?
Acute pain, as referred to above, is pain that lasts under 12 weeks and is, therefore, not a disability requiring reasonable adjustments in the workplace according to the Equality Act 2010. Although employers should be encouraged to support an employee with reasonable adjustments during a period of acute pain to reduce the likelihood of days off because of sickness, which is a cost in itself that may be avoided.
Chronic pain can follow injury or a surgery, but may develop of its own accord. It isn’t fully understood, but is considered to be linked to a misinterpretation of signals coming from the nervous system which will usually accurately inform the brain of when a part of the body has sustained injury, etc. Chronic pain can also affect people with other conditions such as:
How are pain impairments diagnosed and treated?
Pain impairments are classified as chronic and therefore diagnosed as such once they have lasted 12 weeks. It is not known why certain pain becomes chronic, but people who experience mental health problems, including stress, following an injury or surgery are more likely to see their pain become chronic.
There is no one-size-fits all treatment for pain impairments, but a combination of lifestyle changes – such as regular exercise, exercises in relaxation (meditation, yoga and mindfulness) and doing mood-boosting activities – alongside prescribed pain medication, can help alleviate symptoms.
Physiotherapy can also help, as the person will be given regular exercises to do which can help keep the affected areas mobile. This is better than adopting an approach of inactivity and rest, which can stiffen muscles and lead to bone weakness, in turn exacerbating pain.
Mental health also benefits from physical activity, including staying in work, which can help the person manage their pain impairment through distraction and generally remaining happier.
It is important to take medication only as prescribed and maintain a dialogue with health professionals in order to reassess medication when required. Some pain medication typically prescribed for chronic pain, such as the opioid codeine, can become addictive if not taken with correct medical guidance.
There are a few ways to determine whether an employee has pain impairments, or to confirm a pain impairment which requires reasonable adjustments:
An employee may not disclose their pain impairment upfront, but if they do, questions regarding the nature of an employee’s pain impairment and what extra support they may need can be broached sensitively. For example:
- Have they required adjustments in the past? For example, avoiding certain types of manual tasks which might exacerbate their symptoms, or avoiding sitting at a desk which could cause stiffness.
- Encouraging the employee to express their strengths and interests and which tasks they might enjoy doing is a positive way of adapting to their needs and empowering them, benefiting their mental health.
- Even if the employee does not wish to disclose their pain impairment – or they have not even received a precise diagnosis – an employer can focus on making reasonable adjustments, rather than seeking to determine the precise disability their employee has.
What reasonable adjustments are possible with pain impairments?
Employers have a legal duty to make reasonable adjustments for employees with pain impairments if they know, are aware of, or could ‘reasonably be expected to know’ that the employee has one of these impairments. Most employees will tell their employer what reasonable adjustments they need. They often involve simple changes in the way an employer might usually do things.
If the employee does not disclose a health issue or disability which may affect their performance upfront, an employer should broach the subject sensitively if they suspect that there may be a disability behind the employee’s reduced performance. Reasonable adjustments can then be made in accordance with the employee’s needs, including, in the case of pain impairments:
- Flexible working hours to accommodate medical appointments and periods of increased absence or decreased productivity following a flare-up in symptoms.
- Additional breaks if the person’s pain medication causes their concentration to lapse or makes them drowsy shortly following taking it.
- Adjustments to duties depending on the severity of their symptoms, which may be variable and improve or deteriorate from one week to the next. This may also be dependent on when they take their medication if they are required to operate machinery, for example.
- Raising awareness so that colleagues understand the employee’s pain impairment and can help ensure the employee feels comfortable at work, for example, when taking additional breaks.
- Ergonomic equipment to reduce pressure on the back, joints and other susceptible parts of the body while sitting at a desk.
Pain impairments Signposting
https://www.britishpainsociety.org – organisation advocating better care for people living with pain impairments and for better understanding of what causes them, which includes the provision of education, training, and research and development (020 7269 7840).
https://painuk.org – charity working to change the perception of pain and to promote the idea that pain is an issue in its own right. It also provides services and support for people living with pain impairments.
https://painconcern.org.uk – charity working to support people living with pain impairments and to better inform the health professionals who treat people with these impairments (0300 123 0789).
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