Recap of Current State of Chronic Pain Management in Workers’ Compensation
Chronic pain is a persistent and complex issue in workers’ compensation, often resulting from workplace injuries. It can significantly affect workers’ recovery, quality of life, and ability to return to work. To improve outcomes, it is essential to understand the current treatment approaches, associated costs, and recovery timelines for chronic pain.
Workplace injuries that are not treated promptly or effectively can evolve into chronic pain. Common causes include musculoskeletal injuries (e.g., back or joint injuries), repetitive strains like carpal tunnel syndrome, or acute incidents such as falls.
Chronic pain not only affects workers physically but also impacts their mental and emotional well-being, leading to stress, anxiety, and even depression. These factors can prolong recovery and delay a worker’s return to pre-injury productivity levels.
Current Treatments for Chronic Pain
The primary goals of chronic pain treatment are efficacy, affordability, and patient safety.
First-line treatments: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, are commonly used for mild to moderate pain. For patients who cannot tolerate NSAIDs due to gastrointestinal side effects, acetaminophen may be an alternative.
Neuropathic pain treatments: In cases with neuropathic pain, medications like gabapentin are often prescribed for long-term relief of nerve-related pain.
Alternative therapies: Medical marijuana is gaining popularity in certain states. It is essential to assess the safety of such treatments, especially since they may not appear in claims data.
Severe Pain: In cases of severe pain, opioids remain a common treatment option in workers’ compensation. While highly effective in managing acute pain, opioids carry significant risks, including dependency and overdose. Long-term opioid use should be avoided unless absolutely necessary. Pairing pharmacological treatments with non-pharmacological approaches, such as physical therapy and behavioral health support, can enhance outcomes and reduce reliance on opioids.
Cost Considerations of Chronic Pain
Chronic pain generates both direct and indirect costs:
Direct costs: These include diagnostic tests, medications, and physical therapy.
Indirect costs: Lost productivity due to time away from work can strain employers’ budgets. Additionally, the psychological effects of chronic pain, such as stress and depression, can further delay recovery and return to work.
Effective and timely management of chronic pain is essential to minimize these combined costs and improve outcomes for both workers and employers.
The Importance of Returning to Work
Returning to work is a critical milestone in an injured worker’s recovery. Unfortunately, chronic pain often delays this process. Factors such as timely access to care, severity of injury, and appropriateness of therapy all play a role in determining return-to-work timelines.
Research shows that continued opioid therapy beyond 90 days significantly reduces the likelihood of a worker returning to their job.
A multifaceted approach—combining medications, physical therapy, and mental health care—can help shorten recovery times and support smoother transitions back to work.
Innovations in Chronic Pain Management
Emerging non-opioid therapies offer promise for managing pain while mitigating the risks of dependency and overdose. These advancements could revolutionize how chronic pain is treated in workers’ compensation cases.
Check back in the coming weeks for updates on the latest innovations in chronic pain management and their potential to improve outcomes for injured workers.
By Anna Skubal
PharmD Candidate (P4)
For questions, e-mail pharmd@prodigyrx.com
List of References:
https://injuryfacts.nsc.org/technical-appendix/costs/https://www.acpanow.comhttps://stacks.cdc.gov/view/cdc/43508https://www.dol.gov/resource-library/workers-compensation-and-opioid-epidemic-analysis-and-research-design-optionshttps://pmc.ncbi.nlm.nih.gov/articles/PMC10576544/#:~:text=Both%20TCAs%20and%20venlafaxine%20have,at%20least%20moderate%20pain%20reliefhttps://nida.nih.gov/research-topics/cannabis-marijuanahttps://pmc.ncbi.nlm.nih.gov/articles/PMC3250639/https://pubmed.ncbi.nlm.nih.gov/35718393/