Working While in Pain: Strategies for Overcoming Cognitive Impairments

Evidence supports that your mind and body are always influencing one another, and one cannot be fully functioning without the other. It is important to acknowledge how lowered physical function can affect employee’s work performance. Have you ever had an injury and couldn’t think straight? When you are in pain, it can reduce your ability to focus, emotionally regulate, sleep, as well as use other cognitive functions such as memory, decision-making, planning, problem-solving, and information-processing.

An employee may be able to manage short-term pain at work or recover at home before returning to full health. For those living with chronic or prolonged pain, continuing to work while being productive and engaged may be more of a challenge. Managing chronic pain requires a holistic approach that addresses both the physical and psychological aspects of the condition. This means using strategies to help mitigate pain-related cognitive impairments and promoting overall well-being.

The Complex Connection Between Cognition and Pain

The relationship between cognition and pain is multifaceted. Many individuals who suffer from pain on a regular basis may not even be aware of the extent to which their cognitive abilities are affected by this pain due to masking or normalization of symptoms.  

Chronic pain can negatively affect mental health, exacerbating cognitive challenges. Research shows that individuals who suffer from chronic pain are four times more likely to have a mood disorder, such as depression or anxiety, compared to those are pain-free¹. Depression has been shown to have a direct link to cognitive impairment – specifically affecting an individual’s ability to concentrate, to learn and retain information, and to make decisions². Pain medication can be another factor that affects cognition. Individuals who are prescribed opioids for pain relief may benefit initially, but they may be at risk of addiction and could be caused more harm after prolonged use. Not only can opioids become dangerous when abused, but they negatively affect cognitive function. They can slow reaction times, decrease the attention span, and impact memory and judgement capabilities.

Conversely, cognitive processes can influence the mental perception and experience of pain. Factors such as attention, expectations, beliefs, and coping mechanisms can modulate pain perception. For example, individuals who catastrophize their pain or anticipate negative outcomes may experience heightened discomfort, while those who employ effective coping strategies may have better pain management. This underscores the importance of finding cognitive and mental heath strategies in the workplace to help manage the symptoms of pain.

Strategies for Managing Pain in the Workplace

Individuals experiencing cognitive challenges can use a variety of accommodation strategies to help them remain productive at work, depending on their functional abilities. Those experiencing pain can also increase their cognitive function by implementing strategies to reduce and manage their pain. Some strategies include:

• Ensure your workstation is ergonomically sound. Having a workstation that fits your stature and abilities can minimize discomfort and reduce the risk of exacerbating pain.
• Engage in Cognitive Behavioral Therapy (CBT). CBT can be effective in managing both chronic pain and cognitive challenges associated with it. By addressing negative thought patterns, building coping skills, and promoting behavioral changes, CBT helps individuals develop resilience and adaptability in the face of pain.
• Build your activity levels gradually. Often individuals who suffer from chronic pain stop engaging in physical activity, which results in more pain. Staying active on a regular basis has been shown to have immediate and long-term benefits for chronic pain patients.
• Take regular breaks throughout the workday to stretch, move around, and relieve tension. Engage in gentle exercises or stretches to promote circulation and alleviate stiffness. Incorporating brief movement breaks can also improve cognitive function and boost productivity.
• Avoid the overuse of pain killers. Always follow prescriptions properly and be aware of potential side affects of prescription pill use.
• Engage in cognitive mind-body therapies. Incorporating mindfulness meditation, deep breathing exercises, or progressive muscle relaxation into your daily routine can help alleviate stress and reduce the perception of pain. These practices promote relaxation, improve focus, and enhance overall well-being.
• Use pain management strategies. Explore various techniques, such as heat or cold therapy, over-the-counter medications, or alternative therapies like acupuncture or physical therapy. Consult with healthcare professionals to develop a personalized pain management plan tailored to your needs.
• Communicate with your employer and/or colleagues about your pain condition. This can foster understanding and support in the workplace. Discussing accommodations or adjustments that may facilitate your work performance, such as flexible scheduling or modified tasks, can help create a more conducive environment.

What Can Employers Do?

If you are aware of an employee struggling with pain or cognitive function, or would like to preventative action, here are some actions you can take.

• Have an open and honest discussion with your employee – they may be open to disclosing to you what has caused a decrease in the performance or may be willing to participate in an accommodation process.

• Ensure you have processes in place for ergonomic adjustments, accommodation assessments, and mental health support to support those experiencing chronic pain. An Occupational Therapist can provide all of these services and determine the needs of an employee to successfully perform a job.

• Have an Occupational Therapist complete a functional cognitive assessment to thoroughly assess employee cognitive strengths and limitations and make recommendations on how to improve their job performance.

• Determine what physical and cognitive skills a job requires by having a Cognitive Demands Analysis This will help guide you in creating return to work and stay at work plans for employees.

References

[1] Mental Health America. (n.d.) Chronic pain and mental health. https://mhanational.org/chronic-pain-and-mental-health

[2] Rubin, Eugene. (2016, June 8). Cognitive Impairment in Depression. Psychology Today. https://www.psychologytoday.com/us/blog/demystifying-psychiatry/201606/cognitive-impairment-in-depression