Pain and Work: whats known Chronic Pain 1. 20% adult EU citizens 2. - - PowerPoint PPT Presentation

Rehab works

• prof. dr. Michiel Reneman

WG 4 – secretary SIP Brussels May 24, 2016

REHABILITATION MEDICINE CENTER FOR REHABILITATION

Pain and Work: what’s known

Chronic Pain

• 1. 20% adult EU citizens
• 2. Major economic impact – main impact driver: WORK

7 days 4 weeks 7weeks 12 weeks 80% 26% 17% 13% 8% 6 months

Study 4: Work ability and work performance (0-10) Stay at work with pain

• possible
• slight loss

Baseline Rehab

• substantial loss

Pain Self-Efficacy consistently explained higher WA and WP

Impact of work on health and well-being

• Strong evidence showing that work is generally good for

physical and mental health and well-being.

• Overall, the beneficial effects of work outweigh the risks of

work, and are greater than the harmful effects of long- term unemployment or prolonged sickness absence.

• Worklessness is associated with poorer physical and mental health and well being.

Work can be therapeutic and can reverse the adverse health effects of

• unemployment. That is true for healthy people of working age, for many disabled

people, for most people with common health problems and for social security

• beneficiaries. The provisors are that account must be taken of the nature and the

quality of work and its social context; jobs must be safe and accommodating. Independent review: 'Is Work Good for Health and Well-being?‘ Commissioned by the UK Department for Work and Pensions Waddell en Burton, 2006

Prevention of work disability

• It can be done
• It should be done

How? Comprehensive program, including:

• Vocational Rehabilitation
• Public Education
• System changes
• Healthy Aging @ Work

Vocational Rehabilitation

Whatever works to get people to return to work and / or stay at work…

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Vocational rehab with chronic musculoskeletal pain: effective and cost-effective

Effective

• Better work participation
• Less disability
• Less pain

Cost-effective

• Ratio 1:5
• Largest benefit: work participation

However: silo’s between health and employment Professional evidence based guidelines e.g. Cost B-13

Vocational Rehab: Working principles

• 1. Bio-psycho-social perspective in assessment and treatment

– Work focused health care

• 2. Gradual increase in activities and work

– Modified work

• 3. Shared goal and plan: client / worker – work – rehab team

– RTW Coordinator

• 4. Timing / stepped and matched care

– ~ 2-4 months

Public education

• Basic assumption: beliefs guide behaviors
• Pain beliefs: pathology needs rest to heal
• Changing beliefs has been focus of public campaigns
• Alignment with policies
• Messages: be active, stay at work (modified), work heals …

Australia, Canada, Norway, Scotland Netherlands: preparations Europe ???

Example Montana USA: Work heals

Example Montana USA: Work heals

Pain and Work: Challenges

• 1. (Evidence Based) Vocational Rehab not available for all

EU citizens

• 2. Modified work not available for all EU citizens
• 3. Silos between health and work policies hinder RTW and

SAW

• 4. Beliefs about Pain and Work: not evidence based
• 5. Aging workforce: physical decline and increase chronic

diseases Present and future missed opportunities for

• Patient / worker, Employers, Countries, EU

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Rehab works – summary slide

• 1. VR: proven effective and cost efficient; rehab

works!

• 2. VR / modified work / silos: fix system flaws
• 3. Public education
• 4. New technology to assist Healthy Aging @ Work

Prevention of work disability It can be done – it should be done

Thank you

m.f.reneman@umcg.nl

REHABILITATION MEDICINE CENTER FOR REHABILITATION