User: Login or Register

We comply with the HONcode standard for trustworthy health
information:
verify here.

Working with chronic pain

Chronic pain costs U.S. employers an estimated a $100 billion a year. Increasing workloads get some of the blame, and the activity-filled pace of today's lifestyles contributes.

By H.J. Cummins, Star Tribune

Last update: April 09, 2007 – 9:24 PM

Sarah Schmalenberger

Cancer surgery, chemotherapy and radiation could not slow down musician Sarah Schmalenberger. But chronic pain did.

Schmalenberger, a French horn player and music professor, missed just five days of work when she had breast cancer five years ago. But the pain that developed a year later -- residual nerve and muscle damage on her left side -- has her turning down freelance gigs and questioning her teaching ability at the University of St. Thomas in St. Paul, where she is an assistant professor of music history and horn.

"I just haven't felt good about how I'm dealing with anybody," said Schmalenberger, 44. "If I move my arm in class and it hurts, I wince. And I don't like to wince in front of the students. They know I've had cancer, and they worry."

Schmalenberger is one of an estimated 22 million Americans who live and work in chronic pain -- close to one in five workers, according to a 2006 survey by the National Pain Foundation. That's up from about 15 million in 1996. The group doesn't estimate how much of the pain is caused on the job.

Like Schmalenberger, almost half of those in the survey who reported chronic pain said it affected their ability to do their jobs.

It's a problem that costs U.S. employers $100 billion a year in medical expenses and lost work, the foundation estimates.

Medical professionals said ever-growing workloads get some of the blame. But more than that, these professionals blame general wear and tear on the workforce, including illness, sedentary lifestyles and baby-boomer demographics that now have the number of 55-plus workers growing at twice the rate of the overall workforce.

Because employees now walk in the door with so many of these problems, some of the answers have to come from outside the workplace, doctors and therapists said.

"I think it's a shared responsibility," said Dr. Jennine Speier, medical director at the Sister Kenny Rehabilitation Institute in Minneapolis.

Speier still sees plenty of clients with work-related problems.

"What I hear a lot is, 'I'm doing the work of three people now; they laid off two others and it's only me left,' " she said.

A day in the life of arms

But today's frantic lifestyles -- two-job households, extra activities, watching TV late into the night -- are also a problem, she said.

"I tell people, 'Give me a day in the life of your arms,' " Speier said.

People don't realize the strain that comes with this fast-paced society, said Dr. Gary Carlson, a consultant at the Institute for Health and Healing at Abbott Northwestern Hospital in Minneapolis.

"Then their body rebels with pain," said Carlson, who recommends antidotes such as yoga, massage and meditative breathing.

One workplace-based answer has been "ageonomics," a program that applies ergonomic principles specifically to vulnerabilities of age, such as arthritis and repetitive strain injuries.

One-third of all workers' compensation injuries "are those kinds of musculoskeletal injuries, and we know that people will be working longer," said Suzanne Bade, an occupational therapist with the ageonomics program at the University of Michigan.

"Other cost drivers are spinal surgeries, and hip and knee replacements, which used to go to Medicare, but now they're more in the workplace," said Christy Kriha, a director of health and wellness programs at Blue Cross and Blue Shield of Minnesota.

Another workplace-based solution is pain-management components in employer wellness programs -- something only 22 percent of the programs have, the pain foundation said.

Blue Cross and Blue Shield has one for its employer clients, Kriha said. It sets up a schedule of phone calls between nurses and workers with pain diagnoses. That regular support has improved workers' compliance with their treatments and therapies from as low as 20 percent to as high as 70 percent, she said.

After breast cancer

Schmalenberger, the French horn player, said she knows other women musicians and performers who survived breast cancer who got hit with the same chronic pain she did.

What happens is that the radiation can leave some muscle and nerve damage in the chest, causing the women to hunch their shoulders against the hurt. The hunching then creates other posture problems, which creates more pain, and eventually the ribs, nerves and muscles became a tight curl of pain in their chests.

"It's a vicious cycle," Schmalenberger said. "I had no idea how connected all this was."

She is recovering through physical therapy, after nearly giving up on the French horn.

"I was in pain, discouraged, depressed and thinking about selling my horn," she said, "and now I'm back to playing every day."

H.J. Cummins • 612-673-4671 • hcummins@startribune.com

Posted 4-14-07