Staying at work with chronic nonspecific musculoskeletal pain: a qualitative study of workers' experiences

Abstract

BackgroundMany people with chronic nonspecific musculoskeletal pain (CMP) have decreased work ability. The majority, however, stays at work despite their pain. Knowledge about workers who stay at work despite chronic pain is limited, narrowing our views on work participation. The aim of this study was to explore why people with CMP stay at work despite pain (motivators) and how they manage to maintain working (success factors).MethodsA semi-structured interview was conducted among 21 subjects who stay at work despite CMP. Participants were included through purposeful sampling. Interviews were audio-recorded, transcribed verbatim, and imported into computer software Atlas.ti. Data was analyzed by means of thematic analysis. The interviews consisted of open questions such as: "Why are you working with pain?" or "How do you manage working while having pain?"ResultsA total of 16 motivators and 52 success factors emerged in the interviews. Motivators were categorized into four themes: work as value, work as therapy, work as income generator, and work as responsibility. Success factors were categorized into five themes: personal characteristics, adjustment latitude, coping with pain, use of healthcare services, and pain beliefs.ConclusionsPersonal characteristics, well-developed self-management skills, and motivation to work may be considered to be important success factors and prerequisites for staying at work, resulting in behaviors promoting staying at work such as: raising adjustment latitude, changing pain-coping strategies, organizing modifications and conditions at work, finding access to healthcare services, and asking for support. Motivators and success factors for staying at work may be used for interventions in rehabilitation and occupational medicine, to prevent absenteeism, or to promote a sustainable return to work. This qualitative study has evoked new hypotheses about staying at work; quantitative studies on staying at work are needed to obtain further evidence.

A meta-ethnography of patients’ experience of chronic non-malignant musculoskeletal pain

“…We did not include papers that did not meet our criteria for inclusion, and included an additional nine fibromyalgia studies. 324,327,335,351,352,366,373,377,381 Their synthesis supports important areas of our conceptual analysis, for example the 'conscious awareness' of the body in pain; the unrelenting nature of fibromyalgia; isolation and loneliness; the search for an diagnosis; the ambiguity of diagnosis and loss of legitimacy. It also supports concepts related to moving forward with pain, including listening to the body, accepting loses and re-evaluating life.…”

“…66,312,323,325,326,330-334,336,338,342-345,350,353-358, 362-365,367,372,374,376,379,385-387 Twenty-eight papers (23 individual studies) explored the experience of people with fibromyalgia. 324,[327][328][329]335,337,[339][340][341]346,349,351,352,[359][360][361]366,373,375,377,378,[380][381][382][383][384] A description of these studies is provided in Tables 6 and 7, showing for each study the age range and source of participants, the country where the study was carried out, the method of data collection and the methodology used. …”

“…accepting support as may be necessary). Not everyone at work experiences this latitude at work de Vries 2011: 324 success factors (work) -coping with pain Ambivalence about medication: for some it enabled them to stay in work, others did not want to take medication for fear it would mask symptoms or make them drowsy at work. Some wanted to stop medications and take control of the pain themselves.…”

“…Second-order construct: de Vries 2011: 324 motivators for staying at work -work as responsibility A few perceived their work role as indispensable and that others relied on them. Therefore felt their absence impacted on work productivity as they could not be substituted, therefore worked through pain to meet work responsibilities and to not place a burden on their colleagues.…”

“…de Vries 2011: 324 success factors (work) -use of health-care services 337 constant struggle -using pain as a guide…”