MSK Pain and Opioids
How Chronic Musculoskeletal Pain Opens The Door To Opioid Dependency
Chronic pain in the workplace
People who live with chronic pain are less productive in the workplace and are costlier for their employers. The average workforce experiences a 13% loss in productive time due to chronic pain conditions. 1
Most large employers are acutely aware of their opioid problem, but what they may be less aware of is the pathway that leads workers to opioid misuse: chronic MSK pain like back and joint pain.
When people seek relief from chronic MSK pain, they often receive opioid painkillers, either as first-line treatment or after surgery. Indeed, surgery for MSK pain is a growing contributor to the opioid crisis both because MSK surgeries are increasing in frequency and because these patients are uniquely susceptible to dependency. 2
But beneath the headlines and statistics, there is some good news. The most sophisticated employers are disrupting the common pathway from chronic pain to opioid misuse by making non-invasive interventions 3 available to their members with MSK pain.
- IOM (Institute of Medicine). Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. Washington D.C. 2017.
- Castlight Health. The Opioid Crisis in America’s Workforce. San Francisco, CA. 2016.
- Tick et al. Evidence-Based Nonpharmacologic Strategies for Comprehensive Pain Care. New York, NY. 2018.
Employee Opioid Misuse Increases With Inappropriate Chronic Back And Joint Pain Care
More than half of American adults live with chronic pain (pain lasting longer than 3 months). 1 in 10 U.S. workers uses their medical benefits to obtain treatment for chronic pain. Two-thirds of this pain is due to MSK disorders of the back and joints.
The use of surgery to treat pain related to MSK disorders has risen dramatically. The opioid painkillers patients often receive as part of their recovery from surgery are the most common gateway to opioid dependence. When patients bring opioids home after surgery, this also puts spouses and dependents at risk of abusing unused medication.
Chronic and acute pain have different brain pathways. Your perception of pain is different when you stub your toe (acute pain) compared to the long-term, continuous suffering of chronic pain.
While opioid painkillers are an appropriate treatment for acute pain, there is a lack of medical evidence to support their effectiveness for chronic pain. Despite this, 1 out of 5 patients with chronic pain are prescribed opioids.