Working With Pain: 10 Tips

Continuing to work can be a challenge for many people who live with the pain of arthritis or other diseases, but that doesn’t mean that you can’t have a career. Here we offer 10 tips for working with pain to help you find, keep, and thrive at a job.

1. Know your rights

One of the first things to understand is that you have legal rights. The Americans with Disabilities Act (ADA) was signed into law in 1990, and earlier laws such as the Rehabilitation Act of 1973 also give important protections to workers.

“Being considered ‘disabled’ under the ADA is different than qualifying for disability benefits through the Social Security Administration,” says Ashley Lindberg, a patient navigator with the National Psoriasis Foundation. “It prevents your employer from discriminating against you if you can successfully perform the essential functions of your job.”

The ADA applies to employers with 15 or more workers. If you are otherwise qualified for the job, an employer cannot discriminate against you because of your pain. The law covers all areas of employment from hiring and job assignments to promotion, pay, and benefits. It even applies to discrimination in company-sponsored social events.

To be protected by the law, you must have a disability that, according to the act, “substantially limits” a major life activity such as walking, performing manual tasks, or working. Of course, you still have to have the education or work experience the employer requires for the position.

2. Understand “reasonable accommodation”

Under the ADA, an employee must be given the opportunity to perform the essential functions of a job with “reasonable accommodation,” meaning an employer may need to modify a workplace to accommodate a person’s disabilities.

Accommodations may include making adjustments to work schedules so workers can receive medical treatments, providing assistive equipment or devices, or changing the height of a desk. (Learn about Varidesk.) Reasonable accommodations, however, are not open-ended. Changes to a workplace that would cause significant difficulty or expense to an employer are not considered “reasonable.” Employers also aren’t required to give you a specific job if they believe that doing so would put you or others at risk.

For accommodations not deemed “reasonable,” the employer must give you the option of paying for them yourself or sharing the cost. However, if workplace fixes fall under the “reasonable” definition, it is illegal for the employer to force you to pay them or to decrease your pay.

3. Be honest with your boss

You are the expert on what you need to do the work. To ensure that your employer trusts you to do your job, you may need to offer suggestions for changes that fit your situation. For example, perhaps the job can be structured so you can work from home on days when your pain is particularly bad.

“You may want to keep a pain diary,” says Shaina Smith, director of state advocacy and alliance development at the U.S. Pain Foundation, Inc. “This helps you track what times of day you tend to be less productive, what helps you feel better, and when your pain level is at its worst. Your employer and you will then have a template to discuss how to best address your invisible illness.”

Some common workplace adaptions for people living with pain include:

• replacing a computer mouse with a track pad;
• moving a keyboard or purchasing a different type of keyboard;
• changing the position of a computer monitor to between 18 and 22 inches away from the eyes;
• adjusting a monitor’s height so that the top 25% of the screen is at eye level;
altering the height of a desk (learn about Varidesk) or chair; and
• asking for help when lifting heavy items.

“This should be a collaborative process between you and your employer,” Lindberg says. She recommends checking the Job Accommodation Network website and its searchable database that list accommodation options by disability.

ADA-compliant assistive devices may help you. Would a special chair or keyboard help alleviate some of your pain? Some employees might benefit from specialized computer programs such as voice-recognition software, which reduces the need to type.

Suggest to your employer that he or she consult a tax professional about deductions or credits that may help with needed expenditures.

Keep the lines of communication open as you go forward. Update your employer on how the accommodations already in place are (or are not) working. As you become more experienced with both your pain and the job, work with your boss to fine-tune or revamp the accommodations or work-related processes.

4. Know when to talk about your medical history

Employers are only required to accommodate employees when they experience problems in the work setting. If your particular job fits your current abilities, there is no requirement that you tell your employer about your medical history. They are also not allowed to ask.

However, if you will need assistance, then obviously the employer will have to know some things. Many people prefer not to give a lot of information. You can limit what you share to the parts of the job you are having problems fulfilling and what your accommodation needs include. For many employers, this may be all they need to know.

Employers have the right to ask for additional medical information, and if you don’t give it, an employer can legally deny the accommodation request. Additionally, when the disability is not obvious (not an unusual occurrence among chronic pain patients), the employer is entitled to require documentation to show that the employee does have an ADA-qualified disability and requires the requested accommodation.

Plan what to say and rehearse ahead of time. This is a business-related presentation and should be approached in a professional manner. Be able to articulate in a clear way how your disability impacts your work. Have suggestions ready about what accommodations will be needed such as adaptive equipment or schedule alterations.

5. Consider occupational therapy

Occupational therapists (OT) offer many services, including injury-recovery assistance, helping children with disabilities participate fully in school, and evaluating clients’ workplaces to improve their job experiences.

“If not already involved in your care, ask your physician for a referral to an occupational therapy professional,” advises Steven Stanos, DO, president-elect of the American Academy of Pain Medicine. “In general, physical therapy focuses on strengthening and range of motion around the painful area. An OT works more on ergonomics such as proper bending, lifting, posture, and pacing work activities or tasks. They can be very helpful in troubleshooting specific job functions that may be limiting a successful return to work.”

In addition to a doctor’s referral, you can connect with a private OT practice or inquire about practitioners at hospitals, community centers, and health-care facilities. Learn more at www.aota.org, the website of the American Occupational Therapy Association.

6. Learn how to talk about your condition

The ADA does not require that you tell coworkers anything about your disability. In real life, though, one of the hardest challenges you’ll face is others’ perception that you’re limited, especially since pain often isn’t a visible disability. However, this doesn’t mean you tell them everything.

“Sharing information about your condition with your coworkers can be helpful in maintaining a positive relationship with them and can prevent future misunderstandings,” says Lindberg. “When living with a specific condition, it can be helpful to share educational material about it. These are often available from organizations that focus on specific diseases.”

Take the lead in these discussions. Others will likely be unsure of how to talk about your condition. Let coworkers know how you prefer to discuss it, if at all.

“Explain things at your own pace,” Smith says. “You might want to specifically name the condition or conditions you live with, symptoms that you experience, and why accommodations are being made within the workplace.”

On the other hand, you may not want to go into great detail. It’s OK to say nothing or keep replies vague. You can simply say, “I have a medical condition,” and let it go at that.

The important thing to remember is that this entirely up to you. Mention only what you feel comfortable revealing and only when you feel comfortable revealing it.

7. Stick with your treatment program

For many kinds of pain, treating the underlying disease can be one of the biggest contributors to working and career satisfaction. Multiple studies of psoriatic arthritis patients, for example, have consistently found the number of sick days they take being cut by as much as half with consistent treatment.

Keep in close touch with your treatment team, too. They work with job-related concerns daily and have a wealth of information gained from the experience of others in similar circumstances. There is no need to reinvent the wheel every time.

8. Recognize when to call for backup

If you think you’re being discriminated against, contact the U.S. Equal Employment Opportunity Commission (EEOC). You generally must file a complaint within 180 days of when an alleged discrimination occurred.

To file a complaint, contact any EEOC field office. They’re located in cities throughout the United States. For information and instructions on reaching your local office, call (800) 669-4000 (voice) or (800) 669-6820 (TDD), or go to www.eeoc.gov.

9. Consider vocational rehabilitation services

Vocational rehabilitation (VR) is another road to employment. State governments operate VR agencies to help individuals with disabilities develop job skills and then find and keep jobs. They can also help people become self-employed or find telecommuting opportunities. The services provided vary from state to state but usually include:

• counseling and guidance about possible careers;
• help in finding transportation and mobility devices such as wheelchairs;
• assistance in finding tools, equipment, and supplies needed for work;
• guidance in licensing or other governmental requirements; and
• personal assistant services.

You can find VR agencies in your state government phone listings. A state-by-state list is available here.

10. Address new or worsening problems immediately

If you are having pain or other symptoms that get worse as either the workday or the workweek go along, talk to your boss right away. Changes in the workplace environment often stabilize or even improve pain management.

Talk to your doctor or other health-care provider as well. Perhaps a change in your treatment regimen could reduce the pain or other symptoms. An occupational therapist may suggest new adaptive devices or equipment.

“If some specific job activity at work is aggravating your condition, it is critical to be re-evaluated by your therapist or physician,” says Stanos, a Seattle-area pain physician. “Your health professional needs to reassess the physical complaint, evaluate if restrictions are being supported, or perhaps make modification to the therapy program. Sometimes employers aren’t correctly or consistently adhering to the restrictions prescribed.”

Address changes in your condition quickly to help lessen future damage. If you live with chronic pain, learn to advocate for your own health and to minimize discomfort. Following the old adage of “no pain, no gain” is not helpful if you are seeking to maintain a successful career.

Want to learn more about working with pain? Read “Searching for a Job When You Live With Pain” and “Working When You Have Arthritis.”

Kurt Ullman is a medical writer and a registered nurse. He has worked as a nurse, mostly in psychiatry, and as a staff writer and editor in radio, television, magazines, and newspapers.

Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.

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