Persisting pain and chronic stress — how much do they cost your business?

Persisting pain and chronic stress –> 20% of people suffer chronic pain according to recent figures. The number who describe feeling stressed is also high. In many cases, those who are in persisting pain will also feel stress, and those who are chronically stressed will describe on-going aches and pains. Biologically there are links between pain and stress explaining the ‘bed-fellow’ relationship, often involving inflammation.

From a business perspective, if you have a workforce it is likely that there will be a number of people suffering pain and stress. This undoubtedly will affect performance with financial consequences for the business. One of the biggest influences upon performance is the level of happiness that an individual experiences at work.

Stress and thinking

Feelings of stress result from our perception of threat. This is individual and depends upon the meaning that we ascribe to the situation that can be real and in front of us, or to a thought. The bodily sensations associated with stress are well known: tension, increased heart rate, sweatiness, ‘butterflies in the tummy’ (this is actually changing blood flow through the gut) — all are preparation for a fight or to escape from a physical threat; a wild animal.

See Robert Sapolsky talking about stress here

Most of the time we feel stress because of what we are thinking about; the brain not differentiating between a thought and actually being in the situation in terms of the reactions and responses that it initiates. These are of course natural and normal responses if there is a genuine threat. However, if we are consistently kick-starting protective measures when there is no actual threat present, the system becomes increasingly efficient and vigilant, firing off even in innocuous situations. In other words, the body protects itself when it does not need to.

Chemistry

Similar to all experiences there is a chemical basis to stress that manifests as our ‘reality’. In the short-term, the feelings of stress motivate action to deal with the stressor and thereby restore balance, or homeostasis. If the system continues to be provoked, in essence a chronic stress, these chemicals will persist in preparing the body for action, shutting down the gut (or clearing it out), similarly the bladder and reproduction (because there is not much point thinking about sex when you are being chased by a tiger) — and now consider the seeming rise in issues around fertility. The continued release of these chemicals in response to thinking and perceiving threat drives increased muscular activity that begins to hurt (chronic back pain, neck pain, pelvic pain etc), uses much energy that becomes depleted (chronic fatigue), suppresses the immune system (regular infections, poor healing, on-going pain and sensitivity — especially females) and impacts the endocrine system (dysmenorrhoea, anxiety).

Functional pain syndromes & Women in Pain

Many of the common yet significantly troubling conditions are underpinned and heavily influenced by the chemical balance. Chronic stress cultivates inflammation that is normally in delicate balance. Inflammation affects all body systems, sensitising the controlling nervous system that manifests as a painful syndrome: irritable bowel syndrome, pelvic pain, migraine, headache, chronic back pain, TMJ dysfunction, fibromyalgia¬†and bladder dysfunction (recurring infections — or are they? — interstitial cystitis); often accompanied by anxiety and depression. Interestingly there is good evidence that depression has an inflammatory basis.

At work

We can only attend to one activity well at any given moment. Multi-tasking is an illusion — this is just doing many things badly. To maintain our focus and attention requires discipline. When the mind wanders, which it does, we lose focus and attention. If we do not have the ability to control the meanderings and we are taken to places that are troubling through rumination, the body always responds as if we are actually in that place. To become skilled at recognising this as a process and to be able to maintain awareness of the present moment is potent for both health and productivity.

Focused attention training or mindfulness training allows us to become aware of the wandering mind and recognise that the body is responding to thoughts of the past or the creation of a future. Of course neither of these actually exist, they are tapes being played by the brain. They do feel real.

Simple techniques that can be learned and practiced, anchor us to the present moment, disarming the thought. It is just a thought. This does not mean that we stop thinking, and this is impossible as thousands pass through the mind each day. Rather, we can decide which thoughts need attention and those that can be let go as they offer nothing but discomfort. On living out a thought, there is always a physical and emotional response. We become very good at letting this happen automatically, habitually, the so-called autopilot. Creating awareness around this delivers control and clarity that leads to clarity.

And pain

Pain is meant to grab our attention so that we take action. It is a great motivator and this is a vital device for survival. When pain persists beyond a useful time, the adaptations within the body systems and the behaviours we adopt become part of a cycle that becomes increasingly difficult to break. Yet change is always possible with the right understanding of pain and strategies to target the biological mechanisms of pain and those of the influences upon the sensation of pain: stress, fatigue, emotional state, physical activity.

Here’s a great video about pain

Certainly, when pain is the running mode, it directs attention to the body area deemed to require protection. In brief, pain is part of a protective response to a perceived threat, similar to a stress response that equally directs our attention towards something assessed to be dangerous — but it does not have to be actually dangerous for the same set of responses. The body (tissues) is where the pain emerges, yet we require a brain and the densely interconnected highways of communication ¬†between neurones, the brain cells, for the creation of the sensation.

Whilst working the focus needs to be on the task in hand. Pain certainly interrupts this focus, taking up mental resources as the attention both drifts and dwells upon the body part being protected.

Stress and pain

The two are inextricably linked in many ways. To tackle one needs consideration of the other in both mechanism and the drivers that maintain the responses to the perceived threat — recalling that pain and stress are both reactions to the perception that danger exists.

When an individual experiences stress at work it can be due to a feeling of being undervalued or insufficiently challenged. There are many other reasons.

Approaching the problem at work — a brief overview

Much has been written about strategies that the workplace can use to cultivate a positive environment at work. If the employees are valued, have a sense of purpose and support, clearly this will feed into the business. On the other hand, a disconnected and stressed workforce will under-perform within a climate of resentment.

On an individual basis, learning strategies that deal with stress can make an enormous difference. Building resilience and developing positive psychology skills certainly enhances performance at work, cultivating satisfaction and self-esteem.

A practice that has a profound and potent effect upon stress is mindfulness. Becoming skilled at being present by focusing upon breathing disarms the thinking that pulls us into the past or creates a future. The benefits of mindful practice include improved physical health, clarity of thought and enhanced performance. Neuroscientists are now looking at the mechanisms that underpin mindfulness so that we can optimise the effects.

Movement is vital for our health. A work environment should encourage regular movement and permit exercise at lunchtime. Eating at the desk is simply unhealthy, especially when you are concentrating on something other that the food. Recall that the digestive system turns off in stressful situations, hence why so many people describe varying degrees of irritability in their gut.

Summary

Individuals suffering stress and chronic pain will be unable to fully focus upon their work. Biologically, attention will not be upon the work for sufficient periods to perform.

A supportive workplace using a range of simple strategies that include supporting those in need, allowing gradual return to work when employees have been off and looking at ways of enhancing performance by cultivating a positive environment with the basics — for example, allowing movement opportunities, healthy snacks and water.

On an individual basis we can tackle pain and stress in a number of ways that should include exercise, movement at work and mindful strategies.

With both the individual and the workplace communicating well and taking responsibility, we can cultivate positive environments for working and performance.

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