Low Back Pain And Unemployment
Tags: Unemployment, Healthcare, Pain Management, Low Back Pain, Health Care Reform

A recent study of almost 1 million participants, conducted in Japan, looked at back pain and unemployment and found that for every 1% increase in unemployment, low back pain increased by around 770,000 cases.

The costs associated with treating chronic pain run into the hundreds of billions of dollars in medical treatments and lost productivity and yet pain is still not optimally managed in the US, or around the globe. So with the US being in the middle of a major economic recession due to the Coronavirus Pandemic, we took a look at the research to see how exactly unemployment affects low back pain, and what can be done to address this issue.

Low back pain affects 80% of the population at some point in their lives and WebMD reports that there are over 100 million Americans living with chronic pain. Pain is a complex experience — it can impact our mood, our thoughts, and our behavior. But outside factors, such as unemployment, can also play a part in our experience of pain.

According to a recent report from the US Labor Department, the percentage of employed workers has dropped to its lowest level since 1975. Between February and April of 2020, 10 percent of Americans aged 25 to 54 became unemployed due to job losses. The number of Americans who were classified as long-term unemployed (a category that includes those actively searching for work for 27 weeks or more) surged by 781,000 in September, to 2.4 million people.

Sadly, this situation is unlikely to change soon as recent data from Bloomberg cited that the number of permanent job losses rose by 345,000 to 3.8 million in September, while the number of Americans on temporary layoff dropped 1.5 million to 4.6 million.

We know that losing the sense of identity and control that having steady employment often provides, especially when compounded by a loss of income, can be an enormous physical and mental challenge for many people. As such, unemployment has also been associated with the development, or exacerbation, of a range of health issues including:

But how does it affect low back pain, specifically? That answer may be more complex and connected than you think.

Unemployment causes stress which can lead to depression.

In a 1991 study by Turner, Kessler and House, involuntarily unemployed workers experienced ‘significantly higher levels of depression, anxiety, somatization, and self-reported physical illness than employed people’. A previous study that they had conducted in 1988 had found that there were ‘significant elevations of depression, anxiety, somatization, and self-reported physical illness among currently unemployed adults, but symptoms were greatly reduced by re-employment’.

Research has shown that individuals who are employed experience greater feelings of self worth and improved mood than those who are unemployed.

2. Stress intensifies pain sensations

Researchers Leavitt, Garron, and Bieliauskas (1979) found that just experiencing a stressful event does not necessarily lead to low back pain, but stress does exacerbate and intensify certain types of pain, particularly low back pain.

Unemployment is a major stressor in the evolution of chronic pain, causing higher levels of stress and pain to be experienced. When an individual suffers from chronic pain, changes in employment status may be responsible for an increase in stress and pain levels. Dolce and Raczynski (1985) proposed that back pain may result from a pain-spasm-pain cycle. ‘The unemployed person feels stress which then causes depression which causes increased sensitivity to pain, which then causes more depression or anxiety’.

3. Stress changes our cells

Telomeres are the caps at the end of each strand of DNA that protect our chromosomes, like the plastic tips at the end of shoelaces. Without the coating, shoelaces become frayed until they can no longer do their job, just as without telomeres, DNA strands become damaged and our cells can’t do their job. They are an essential part of human cells that affect how our cells age.

Recent studies in epigenetics indicate that negative experiences can actually have a physical effect on our bodies. The long-term effects of chronic stress can accelerate telomere shortening, basically damaging these cells and affecting our bodies. We can now see that stressful experiences can have negative physical effects, including increasing our risk of cancer, diabetes, heart disease, chronic pain, and many other long-term effects.

Some people have suggested that the increased incidence of low back pain during times of unemployment may be linked to decreased access to healthcare systems, especially in the US, as many individuals depend on employer-based healthcare plans for their medical needs. A study conducted in Japan, however, showed that low back pain increased with unemployment even though Japan has universal healthcare for all of its citizens.

So, with all of the research pointing to the fact that external factors can have an enormous influence on how we perceive and experience pain, how do we regain control and manage pain effectively?

When treating your low back pain, search for treatments and products that address the person as a whole, and that don’t just address the pain.

2. If you have been laid off from your job, look for new job opportunities. Research has shown that just conducting an effective job search can reduce depression.

3. Take time to update your resume or further your education. There are several colleges and universities that are still offering free courses to those looking to learn something new.

4. Take care of your mental health. Dr Blackburn, who has done some of the leading research on telomeres, calls this developing “stress resilience”. Our perception of stress, rather than the actual situation, is really the determinant. Studies show that being under chronic stress does not automatically lead to damaged telomeres. Our attitude to stress can make an enormous difference.

5. Try some alternative therapies. Rehabilitation centers are increasingly making use of progressive muscle relaxation and meditation to treat pain. There are several free apps that you can use to try these techniques, or you can just look on YouTube.

The more we learn about pain, the more interconnected we see that everything is. Our environment plays a huge part in our health and learning how to identify and manage external stressors can ultimately help us live a healthier, happier, less medicated life.

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