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Stress, Musculoskeletal Pain, Depression, & Drug Addiction - Suicide
Is there a connection?
Yes, there is a connection, and I hope to connect some dots in a simplistic manner.
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I came across an on-line Construction Executive article this week from about a year ago titled “Curing Construction’s Suicide Crisis: How Employers Can Respond”.
The article states: “Suicide has become a global workforce issue given the common factors behind its rise. It’s an act more often committed by males and according to the Bureau of Labor Statistics, 97% of the U.S. construction workforce is male. Work pressures are also a major contributor. The seasonal work aggravates job security concerns and labor-intensive repetitive work can lead to injuries and chronic conditions. This, in turn, can add prescription drug and alcohol abuse as a means to self-medicate and further compound the industry’s mental health issues [emphasis added]. The pandemic has amplified some issues, creating uncertainty and stress over jobs and health (for starters), and has made mental health issues more urgent to address, not just in construction.”
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But then later in the article NEVER mentions the prevention of injuries, which we all know are most commonly musculoskeletal, as a solution even though he calls it out as a contributing factor to suicide. The author only suggests mental health approaches.
Stress & Musculoskeletal Pain
Occupational and Physical therapists learn in graduate school that stress is known to cause tension in the muscles. And that, over time, muscle tension creates generalized discomfort and even pain.
Musculoskeletal Pain & Depression
This may seem to be an obvious connection once it’s pointed out. Think about your own sprained ankle and how it prohibited you from exercising and made everything in your life harder. How did that make you feel? Not happy, that’s for sure! A bad sprain takes at least 6 months to heal. Pretty depressing.
Dr. Crofford’s publication in 2015 described the connection between musculoskeletal pain and depression this way: “Chronic musculoskeletal pain, by its very nature, will be associated with negative emotions and psychological distress. There are individual differences in personality, coping skills, behavioral adaptation, and social support that dramatically alter the psychological outcomes of patients with chronic pain.” Dr. Crofford also noted that “pain affects mood and vice versa.” Crofford, L. Best Practice & Research Clinical Rheumatology. 2015 Feb; 29(1): 147–155. Psychological Aspects of Chronic Musculoskeletal Pain
Furthermore, in a 2016 research article from the Journal of Occupational Rehabilitation, it states “Musculoskeletal disorders (MSDs) is the term given to a variety of painful conditions that affect the muscles, bones, and joints. Research has shown that workers taking time off work as a result of MSDs are also at risk of developing symptoms of depression in the first year after their injury. 30% of those who had taken a year off work were also receiving treatment for depression.” Carnide, N., Franche, RL., Hogg-Johnson, S. et al. Course of Depressive Symptoms Following a Workplace Injury: A 12-Month Follow-Up Update. Journal of Occupational Rehabilitation volume 26, 204–215 (2016).
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Musculoskeletal Pain & Opioids
An NIH funded project published in 2020 notes that “Patients with newly diagnosed musculoskeletal pain are prescribed opioids more often than recommended”. Feldman et al wrote “During their first physician visit, patients experiencing newly diagnosed chronic musculoskeletal pain are prescribed opioids more often than physical therapy, counseling, and other nonpharmacologic approaches….. The results concur with the high prevalence of chronic musculoskeletal pain in the United States, with an average of 36.8 million initial visits (for a new chronic pain problem) per year or approximately 11.8% of the population. Overall, on initial visit, patients were prescribed nonopioid medication 40.2% of the time, opioids 21.5%, counseling 15.2%, other nonpharmacologic treatments 14.3%, and physical therapy (PT) least often, at 10%.”Feldman DE, Carlesso LC, Nahin RL. Management of Patients with a Musculoskeletal Pain Condition that is Likely Chronic: Results from a National Cross Sectional Survey. Journal of Pain. 2020 Jul-Aug;21(7-8):869-880.
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Opioids & Suicide
Well… We all know the connection between opioids and suicide.
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In Conclusion...
Prevent the musculoskeletal pain in the first place using Prevention Through Ergonomic Design and through Ergonomics Education so employees are empowered to fix their own issues.
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