The connection between musculoskeletal pain & mental health

Chronic pain and depression are the silent killers of productivity in the workplace.

Clinical studies have long demonstrated a strong association between chronic musculoskeletal (MSK) pain and depression. Patients who suffer from chronic pain are more likely to be depressed, and patients with depression are more likely to report symptoms of chronic pain. This vicious cycle results in increased medical spend and decreased productivity, making MSK pain and mental health top concerns for employers.

Affecting as many as 1 in 2 adult Americans, MSK conditions are the top driver of healthcare costs for 76% of large employers, according to the Business Group on Health’s survey of benefit leaders. Meanwhile, nearly 1 in 10 adults and almost 1 in 5 adolescents and young adults will experience a major depressive episode in any given year, studies show. Depression also leads to a staggering 200 million lost workdays each year, costing employers up to $44 billion annually, according to figures cited by the CDC.

How these extremely prevalent and debilitating conditions intertwine and feed off each other has been the subject of a growing body of medical literature. Here’s what we know:

• The majority of people who struggle with depression also have chronic pain, and a close majority of people with chronic pain will experience depression—65% and 50%, respectively. This means that more often than not, a patient with one condition will also exhibit symptoms of the other.
• Pain symptoms are more prevalent in people with depression—and vice versa. For instance, studies have shown that patients with multiple pain symptoms such as back pain, headache, and abdominal pain are 3 to 5 times more likely to be depressed than patients without pain.

Beyond the fact that MSK disorders or depression on their own will lead to greater medical costs, increased worker absenteeism, and lower productivity, the combination of the two is especially concerning to employers for two reasons:

The first is that pain and depression complicate and hinder the recovery process for patients because each condition appears to increase the severity of the other. Pain slows recovery from depression, and depression makes pain more difficult to treat. As an example, the onset of major depression may cause patients to drop out of pain rehabilitation programs. For employers, this can mean extended periods of employee absenteeism and low work productivity.

As a result, people with MSK pain will take longer to recover if they exhibit comorbid depression. That’s why it behooves companies to choose solutions that are able to effectively take a “whole-body” approach to MSK treatment.

The second point is closely related to the fact that MSK patients with accompanying depression are often more difficult to treat: People suffering from chronic pain who also exhibit depressive symptoms become very heavy consumers of medical services, even if they don’t report other underlying conditions or illnesses. For employers, this means higher medical spend.

In fact, medical costs for people with chronic pain who are also depressed are significantly higher for patients with either condition alone. A 2009 study found that for patients with both major depressive disorder and disabling chronic pain, total annual costs were more than 37% higher than for patients with major depressive disorder and no chronic pain.

Fortunately, a digital health solution like Sword Health can tackle both MSK pain and mental health, driving down medical spend while improving health outcomes. After using Sword’s digital physical therapy solution, anxiety improved 54% in patients with acute MSK conditions and 50% in patients with chronic conditions. Depression improvement was even greater: 58% in patients with acute MSK conditions and 64% in patients with chronic conditions.

In a peer-reviewed study published last year in the Journal of Medical Internet Research, researchers at Sword showed that our multimodal digital care programs can produce substantial improvements in both mental health (anxiety and depression scores) and productivity—even in members with significant depression at baseline.

The clinical study included 7,785 participants with diverse levels of mental distress ranging from minimal to moderate. Participants across all three levels of mental distress—minimal or no depression (group 1), mild depression (group 2), and moderate to severe depression (group 3)—reported significant reductions in productivity impairment, amounting to an average decline of 56%:

• 62% in group 1
• 62% in group 2
• 44% in group 3

Across all of our programs and sessions, 60% of Sword members become free from pain, and 63% and 68% are rescued from moderate to severe depression and anxiety, respectively. Members also see other health improvements such as better sleep, lower weight, and increased physical activity—all of which contribute to their mental and emotional wellbeing (which, in turn, makes it easier for them to achieve lasting pain relief).

At Sword, we know that many people suffer silently with pain, even as it affects so many areas of their life. By combining convenient, on-demand physical therapy treatment with ongoing education and cognitive behavioral health therapy, Sword enables members to overcome both their physical and mental challenges. The result is a greater quality of life at home and greater productivity at work.

Request a demo to see how Sword can free your people from pain, improve their sleep and mental health, and increase their workplace productivity—all with best-in-class ROI and clinical outcomes.

Recommending reading:

• Explained: The Connection Between Mental Health and Physical Health
• Sword's Impact on Mental Health & Work Productivity
• Explained: The Role of Cognitive Behavioral Therapy in MSK Care