The Ripple Effect of Mental Health on Pain and Productivity in the Workplace

Every employer has witnessed firsthand the detrimental impact that musculoskeletal (MSK) pain and mental health conditions have on workplace productivity—but what happens when an employee suffers from both? The answer is clear: higher healthcare costs and lower quality of work—both of which create a measurable impact on the bottom line.

Between the $380 billion MSK bill and $280 billion spent on mental healthcare, the costs to treat these conditions can easily put an organization in the red (Dieleman, 2020; White House, 2022). That’s a problem when over 25 percent of employer healthcare spending funnels directly into these two buckets (Optum, 2019; Fronstin, 2022).

Research indicates that the relationship between these disorders is both extensive and cyclical. In fact, MSK and mental health conditions exist together more often than not. Up to 85 percent of employees with an MSK condition report depression, and 65 percent of depressed employees also suffer from MSK pain (Melkevic, 2018). Yet many treatment models for MSK pain fail to take into account the comorbid nature of these conditions. As a result, patients continue to face unsatisfactory outcomes and employers continue to struggle with a significantly sicker workforce. According to one systematic analysis, MSK and mental health disorders compete with cancer and cardiometabolic disease as top threats to workplace productivity (Rojanasarot, 2023). 

How can employers drive success despite mounting barriers to productivity? The answer may lie in the deep connection between mental and physical health. On the whole, employees suffering from both conditions are more prone to productivity loss in five key ways:

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1. Cyclical loss of mental and physical energy

Employees experiencing both MSK pain and mental health concerns often report having little to no energy and, as a result, lack the desire to exercise and engage in health-promoting behaviors. Thus begins a vicious cycle, as the longer an employee is sedentary and isolated, the worse their pain and feelings of depression and anxiety become. As the cycle continues to repeat and chip away at an employee’s overall health, productivity takes a nosedive while illness-related absences rise. One study assessing the impact of MSK and mental health disorders on long-term sickness absence (LTSA) found that patients with more serious depression and three locations of MSK pain had higher incidence rates of LTSA (Melkevic, 2018).

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2. Pain catastrophizing

The relationship between poor mental health and MSK pain is simple, but powerful. When an employee is depressed or anxious, their perception of pain grows stronger. As a result, mental health disorders often make pain feel worse than it actually is. Many patients may catastrophize pain—meaning they describe their symptoms in more exaggerated terms than the average person—which, in turn, creates heightened feelings of hopelessness and additional roadblocks on the journey to mental healing. According to one study, pain catastrophizing accounted for 40 percent of the variation in the severity of depression symptoms in individuals with chronic neck pain (Park, 2016). Pain catastrophizing not only impacts quality of life but also interferes with treatment success. If an individual believes they are still in pain when, in reality, the condition is improving, they often fail to recognize progress and seek further, unnecessary treatment. 

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3. Work stress manifesting as pain (and vice-versa) 

With an estimated 77 percent of Americans reporting chronic stress from their jobs, work-related stress may top the list of mental health conditions that worsen MSK pain (APA, 2023). On the other end of the cycle, employees with chronic pain are at a higher risk of developing poor mental health in the workplace. One cross-sectional analysis found that employees with chronic pain were 64 percent less likely to feel that their jobs were rewarding, and the cumulative impact of both conditions resulted in nine additional missed work days per year compared to those who were pain-free (Adams, 2021). 

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4. Feeling helpless and isolated

While mental health stigma has improved in certain aspects, the workplace remains a significant source of negativity and judgment for mental health conditions. Results from one national poll from the American Psychiatric Association (APA) found that nearly half of employees are worried about sharing mental health struggles at work, and over one-third fear losing their jobs or other work-related penalties if they reach out for treatment (APA, 2019). This dire lack of support often prevents employees from seeking care, leading to the worsening of mental health disorders and delays in treatment with a concurrent escalation of chronic pain.

5. Lack of access to appropriate, evidence-based care

The standard treatment paradigm for MSK disorders often excludes mental health evaluation and care, focusing only on treating the physical aspects of back and joint pain. What many clinicians in this framework fail to recognize is the integral role that mental health plays in determining MSK outcomes. When employees are inappropriately steered to MSK care that is siloed from mental health treatment, few can experience true improvement and a higher quality of life. The need for whole-person, evidence-based care is still higher than ever for employees suffering from chronic pain and poor mental health—that’s exactly where Vori Health steps in to help.

At Vori Health, our multidisciplinary MSK care teams, led by a specialized non-operative physician, use the biopsychosocial model to address the multiple factors impacting MSK health. Our care journeys are tailored to each individual’s needs and preferences, prioritizing mental well-being while driving measurable improvements in MSK pain. For employees who wish to receive care online or don’t want to travel to an in-person appointment, Vori’s care teams offer virtual visits while still providing comprehensive, personalized care—but in the comfort and safety of home. 

As a result, Vori Health patients report a 70 percent improvement in physical, mental, and social well-being, and a 60 percent reduction in feelings of anxiety or depression. Vori’s holistic care model, as certified by the Validation Institute for low back pain, achieves these results with 78 percent less surgery compared to traditional care models (VI, 2023; Naidu, 2022). By taking a wider angle to focus on the interplay between physical and mental health, Vori Health is moving the needle on whole-person outcomes and changing the way employees receive and experience care.

Reach out to our experts today to discover how our whole-person, medical doctor-led MSK care program can improve mental health and MSK outcomes for your workforce.

REFERENCES

• Dieleman, 2020: Dieleman JL, Cao J, Chapin A, Chen C, Li Z, Liu A, Horst C, Kaldjian A, Matyasz T, Scott KW, Bui AL, Campbell M, Duber HC, Dunn AC, Flaxman AD, Fitzmaurice C, Naghavi M, Sadat N, Shieh P, Squires E, Yeung K, Murray CJL. US Health Care Spending by Payer and Health Condition, 1996- 2016. JAMA 2020;323(9):863-884.

• White House, 2022: Reducing the Economic Burden of Unmet Mental Health Needs. (May 31, 2022). The White House.
• Optum, 2019: Complex, costly conditions: A strategic imperative for payers and employers. (2019). Optum.
• Fronstin, 2022: Fronstin P, Roebuck MC. (September 8, 2022). Use of Health Care Services for Mental Health Disorders and Spending Trends. EBRI Issue Brief No. 569. 
• Melkevic, 2018: Melkevik O, Clausen T, Pederson J, Garde AH, Holtermann A, Rugulies R. Comorbid symptoms of depression and musculoskeletal pain and risk of long term sickness absence. BMC Public Health 2018;18(1):981.
• Rojanasarot, 2023: Rojanasarot S, Bhattacharyya SK, Edwards N. Productivity loss and productivity loss costs to United States employers due to priority conditions: a systematic review. J Med Econ. 2023;26(1):262-270.
• Park, 2016: Park SJ, Lee R, Yoon DM, Yoon KB, Kim K, Kim SH. Factors associated with increased risk for pain catastrophizing in patients with chronic neck pain: A retrospective cross-sectional study. Medicine (Baltimore). 2016;95(37):e4698.
• APA, 2023: 2023 Work in America Survey. (2023). American Psychological Association. 
• Adams, 2021: Adams G, Salomons TV. Attending work with chronic pain is associated with higher levels of psychosocial stress. Can J Pain. 2021;5(1):107-116.
• APA, 2019: APA Public Opinion Poll – Annual Meeting 2019. (2019). American Psychological Association.
• VI, 2023: 2023 Validation Report. (2023). Validation Institute.
• Naidu, 2022: Naidu I, Ryvlin J, Videlefsky D, et al. The Effect of a Multidisciplinary Spine Clinic on Time to Care in Patients with Chronic Back and/or Leg Pain: A Propensity Score-Matched Analysis. J Clin Med. 2022;11(9):2583.

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