One thing that works to help reduce the burden of chronic pain

Adele is a middle manager at a firm based in Perth. She enjoys her work and gets on well with her colleagues but is struggling with reduced mobility and chronic back pain resulting from an injury sustained several years ago. She’s put on weight, which she knows doesn’t help, but can’t get rid of because exercise aggravates her pain, and she’s chronically tired from living with her pain and difficulty sleeping.

Every morning, she wonders how her day will play out. How bad will her pain be, and how much medication can she reasonably afford to take to get her through?

She wonders if she can stay in her position much longer and whether she would be better off taking early retirement.

Do you have or know someone living with chronic pain?

We spend 90,000 hours or roughly 10 years of our life at this place we call work. Work matters. It helps to pay the bills, put food on the table and being in work has been shown to be beneficial to our health.

But what happens if your work is causing or aggravating your pain, whether from heavy physical work straining your back, poor posture from sitting in front of a screen for many hours of the day, injury, accident or headaches due to eyestrain, psychological distress or anxiety?

It’s hard to stay focused, alert and functioning at your best when that nagging pain is just sitting there, unrelieved by painkillers or anti-inflammatories that just make you groggy. Pain can make you grumpy and irritable and unable to think straight. You wish it didn’t, but no one else knows what you’re going through because your pain is only experienced by you and it’s frequently invisible.

According to Pain Australia, 3.37 million people (1:5) were living with chronic pain in 2020, of which 68% were of working age. It also contributes to 40% of early retirement.

In the US, it’s worse, with studies reporting up to 40% of the working population experience chronic pain, exceeding the number of those dealing with cancer, diabetes and heart disease combined.

Chronic pain is any pain that has lasted for more than three months.

It’s subjective and highly complex and is influenced by a number of physiological, social and psychological factors.

Managing chronic pain requires specialist care tailored to the individual.

Rehabilitation counsellors work closely with their clients and employers to ensure there is mutual understanding, empathy and support as well as good communication between all parties. Flexible working arrangements or providing stand-up desks and having access to occupational therapists, physiotherapists, counsellors, psychologists and pain specialists as appropriate can all go a long way to assisting the person in managing their pain.

But is there something else that can help?

The answer may surprise you.

It’s about spending time in nature.

Greenspace exposure works to reduce the pain burden.

It was Robert Ulrich in the mid-eighties who showed that patients undergoing gallbladder surgery recovered faster, had fewer post-op complications, shorter hospital stays and required less pain medication if their hospital bed overlooked a green space compared to those whose outlook was a brick wall.

This showed how the pain experience could be modulated simply by being able to see nature.

So, what about chronic pain?

Jessica Stanhope and her colleagues have been investigating how greenspace exposure works to reduce the burden of chronic pain. This is about making the pain feel more manageable for the person living with it, not eliminating it. They have identified a number of elements that influence pain.

These include phytoncides, the antimicrobial compounds emitted by plants that exert a calming effect on the human body, influence the immune system and improve sleep. In addition, witnessing natural sounds like birdsong or water and sights within nature, such as woodland, parks and ponds, provide a positive distraction, and then there is the effect of sunlight.

We feel better with sunlight exposure. The reason for this is more complex than just boosting vitamin D production. Sunlight also stimulates the production of a natural endorphin and melatonin that helps with sleep.

The other impact of greenspace exposure is that by ameliorating some of your pain, it becomes easier to move a little better, to exercise a little more, to want to socialise with others when outside and to feel you have greater control over your life again.

This is not to suggest that greenspace exposure is a panacea to chronic pain.

However, the research suggests that making greenspace more readily accessible can alleviate some of the pain burden.

This is a perfect example of how good biophilic design in offices and buildings can contribute to better health and well-being.

If it’s possible to use greenspace to alleviate one person’s pain, surely that must be a good thing.

What has been your experience of greenspace in chronic pain?

I’d love to hear your thoughts.

Dr Jenny Brockis is a medical practitioner and board-certified lifestyle medicine physician, workplace health and wellbeing consultant, keynote speaker and best-selling author. Her new book The Natural Advantage (Major Street Publishing) is now available here.