Occupational Medicine Program

Chronic pain is the leading cause of long-term disability in the workplace. Once the acute phase of an injury has been treated successfully, continued unmanaged pain is no longer a symptom but a barrier to returning to work.

As part of its treatment continuum, the Brigham and Women's Hospital Center for Pain Medicine offers an occupational medicine Back to Work Program.

About the Back to Work Program

The fundamental goal of the Center is functional restoration of our patients. For patients where return to work is appropriate, our Back to Work Program offers a strong vocational emphasis to encourage our patients to return to work.

After evaluation by our interdisciplinary team, a time-limited, intensive six- to eight-week program is offered. Each program is designed to meet the unique needs of our patients. Weekly team meetings are held to evaluate progress and modify the program as required.

Case managers or other representatives of employers are encouraged to attend. Close coordination with the employer is vital for the success of the program. Follow-up after the program is vital to avoid exacerbations of pain and potential negative behavioral consequences.

Back to Work Evaluation

Each patient referred to the Center for Pain Medicine's Back to Work Program is evaluated by our treatment team. The treatment team consists of:

  • Pain management physician
  • Occupational medicine specialist
  • Nursing
  • Occupational and physical therapists
  • Psychologist
  • Case manager
  • Pharmacist
  • Volunteer director

The assessment determines:

  • Functional limitations
  • Risk factors that may delay recovery
  • Early contact with the employer for potential work accommodations
  • Willingness of the patient to return to work

Following the assessment, a team meeting along with the employer's representative is used to formulate a treatment plan. This treatment plan is for a defined period of time and is goal-specific.

Goals of the Program

Specific goals of our Back to Work Program are:

  • Targeting specific activity limitations
  • Early vocational emphasis
  • Specific emphases of psychological dysfunction and depression

Patients enrolled in the Back to Work Program become part of the Hospital's volunteer program. This unique feature provides real job simulation opportunities.

Many of the departments at Brigham and Women's Hospital are open to the volunteer program. Each prospective job has a Department of Labor description and rating. Patients are encouraged to progress through this program by working around activity limitations, increased endurance and enhancement of their self-esteem.

Identifying Factors that Delay Recovery

Identifying risk factors for delayed recovery may lead to earlier intervention. These risk factors, in order of importance, are:

  • Physician conviction of high-risk status
  • Poor proficiency in the English language
  • Length of time off work
  • Job satisfaction
  • Patient and physician's perception of heavy work
  • Anger at "the system"
  • Substance abuse
  • Previous injuries
  • Disabled spouse

Patients with injuries that often cause long-term disability such as non-specific low back pain or regional pain syndrome (RSD) should be evaluated for these risk factors and referred early if present.


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