Facilitators and Barriers to Return-to-Work for Employees with Chronic Pain in the United Kingdom: An Integrative Review

Background: Chronic pain profoundly impacts work ability, often leading to job loss, poor health, and reduced mental well-being. This study aims to synthesize UK evidence on barriers and enablers of return-to-work (RTW) for employees with chronic pain.Materials and Methods: A qualitative review synthesized RTW experiences through an extensive literature search across EMBASE, Medline, CINAHL, PsycINFO, the Cochrane Library, Scopus, and Web of Science, covering studies published up to December ۲۰۲۴.Results: Chronic pain weakens work identity and confidence, while stigma and unsupportive workplace cultures hinder communication and accommodations. Systemic challenges-including healthcare structures, employment policies, welfare reforms, and an aging workforce-complicate return to work (RTW). Despite legal mandates, workplace adjustments are inconsistently applied. Multidisciplinary National Health Service (NHS) pain management is essential but often limited by clinicians’ limited understanding of workplace demands. Psychological strategies like acceptance, resilience, and cognitive-behavioral therapy support adaptation and job transitions. Successful RTW requires tailored adjustments (e.g., ergonomic changes, flexible schedules), improved communication, and collaboration among employees, employers, and healthcare providers. Manager training and policy reforms can reduce stigma and enhance accommodations. Employer strategies such as open communication, flexible work during flare-ups (e.g., remote work, adjusted hours), and proactive RTW planning are vital. Ergonomic assessments further improve pain management and productivity.Conclusion: Return-to-work (RTW) for UK employees with chronic pain is influenced by interconnected individual, workplace, healthcare, and systemic factors. Addressing psychological barriers (e.g., fear-avoidance), enhancing workplace flexibility (e.g., phased schedules), improving healthcare coordination (e.g., multidisciplinary teams), and fostering supportive workplace cultures are essential. Integrated strategies that combine policy reforms with multidisciplinary approaches significantly enhance RTW outcomes, workforce retention, and quality of life.

کلیدواژه ها:

Barriers ، Chronic pain ، Employees ، return to work ، United Kingdom