Musculoskeletal conditions and chronic pain among working patients

Session details

Date:

Time:

12:00pm - 1:30pm (Toronto time)

Location:

Zoom videoconferencing

Didactic presentation by:

Andrea Furlan, Lynn Cooper

Session objectives

At the end of this session, participants should be able to:

  1. Describe an approach to examine a person with a musculoskeletal problem
  2. Explain the indications of opioids for nociceptive, neuropathic and nociplastic chronic pain
  3. Cite 10 evidence-based treatments for low back pain
  4. Understand the impact of working with chronic pain on the person

Session resources

Canadian Centre for Occupational Health and Safety (CCOHS)
CCOHS fulfills its mandate to promote workplace health and safety, and encourage attitudes and methods that will lead to improved worker physical and mental health, through a wide range of products and services. Source: CCOHS
Investigating Incidents in the Workplace: Using PEMEP as a Guide
A safety assessment tool using the acronym PEMEP (people, equipment materials, environment and process). Source: Workers' Compensation Board of Nova Scotia
Medical students' abilities to take an occupational history: use of the WHACS mnemonic
Blue, A. V., Chessman, A. W., Gilbert, G. E., Schuman, S. H., & Mainous, A. G. (2000). Medical Students’ Abilities to Take an Occupational History: Use of the WHACS Mnemonic. Journal of Occupational and Environmental Medicine, 42(11), 1050–1053. Source: JSTOR
Musculoskeletal conditions and chronic pain among working patients
In this presentation, Dr. Andrea Furlan discusses an approach to examining a person with musculoskeletal problems, explains the indications of opioids for nociceptive, neuropathic and nociplastic chronic pain, cites evidence-based treatments for low back pain, and discusses the impact of working with chronic pain on the person. Lynn Cooper, from the Canadian Injured Workers Alliance, brings the lived experience of persistent pain from a work injury to the didactic presentation.
Occupational Health and Safety Act (OHSA)
Learn about the Occupational Health and Safety Act and supporting regulations and how they protect workers. Source: Government of Ontario
Occupational History Recording Tool (OHRT)
The Occupational History Recording Tool (OHRT) will help primary health care providers better support patients with injuries and illnesses that affect their ability to work. Source: ECHO OEM
Rights of workers in Ontario
The Occupational Health and Safety Act (OHSA) sets out the rights and duties of workers, supervisors, and employers in provincially regulated workplaces. Source: Infrastructure Health & Safety Association
Take an occupational history
A resource on how to take an occupational history. Source: University of Western Ontario
WHMIS - Safety Data Sheet (SDS)
Safety Data Sheets (SDSs) are summary documents that provide information about the hazards of a product and advice about safety precautions. Source: CCOHS
Workplace Safety and Insurance Act (WSIA)
The Workplace Safety and Insurance Act outlines obligations of healthcare providers in Section 37. Source: WSIB
WSIB Operational Policy Manual: Chronic Pain Disability
The WSIB will accept entitlement for chronic pain disability (CPD) when it results from a work-related injury and there is sufficient credible subjective and objective evidence establishing the disability. Source: Workplace Safety and Insurance Board
WSIB Programs of Care
Programs of Care are available for the most common musculoskeletal injuries and specific illnesses. To participate in programs of care, health care practitioners must complete the following form: Instructions for Delivering Programs of Care (POC). Source: Workplace Safety and Insurance Board

About presenter

Dr. Andrea Furlan is a scientist at the Institute for Work & Health and a physician and senior scientist at the KITE Research Institute at University Health Network. She is also an associate professor in the Department of Medicine’s Division of Physiatry at the University of Toronto.

Furlan is an expert in rehabilitation medicine, chronic pain, systematic reviews, clinical practice guidelines, opioid treatments, cannabis and cannabinoids, and the implementation and evaluation of ECHO projects. Furlan was the first person to bring an ECHO project to Canada in 2014, on chronic pain and opioid stewardship. She has since helped many groups in Ontario start ECHO projects for conditions such as rheumatology, liver disease, epilepsy, mental health, children’s health, care of the elderly and wounds.

Furlan completed her residency in physiatry at the University of São Paulo in Brazil and obtained a PhD in clinical epidemiology from the University of Toronto. She completed a two-year clinical fellowship in physiatry at the Toronto Rehabilitation Institute. Furlan received the Canadian Pain Society’s Excellence in Pain Mentorship Award in 2021 and the Pain Excellence Award from the Pain Society of Alberta in 2020.

For more than 20 years, Lynn Cooper has been a national pain community leader, spokesperson, advocate, and educator, working toward improving pain management for Canadians. As a person with lived experience in workplace injury and persistent pain, Lynn advocates for the voices and perspectives of people with pain to be imbedded in research, policy discussions, and initiatives that will create solutions for more effective and compassionate pain care. She served as a voting member of the 2017 Canadian Opioid Guidelines and on Health Canada’s scientific review panels regarding opioid prescribing. Lynn currently participates on research teams that (1) investigate the efficacy of pain education methods for patients and health professionals, (2) study ways to improve pain care delivery systems, (3) develop online pain education modules for patients, and (4) develop clinical practice guidelines for opioid and cannabis prescribing for chronic pain. Lynn is the Director of Research and Education for the Canadian Injured Workers Alliance. In this capacity she leads projects that connect pain management and education within stay at work/return to work planning and identify the impacts of COVID 19 on injured workers. Lynn served on the SPOR Chronic Pain Network steering committee. 

Case presentations

Most of the learning in ECHO happens through presenting and discussing case presentations. If you have a case you would like to present, please submit a completed case presentation form to the ECHO OEM project coordinator.

Physicians presenting a case may bill OHIP for case conferences (billing codes K707 or K701).