Mental health and chronic pain: Understanding your employees’ invisible illnesses

Support is needed for both mental and MSK health across your workforce

Mental health and chronic pain: Understanding your employees’ invisible illnesses

This article was produced in partnership with the Canadian Chiropractic Association.

There is growing research linking chronic pain and poor mental health and though it appears to be ‘invisible,’ it’s crippling your workforce. As HR leaders, you can rewrite the narrative to improve the lives of staff suffering from concurrent health conditions by first understanding the comorbidities, then collaborating with insurance providers to embrace a holistic and comprehensive approach to employee care.

The 2021 Benefits Canada Healthcare Survey found that 61 per cent of people with mental health conditions also experienced chronic pain; and that up to 65 per cent of people with chronic pain conditions also experienced mental health challenges.

Mental health conditions can present itself through anxiety, depression, and burnout – these medical conditions are referred to as invisible illness because they are not easily visible to others. Similarly, many chronic pain conditions, including musculoskeletal (MSK) conditions like low back pain, carpal tunnel syndrome, and arthritis, are also generally invisible.

The connection between mental health and MSK health

According to the Mental Health Commission of Canada, psychological health problems cost the Canadian economy $51 billion a year, of which $20 billion comes from work-related causes. Supporting team members with mental health conditions means understanding the comorbidities that individuals often suffer from.

“We have moved away from a strict biomedical view of health towards a biopsychosocial model of health, seeing the interconnection between biological, psychological and social factors,” says Doctor of Chiropractic Janet D’Arcy.

D'Arcy’s experience in practice has illustrated the cross section of MSK and mental healthcare. In addition to her own practice in Toronto, she is faculty at Canadian Memorial Chiropractic College supervising fourth year clinical internships and she is also a certified instructor for a course called Mental Health First Aid, offered by the Mental Health Commission of Canada. The course teaches people to recognize the symptoms of mental health problems, provide initial help and guide a person towards appropriate professional help.

Employers wanting to support team members on their mental health journey should be cognizant of the bidirectional relationship between mental health and physical health and ensure they also have adequate benefits to access both MSK experts, such as chiropractors and physiotherapists and mental health care providers.

“There may be instances in which a patient has longstanding MSK pain, and as a result eventually develop depression and anxiety – or vice versa. Part of what we do (as chiropractors) is take a very thorough history of the patient. We ask them questions about mood and sleep, trying to notice common threads of symptoms, like weight loss or gain, poor sleep, irritability, and low mood. Patients may not make the link, but we are trained to see those connections,” explains D’Arcy. Chiropractors do not diagnose nor treat mental health conditions but are often found working as part of team-based coordinated care model.

Because chiropractors receive a wide breadth of education, they are trained to recognize mental health ‘yellow flags’ and make a referral, especially when a comorbidity has an impact on current prognosis. By addressing chronic pain symptoms, chiropractors may be able to help create the conditions for mental health to improve.

You probably have a mental health strategy. Do you have an MSK strategy?

In recent years, many organizations have established mental health care strategies that offer employees increased or extended mental health insurance, and workplace programs like wellness rooms and/or wellness allowances. These are important initiatives but may fall short of serving the complex prognosis that often accompanies these conditions. What if you approached your employee care programs through a wide lens supporting both mental and MSK health?

“To divide mental health care and MSK care strategies is counterproductive; employers should have a human health strategy. A person’s health is mental, physical, and environmental,” says D’Arcy. “For employers, it’s important to be cognizant of the biopsychosocial model, and develop programs and policies that serve the whole person.”

There are many solutions to improve the overall health of your staff.  Start with reviewing your current plan and educate staff on what kind of extended care is available. Leaving your door open to feedback from your team also makes room for you to find out how best to support them, and investigate other flexible approaches your insurance providers may be able to offer. 

Mental health and MSK conditions represent the two leading causes for short- and long-term disability claims in Canada. Supporting your mental health strategy with an MSK strategy might be the gateway to a healthier, productive workforce.

To learn more about chiropractic care and how MSK experts can support your organization, visit

Latest stories