May 19, 2008 -- Does your job pain you?
No matter how much you love your job, there always will be days of strain and headaches. But for some, work brings daily aches and pains that can develop into something worse. In some professions, people suffer the hurt -- but keep going back every day.
For many, the problem is that they don't feel they have the skills necessary to get another job. And even if they can develop new skills, "they're not interested in retraining because they have to start from the beginning again. It's a much lower-paying job," said Mitchell Freedman, director of physical medicine and rehabilitation at the Rothman Institute at Thomas Jefferson University Hospital in Philadelphia.
"The instance of chronic pain goes up with job dissatisfaction, a feeling of helplessness about your job," Freedman said.
"And you can't get out of the job because it's either do that or not work. You'll do the best you can until finally, your body breaks down," he said.
For some, the pain comes just from sitting in the same position all day, such as police officers on patrol or heavy-truck operators. For others, it comes from repeated motions, such as a blogger typing at the keyboard for hours straight and straining to look at the computer monitor. And for some, the pain can come from both -- such as musicians, who have to sit and play for hours on end.
Some occupations may have more obvious risks, but for a Hollywood stuntman, the need to stay in shape may help the pain go away sooner.
Here are 10 jobs where physical aches can be a regular part of the daily grind.
To Serve and Protect
Patrol Officer Michael Best loves a thrill.
"When you pull a car over, your heart can go from resting to a 1,000 beats a second. At every encounter, you don't know what to expect," Best said. "This is what I've wanted to do since I was 4 years old."
Now, 20 years older, Best has earned his spot on the Weymouth Police Department in Massachusetts. Along with routine car stops and a few arrests in the last year, he also has been on foot chases and multiple hostile situations.
But his life is not like the games of cops and robbers or Matchbox cop car chase he played as a kid.
"The physical and emotional stress takes a toll," Best said.
Best has been injured three times on duty after only one year on the force. "That's more than I've ever been injured in my life," he said. One of his major injuries was having his hand hit by a passing car while directing traffic.
Besides nonroutine physical injuries, everyday stresses cause pain for several officers.
"Long durations in the car and pivoting their lower back to get in and out of the car takes a toll on their back," said John Gentile, chairman of the Board of Governors with the American Chiropractic Association.
Although Best is only a year into his career, he already sees a massage therapist for his neck and back pain. He also notices the physical effects on officers who have been with the department for a while -- a sign to him of what may be to come.
"Joint pain and years of pain from injuries catch up with them after a while," Best said.
As for the emotional toll, several studies have shown police officers have the second-highest suicide rate among any occupation -- and the divorce rate of officers is three times the national average.
"I'm not surprised," Gentile said. "[Police officers] are under tremendous stress. They're always on guard, they work long hours and sometimes in dangerous areas."
Gentile said daily stress causes some officers to tense their back and neck, which causes upper back pain and headaches.
"There is definitely a physiological manifestation of the psychological stress," Gentile said.
So why do police officers such as Best submit themselves to daily strains and sprains that eventually may turn to deep aches and pains?
"In only one year, I can recall so many times I've served my community," Best said, "and that outweighs the pain."
Fighting Flames … and Back Pain
While we might assume their name explains it all, firefighters suffer pain beyond just fighting fire.
Firefighters undergo exposure to extreme heat. At times, their proximity to heat can burn them, even if they haven't touched the fire at all.
But burns are not their only cause for pain, said Robert Hayden, spokesman for the American Chiropractic Association.
In the midst of battling flames, firefighters are exposed to intense shoulder and lower back stress as they resist powerful water pressure shooting through the large and heavy hoses they lift. They climb up and down ladders and through windows strapped to a 25-pound breathing tank -- sometimes while carrying a person to safety.
"I've seen firefighters forced to retire after falling through floors or the roof to the level below," Hayden said. "They have to balance on unstable ground while carrying so much."
While police officers incur more physical injuries, Hayden said firefighters endure deeper pain by heavier lifting.
Firefighters' rigorous shift hours add further physical stress. On an overnight or two-day shift, firefighters often sleep at fire stations where the mattresses or cots that are available may not provide adequate back support.
"It's far from comfortable, but these guys are warriors," Hayden said. "They have to call on their bodies to do anything at any given time."
A Truckload of Pain
Long drives behind the wheel of a heavy truck made the pain in Duane Strating's legs unbearable.
Fifteen years ago, Strating had spinal disc surgery to relieve the nerve pressure causing his leg pain. But now driving trucks has taken a toll on his back and neck.
Strating, who owns a car hauling company, said the pain is not only due to the constant vibrations and bouncing his body experiences when driving, but also from heavy lifting and pulling he is required to do to prepare his transport.
Although David Paris, his chiropractor, recommends exercise, Strating said it is difficult on days when he is driving his truck.
"It is easier to pull over on the side of the road when you're driving a car and stretch," Strating said. "There are not as many places for trucks to pull over."
Paris said the most physical stress on truck drivers comes from driving through mountainous areas as they maneuver curves and pull their truckload uphill.
"[Truck drivers] are in a unique situation wherein they take on the highest pressures in the back via sitting, often unsupported, then may get out and lift and load, without warm-up in varying weather conditions," Paris said. "Depending on what they are hauling this can be very strenuous."
Paris said truck drivers also face logistical challenges. They spend most of their time on the road, often making it difficult for them to find time to see a specialist concerning their pain. Paris said without the ability to manage Strating's pain through medication, there are not many choices for truck drivers like Strating. Aside from the over-the-counter aspirin Strating occasionally takes, he said he cannot do much to manage his pain.
"I can't operate a truck and be on medication," Strating said. "I've just gotten used to [the pain]."
Paris added, "Anyone left with chronic pain and limited options feels like on some level they 'live with it' -- and in fact they do."
Strating said he has gotten used to painful days and does not think about leaving his job to relieve his back pain.
"I've done this for so long now," Strating said. "I know the routine and it makes a living for me."
When Pain Is Your Co-Pilot
Todd DeClairmont felt the familiar speed of his fighter jet as inertia locked him into his seat during flight. DeClairmont said he suffered severe spine compression and neck pain from the force and speed of the plane -- but refused to see a chiropractor at the time.
"I didn't want to take time away from flying," DeClairmont said.
Gary Kearney, senior medical examiner for the Federal Aviation Administration, said it is common for fighter pilots not to report pain they feel while flying.
"Fighter pilots are concerned about reporting even minor complaints because it could jeopardize their time in the air by being grounded by their flight surgeon," Kearney said. "They always want to feel on top of their game."
DeClairmont said he eventually gave in to the pain and saw a chiropractor. That was nine years ago, when DeClairmont served as a fighter pilot with the U.S. Air Force. DeClairmont now flies commercial airplanes and said the greatest strain on his back is carrying his navigation bag -- a carrier that contains chart cases and flight manuals pilots need to map their route.
"I only carry the bare minimum in my bag, and it's 37 pounds," DeClairmont said.
Like many commercial pilots, DeClairmont sometimes switches airplanes multiple times a day, which has him rushing through different terminals, navigation bag in tow.
"I can feel myself leaning sideways when I'm walking with my bag," DeClairmont said.
The FAA has approved the use of Electronic Flight Bags -- a device that stores a pilot's information electronically. However, many airline companies have not implemented its use among their pilots.
Kearney said that concern over being grounded can keep commercial pilots from telling their medical examiner about secondary pain.
"If older pilots only have a few more years left before they're grounded, they generally will not hasten that time by reporting anything minor," Kearney said.
Vahe Talatian, a licensed airline transport pilot, began flying 24 years ago. For the last three years, Talatian has been flying corporate jets. Unlike working for a large commercial airline where a pilot may change planes for a different flight path, Talatian flies the same airplane to every destination.
"I'm sitting in close quarters on one airplane the whole time," Talatian said. "After three or four hours, you feel fatigue from sitting and that need to walk around."
Kearney said pain management techniques specific for a pilot is unusual.
"If an airline pilot is sitting immobilized for a long time [it] is a difficult situation," Kearney said. "But it is just like travelers who fly trans-Atlantic. It's about how to conduct the right measures to keep from experiencing the pain."
Talatian said lack of sleep also contributes to his headaches. He said he tries to plan ahead on sleeping, but pilots frequently do not have consistent flight schedules.
"If I have a flight at 3 a.m., I plan to sleep at 9," Talatian said. "But sometimes I'll look at the clock and realize it's 10:30 p.m. and I'm still not tired."
"Pilots do have some demands like traveling long distances and constant commuting," Kearney said. "For example, if they live in Maine and have to catch their flight in New York."
However, Kearney said it is not the profession that is painful, but how pilots perform the duties they are given.
"All pilots have the responsibility to ground themselves if they feel they are in danger to themselves or their passengers or have chronic pain," Kearney said.
Chronic Pain a Familiar Tune for Musicians
Lori Inglis' tap on the cymbals signals the start of the show.
Inglis, 43, is a drummer with The Dixie Diehards, a New England-based Dixieland Jazz Band. She has played with many bands in the last 26 years.
Early in her career, Inglis played five nights a week. On some nights, when she held her drumsticks, she could feel her palms cramp and the tips of her fingers tingle. At 17, she was diagnosed with carpal tunnel syndrome in her wrists. Inglis' doctor suggested that she wear a cast and receive cortisone shots to ease the pain and swelling.
"I avoided going to the doctor's after that because I was afraid they would tell me that I couldn't play," Inglis said. "I thought, 'Man, wearing a cast isn't going to work.'"
"Anytime people believe they are going to be taken away from what they love to do they will avoid [seeing a doctor]," Paris said. "It's important to see providers or specialists who are willing to consider the patients' desires and give options."
Although drummers sit through most of their shows, their lower bodies may endure as much pain as their wrists.
"Your wrists are tapping the drums for three or four hours," Inglis said. "But at the same time, you're tapping your foot on the pedals for just as long."
Paris said most musicians develop chronic pain because of the constant repeated movements in the same joints, depending on the instrument they play.
"Some musicians like drummers and singers should really be considered as athletes, as performing can be very strenuous," Paris said.
Seven years ago, Inglis was performing on stage when her knee blew out while tapping the foot pedal to the high-hat cymbal.
"It hurt so bad, but I couldn't show it," Inglis said. "I just had to keep going."
Inglis said every member of the band experiences pain in different areas.
"Our trumpet player has to manage his shoulder pain," Inglis said. "And our guitarist wears a strap to keep his lower back from hurting."
Inglis manages her pain by warming up and stretching her wrists and legs every day -- even on days when she does not have a show. She also keeps her mind on the music.
"When I play, I think about the music and the pain just goes away," Inglis said.
Pain on the Digital Frontier
Their fingers rhythmically tap and tap and tap on the keyboard -- letter after letter rapidly forming word after word. And when they click "publish post," their words are transported to a new realm: the blogosphere.
For some people, blogs are leisurely Internet diaries. But for full-time professional bloggers who earn their living on the number of posts they publish and the popularity of their site, every word counts.
Kim Stagliano, managing editor of the blog Age of Autism, describes the blog world like a game of cat and mouse. Everything is faster on the Internet -- and bloggers feel the need to catch up.
"I always feel like I'm behind," Stagliano said. "I always think, 'Is this story old now, did I grab it fast enough … OK, now what's next.'"
Stagliano handles all the physical work required to keep the blog active. She monitors the interactive components of the site, answers comments and now enhances the blog's appearance.
"I'm constantly clicking, going through stories, writing, posting content, clicking," Stagliano said. "Some days I'm on from 6 a.m. until 9 p.m."
Sean Conroy, director of pain management services at Beaumont Hospitals, said bloggers are the extreme version of any administrative work that requires using a computer because bloggers spend more time locked in one place.
"Many people who read computer screens lean forward and tilt their head up, causing back, neck and jaw strain," Conroy said. "Typically we don't think of bloggers and jaw pain."
"Blogging has made me less healthy," said Stagliano, who said she drinks more coffee and lost weight because she does not eat full meals during the day. "My eyes get buggy, and I have to take a walk to get away sometimes."
Although Stagliano said she understands the physical health concerns from a job where the only movements she may experience on some days are her fingers pressing keys, Stagliano said she has prepared herself for long days in the blogosphere.
"I bought a good ergonomics keyboard, a huge screen, a comfortable seat," Stagliano said. "Nothing's going too south with my physical health right now."
Despite precautions taken by bloggers to ensure they feel comfortable as they surf, write and post for hours on end, Conroy predicts seeing more physical health problems due to blogging in the future.
"This is relatively new so many bloggers may not complain now," Conroy said. "But we will see more pain as we move further along in the electronic age."
Sacrificing It All for the Shot
Branko Racki calls himself the jack-of-all-trades.
"I can do fires, high falls, rolling cars, fights scenes, boat chases," Racki said.
This time Racki, 48, played a cop on a high-speed car chase. The car he chased was supposed to screech to a stop, and Racki's cruiser was to stop right behind the car. A tractor-trailer then slams into his cruiser. The impact should have launched Racki through the windshield and only a few feet through the air before he landed on the ground. But even though Racki rehearsed his scene numerous times, it still went wrong.
This time the cameras were rolling.
"I'll never forget being thrown 20 feet in the air, flying forward about 50 feet and thinking I'm not supposed to be this high up," Racki said.
Racki tore ligaments in his arm and leg and partially dislocated his hip. In the stunt world, Racki said, his injuries are equivalent to a few bumps and bruises.
Racki has been a stuntman for 26 years. He has worked on more than 300 feature films, including "The Day After Tomorrow," "The Hulk" and the 1988 Tom Cruise movie "Cocktail." Racki has dozens of stories to tell of flips, flights and falls he has mastered to capture the perfect Hollywood action scene.
Joseph Guettler, orthopedic surgeon at Beaumont Hospitals, said that with time stuntmen such as Racki become much more desensitized to pain than people who rarely submit themselves to hazardous situations.
"Their profession makes them so prone to breaking an arm or leg that they minimize the pain," Guettler said. "If you're used to getting banged up, your tolerance to pain will be higher."
"The weakest link for a stuntman is our neck and head," Racki said. "You break an arm, you'll be fine. But head injuries can end your career quite fast."
Although Racki can recount numerous injuries related to stunts that have gone wrong, he said he does not suffer from long-lasting muscle pain.
Racki built a gym in his house so he can continue increasing his strength and flexibility. "Most stuntmen are flexible so that's what keeps us going," he said. "We plan with our bodies before we go on set, and we rehearse our stunt before we roll."
Although Guettler recommends warming up, stretching and practicing the body movements required for the stunt, Guettler said injuries are unavoidable for stuntmen no matter how much they train.
"I've watched my friends die in this business because stunts do go bad," Racki said. "But that's the risk we take."
Laying the Foundation for Long-Term Pain
Dan O'Neal, 56, was managing a construction project when a loose cabinet board fell and hit him on the forehead. O'Neal lost consciousness and twisted his back before his body slammed on the deck of the scaffolding.
O'Neal returned to work later that week, even though every movement he made sent shooting pains down his leg. Less than six months later, while lifting a table saw, O'Neal felt a pop in his back.
"I was hurting so bad and I couldn't take it anymore," O'Neal said.
Paris said the trade of a construction worker requires constant lifting and maneuvering, and construction workers can expect injury on any part of their bodies.
"It's more likely than not that at some point your body is going to let you know it's taking its toll," Paris said.
After his first injury, O'Neal was afraid to seek treatment for his pain. His manager warned him that he would be terminated if he filed for workers' compensation.
"It is very common that men and women in construction will endure the pain because they don't want their supervisors to think they cannot handle the physical demands of the job," said O'Neal.
Although Paris, a chiropractor, advised getting early evaluation by a specialist to avoid long-term pain, he said he treats many workers who hesitate telling him their pain is work-related.
"Most employers are not encouraged to report as they see workers' compensation as just another cost driver," Paris said. "Many employees actually fear for their jobs or feel they will not get promoted once they've reported an injury."
Despite the injuries that sealed the end of his construction career, O'Neal said working many years under daily pressure to finish projects fast also contributed to his pain.
"It doesn't matter how many precautions one takes," O'Neal said. "You're using every part of your body to build and transport and fix things."
Despite guidelines set by the Occupational Safety and Health Administration to enforce safe practices by workers, Paris said with many construction workers productivity takes precedence over safe working habits.
O'Neal said he now pays the price for putting his job before his health.
"I am fortunate I endured 30 years working," O'Neal said, "[but] the pain I experience now is a living hell."
When Helping Hurts
Nurse aides log the largest number of reported cases of taking days off from work due to injuries and illnesses than any other profession, according to a November 2007 report released by the U.S. Department of Labor's Bureau of Labor Statistics.
Marie Paul, 45, a nurse aide who works on the rehabilitation floor of a Randolph, Mass., nursing home, is no stranger to taking time off because of her chronic back pain.
"Some days it is too much for me," Paul said. "I either cannot come in at all or have to leave work to lie down."
Five years ago, Paul was helping a patient walk from the bathroom to a chair when the patient suffered a seizure. Paul lost her balance and pinched her sciatic nerve while trying to hold the patient up.
"I was sent to the hospital right away and given light duties at work for the rest of the month to help me recover," Paul said. "But the pain has only gotten worse."
Conroy said, "That's an incredibly common occurrence. Ironically, it's in helping others that nurse aides will end up needing help for themselves."
A nurse aide's daily requirements may include bending to help patients put their shoes on, helping patients get from one place to another, transporting patients who cannot walk and adjusting patients after they have been lifted into bed.
Conroy said overweight patients contribute to most of the pain experienced by nurse aides.
"The weight epidemic that's sweeping this country is the main problem," Conroy said. "The heavier the patient is the more physically demanding for a nurse's aide to move a stretcher or hold a patient up."
Conroy added that many nurse aides bear the brunt of frustrated patients.
"Many times they are mistreated by patients who demand a lot from them," Conroy said. "When you're burnt out, you're more prone to injury."
"It doesn't matter how experienced you are," Paul said. "For 13 years, I used to be able to do everything. Once I hurt my back, that was it."
Despite wearing a back brace to work, Paul said as long as she is on her feet the pain persists.
"I wish I could just tell other nurse aides that there are ways to go back to work after an injury and not feel the pain I feel," Paul said. "But I haven't found anything."
"Prevention is the best tool to manage pain," Conroy said. "Nurse aides should take their own job description to heart and not be afraid to ask for help."
Dangers of Dancing
Throughout college, Cynthia Toussaint's dance teachers told her she had the body of a ballet dancer. Toussaint, who was studying performance at University of California Irvine, felt pressure to dance professionally.
"Even though I lived to perform, I wasn't sure I wanted to go professional," she said. "Dancers have really short careers because we suffer so many injuries."
Although Toussaint foreshadowed the end of her career, she allowed herself to be swept away by pirouettes and pliés.
"People wouldn't see ballerinas as athletes, but we are the highest caliber of athleticism," Toussaint said. "It is so competitive in nature because there are hundreds of women who want the job."
Three years into her career as a young ballet dancer, Toussaint tore her right hamstring while stretching.
"I was raising myself up after bending into a stretch when I heard a pop," Toussaint said. "It felt like a guitar string got plucked."
Toussaint said her trainers told her the pain would go away after eight weeks. She kept dancing through her injury until her right leg turned purple.
"Ballet dancers are taught to smile no matter how grueling the pain is," Toussaint said. "I couldn't imagine a small injury I had could result in something so catastrophic."
Jonathon Mackoff, a chiropractor who works with Chicago-based ballet companies, said it is common for dancers to push through the pain.
"Ballerinas don't dream of dancing in the chorus. They have the vision to be a feature performer," Mackoff said. "Often times they push through the pain because they want to perform."
Toussaint developed Reflex Sympathy Dystrophy, otherwise known as "suicide disease." RSD begins as pain limited to the region of the injury often leaving someone unable to move that part of his or her body. The pain spreads over time to all parts of the body. Doctors are generally able to treat RSD within a year of diagnosis. However, Toussaint was not diagnosed with RSD until she had spent 15 years in a wheelchair after her injury.
"My brain just kept saying, 'pain, pain, pain,' and the pain spread everywhere," Toussaint said. "I [still] feel like I've been doused in gasoline and set on fire."
"Every injury is unique to the dancer," Mackoff said. "You never know what injury is going to trigger the end for that dancer's career."
Mackoff said the pain dancers experience in a certain area of their body may not always be where the injury occurred. According to Mackoff, dancers overcompensate by putting more pressure on the area of their body that is not injured, thus causing more pain in the region not directly affected by the injury. However, Mackoff recommends early treatment for any injury.
"At some point, pain is inevitable for a ballerina," Mackoff said. "It helps to use a whole body approach when assessing and managing their pain, rather than a site of injury approach."
Toussaint now speaks regularly to ballet students at University of California Irvine about understanding the difference between pains that accompany minor ballet injuries and realizing when the pain is the injury.
"I told them I wish I could have heard me speak 26 years ago," Toussaint said. "If I saw a former ballerina in a wheelchair speaking to me about preventing pain, I don't think I would be where I am now."
Joseph Brownstein contributed to this report.