What do you do when work really does become a pain?
Physical strain related to a job can be so debilitating it can force a change in career direction
Morwenna MacLean: Playing the harp makes her back problem worse. Photograph: Michael Mac Sweeney/ Provision
While unemployment is obviously a major source of stress for those affected, people with jobs often suffer from occupational hazards that, if not managed well, can lead to a change in careers.
Back pain, repetitive strain injury (RSI) and jaw pain, known as TMJD (temporomandibular joint disorder), are just some of the common conditions that can make working life miserable, with varying degrees of effective treatment available.
Dr Eamon A Murphy, who practises in Cork, says he is one of just two dentists in Ireland who specialises in orofacial pain. He says that, generally, orofacial pain is the result of temporomandibular joint problems and is poorly diagnosed.
“The biggest factor leading to the condition is clenching and grinding teeth which, in most cases, is stress related,” says Murphy.
Jaw-clenching“People can hold tension in their neck or their back. Others hold it in their jaw. Jaw pain is perpetuated by jaw-clenching behaviour. In many cases, it will present clinically as an earache or headache, which tends to throw a lot of patients. They end up going to their doctor.
“Then there are patients who present with clicking or a locked jaw, which leads to difficulty in chewing and opening their mouths.”
Murphy has been treating a lot of teachers in recent years. “Any job that involves a lot of jaw function and increased workloads or stress levels can lead to TMJD. The focus of treatment is identifying and managing the problem. A teacher might unconsciously clench their jaw because of a difficult student.
“Treatment is all about correcting jaw posture, learning relaxation-based breathing exercises, heating muscles and, sometimes, wearing a jaw splint at night in bed.
“The TMJ is no different from any other joint in the body. But if you don’t identify what perpetuates the problem, then the problem will always come back. Acupuncture and yoga can help. Mindfulness can be hugely effective. In severe cases, there will be a need for a non-steroid anti-inflammatory.”
Fear of bullying A number of teachers declined to go on the record about their experience of TMJD for this report
for fear of bullying.
Claire (not her real name) is a secondary school teacher of languages and the mother of two young children. She was recently diagnosed with TMJD.
“There were a few warning signals,” she says. “I had an ongoing ache in my right shoulder. I also had an ongoing toothache.
“My dentist said there was nothing wrong but that I needed to make sure I was wearing my mouthguard at night, which I had become lackadaisical about doing. Then, in March, the pain became acute.”
Claire was referred to Murphy.
“I was aware that I was grinding and clenching at night but I didn’t know I was doing it during the day.
“Murphy recommended mindfulness. I was told to breathe in very deeply through my nose and exhale through my mouth.
“That leads to the natural position of your jaw, which is unclenched. But my jaw can be locked even when I’m not clenching it. It’s very hard to know it’s happening.
“I’m a bit of a cynic about mindfulness. I’ve been told that every time the bell rings at the end of class, every time there’s an announcement over the intercom and every time the lights go red when I’m driving, they are my cues to check if I’m clenching.”
“It’s a simple solution at one level, but it’s surprisingly difficult. It’s a fine balancing act between being acutely aware and not obsessing. Certainly, my job doesn’t help.
“I work in a school where the students are very high achievers. Teaching gets very bad press. But it is very stressful. The summer holidays will tell a lot.”
Change of careerFor science writer, broadcaster and media trainer Mary Mulvihill, RSI necessitated a change in career direction. She developed RSI after 10 years of reporting and “writing very fast”.
“My right hand became fatigued. It’s like muscle fatigue, caused by overuse and then exhaustion. It’s a chronic condition.
“I can’t chop vegetables with my right hand. I can still write, provided I don’t have to do it very quickly. My lifesaver has been voice-recognition technology, which allows me to dictate to my computer through a headset that has a microphone.”
She adjusted her office to make it more ergonomic, and moved from reporting to training.
“When you’re in a business, you try to stay in it. From where I’m at, moving into training is a natural evolution from reporting as I have the necessary experience and expertise under my belt. I’m able to continue working in science media.”
Morwenna MacLean, who has just completed second year at the Cork School of Music, specialising in the harp, says her choice of instrument exacerbates her back pain.
The 20-year-old student works part-time at a stall in the English Market. Last summer, while lifting a crate at work, she failed to bend her knees properly.
“The alignment in my pelvic floor area got displaced. I was in absolutely horrible pain and had to go to a chiropractor. About two months ago, I got really bad pain in my upper back; so painful that I couldn’t do anything.
“Playing the harp makes it worse. I use a piano stool, and it and my two legs make a triangle which supports me. But I have to change pedals at the bottom of my harp, which means my back is holding all the weight. It aggravates my back problem.
“I’m now going to see a chiropractor twice a week. He is trying to realign my back and feels that once he fixes it, I should be okay. But the harp is a very heavy instrument to carry around.
“As much as possible, I try to get someone to help me transport it when I’m playing at weddings and concerts.
“After college, I plan to travel and play the harp. But I’ll definitely bring a smaller harp with me.
“I don’t want to damage my back any more.”