When “Pushing Through” Pain Becomes a Normal Part of the Workday

In orthopedic practice, pain is rarely just a symptom that patients report on a scale from one to 10. It’s often the reason someone stops taking the stairs, turns down a shift, misses an event, or quietly changes the way they move through the day. For people whose jobs require them to stand, lift, climb, or walk for hours at a time, persistent pain can become woven into the workday long before it enters a medical conversation.

As an orthopedic surgeon, I regularly see patients whose pain has changed what they can comfortably do, leading them to give up hobbies, shift roles at work, or avoid events they used to look forward to. New research suggests that many people are navigating these challenges without telling others about their pain, which means those around them may not even know they’re struggling.

The Pressure to Push Through Pain

The Standing Strong: The Impact of Pain on America’s Workforce survey, launched by Pacira BioSciences, Inc. and conducted by Wakefield Research, surveyed 1,000 full-time U.S. adults who spend most of their workday on their feet. Respondents were asked about orthopedic pain related to movement or strain in their joints or muscles. Among those surveyed, 85% said they experience pain at work at least sometimes, and 88% said they typically push through pain without asking for help.

To me, the most concerning finding is not only that pain is common, but that so many workers are carrying it privately: 81% said they have experienced pain at work and chose not to tell a supervisor, manager, or colleague. Some worried that speaking up could affect their hours, role, or job security (41%), while others did not want to appear weak or unfit for work (39%). These responses suggest that pain is not just a clinical issue. It can be shaped by workplace culture, economic pressure, and the belief that asking for help may come at a cost.

I see a similar tendency in my practice. Patients often wait longer than they should before bringing up their pain. By the time we talk, many have already changed how they move, work, or spend time with family without realizing how much the pain has taken over.

Knee Pain Takes the Greatest Toll

Knees were the most commonly affected area among workers surveyed, with 74% reporting knee pain and 56% reporting chronic knee pain, lasting three months or longer. One of the leading causes of chronic knee pain is osteoarthritis (OA) – a progressive joint disease that can cause pain, stiffness, and reduced mobility – affecting nearly 15 million Americans. Unlike many injuries that may heal over time, OA can progress gradually.

The burden may become more significant as workers age. Among survey respondents aged 45 years and older, 28% reported chronic knee pain, underscoring how persistent knee pain can affect workers later in their careers. The impact may also extend beyond work, with 66% of total respondents saying it negatively affected their social lives and personal relationships.

This is something I encourage patients to consider when discussing their symptoms. Knee pain isn’t only about whether you can make it through the workday – it’s also about being able to stay active and engaged in the parts of life that matter.

Addressing Pain Before It Takes Over

Many patients think their pain isn’t bad enough to mention, or they worry that speaking up means giving up activities they enjoy. Neither is usually true, as there are more treatment options than most patients realize.

Managing knee osteoarthritis should be an individualized approach, tailored to each patient. Among surveyed workers with chronic knee pain, 63% used over-the-counter medications, 43% had physical therapy, and 24% used prescription opioids. Yet, 98% said they would consider a long-lasting, non-opioid treatment option if it provided meaningful relief.

For appropriate patients with knee OA, one non-opioid option I discuss is ZILRETTA® (triamcinolone acetonide extended-release injectable suspension), a single-injection, extended-release corticosteroid designed to relieve knee OA pain for up to three months. ZILRETTA is the first and only FDA-approved treatment for knee OA that uses extended-release microsphere technology to slowly release medication into the knee joint.

In my practice, I’ve been using ZILRETTA for patients with knee OA for many years. Some of my patients receive ZILRETTA because surgery isn’t the right option for them, while others use it to manage their symptoms until they become candidates for surgery. Having a range of treatment options allows us to tailor care around both pain relief and a patient’s goals, whether that means working, staying active, or participating more fully in daily life.

If knee pain is changing how you work, move, or live your life, talk to your health care provider about your symptoms and what treatment options might be right for you. Learn more about the Standing Strong survey findings here.

*Dr. Bezwada is a consultant of Pacira BioSciences, Inc., manufacturer of ZILRETTA. This is based on Dr. Bezwada’s experience. Individual patient experience may vary.

 

INDICATION AND IMPORTANT RISK INFORMATION

What is ZILRETTA?

ZILRETTA® (triamcinolone acetonide extended-release injectable suspension) is an extended-release corticosteroid approved to manage osteoarthritis knee pain. The benefits and risks of repeat injections have not been demonstrated.

Who should not receive ZILRETTA?

You should not receive a ZILRETTA injection if you are allergic to corticosteroids, triamcinolone acetonide, or any other component of the product.

What possible side effects of corticosteroids could occur with ZILRETTA?

• Rare serious allergic reactions
• Effects in the injected knee such as infection (with pain, swelling and restricted motion) or joint damage
• Increased chance of getting an infection, and a decreased ability to fight an infection
• Effects on hormone production. These effects can be reversible
• Elevated blood pressure, sodium and water retention, and potassium loss
• Intestinal perforation if you have certain gastrointestinal disorders
• Weakening of bones
• Changes in behavior or mood disturbances
• Increased pressure inside the eye

What are the most common side effects of receiving a ZILRETTA injection?

In multiple clinical trials, the most common side effects seen in people taking ZILRETTA were joint pain, headache, joint swelling, back pain, sore throat and runny nose, upper respiratory tract infection, and bruising.

What should you tell your doctor BEFORE receiving a ZILRETTA injection?

Tell your doctor about all of the medications you are taking (including both prescription and over-the-counter medicines) and about any medical conditions, especially if you have high blood pressure, heart disease, ulcers, diverticulitis or other gastrointestinal disorders, kidney problems, diabetes, glaucoma, behavior or mood disorders, and/or infections.

What should you tell your doctor AFTER receiving a ZILRETTA injection?

Contact your doctor if you develop a fever or other signs of infection, have an increase in pain along with swelling of the injected knee, restriction of joint motion, or a general feeling of discomfort. Contact your doctor immediately if you are exposed to chicken pox or measles, or for any new or worsening changes in behavior or mood.

These are not all of the possible side effects with ZILRETTA or corticosteroid medications. Please see the full Prescribing Information at www.ZILRETTALabel.com/PI.pdf. Always contact your doctor if you have questions or experience any side effects.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

 

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© 2026 Pacira Pharmaceuticals, Inc., a wholly owned subsidiary of Pacira BioSciences, Inc. ZILRETTA is a registered trademark of Pacira Pharmaceuticals, Inc., a wholly owned subsidiary of Pacira BioSciences, Inc. All rights reserved.

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