Chronic pain affects millions of workers and can have consequences that extend well beyond discomfort. For people experiencing pain for more than three months, it can affect concentration, physical capacity, work ability, productivity and the ability to recover from the demands of the working day.
Research led by Behavioural Medicine Professor Holly Blake from the University of Nottingham has highlighted the significant impact chronic pain can have on working life – and the role workplaces can play in supporting workers to manage it.
The study surveyed more than 300 workers with chronic pain from 18 organisations across a range of sectors in England, with data collected between 2023 and 2024. Participants identified 383 health conditions they believed contributed to their pain, including musculoskeletal, migraine, gynaecological and autoimmune conditions, as well as mental health issues.
Almost half of participants (46.4 per cent) reported work productivity loss, averaging 2.2 hours a week. Presenteeism – attending work while unwell – was reported by 44.3 per cent. Participants also reported reduced work ability and difficulties with everyday activities and physical work demands.
Greater pain severity was associated with greater impairment, presenteeism and productivity loss. This highlights an important workplace safety consideration: being at work does not necessarily mean a person is able to work safely and effectively.
Depending on the job, pain may make physical tasks, concentration or ordinary work activities more difficult. It can also affect how well someone is able to recover between shifts.
The researchers found no significant relationship between self-reported pain severity and night work, overtime, work-related travel or driving. However, they identified hybrid working as a potentially useful workplace control. Workers in hybrid arrangements reported lower pain severity, lower presenteeism and lower productivity loss.
The researchers suggest employers consider hybrid working where it is feasible, while recognising that this will not be practical for every role. Other forms of flexibility, including changes to work organisation or, where appropriate, remote working, may provide alternatives.
They also caution that hybrid arrangements need to be managed inclusively so they do not create stigma, isolation or unequal access to workplace resources.
How employers can build support into the workplace
The research also points to a broader issue: employers may not always recognise the prevalence or impact of chronic pain. The researchers say a lack of awareness can be a barrier to implementing supportive measures.
Line managers' awareness and understanding of pain conditions "were perceived to vary significantly, which put access to support down to luck", the researchers said. This is important because employees should not have to rely on individual managers’ personal understanding or experience of chronic pain to receive appropriate support.
Instead, workplaces can build awareness and support into existing systems and processes. Managers should understand how to respond when an employee raises concerns, what support is available and when work arrangements or tasks may need to be reviewed, and be ready to consult with workers and their HSRs about what adjustments or workplace support may help.
Support should also recognise that chronic pain affects people differently. What helps one worker may not be appropriate for another, making consultation and tailored solutions important.
What can HSRs do?
HSRs can help ensure chronic pain is considered as part of normal discussion and consultation around health and safety.
This can include listening to workers' concerns about pain, workload, physical demands and how work is organised; identifying recurring issues that may indicate broader problems with work design; and raising those issues through consultation with the designated work group. Tools such as body mapping can also help identify tasks, equipment, rostering or other aspects of work that may contribute to or exacerbate existing pain.
Encouraging early conversations about possible changes to work arrangements or tasks can help prevent workers from simply trying to work through pain until their ability to work is affected.
Supporting workers with chronic pain is not simply about keeping people at work. It is about ensuring work can be performed safely, sustainably and effectively.
The study was cross-sectional and therefore cannot establish cause and effect. Nevertheless, its findings reinforce the importance of recognising chronic pain as a workplace issue that can affect work participation, wellbeing, safety and productivity.
Read more: Chronic pain and its relationship with work participation | Occupational Medicine | Oxford Academic