Living with chronic pain at work: Supportive managers can help, but they can’t solve everything

“I don’t want the pain to define me. I want me to define me.”

This was how one employee described working with chronic pain in interviews conducted in 2021 by one of us, Duygu Biricik Gulseren, and co-researcher Kevin Kelloway. The employee wanted colleagues to understand their experience without pain becoming the centre of every conversation.

For many workers living with chronic pain, disclosure is complicated. Some interviewees worried that revealing their pain would make them seem less capable or put their jobs at risk. Yet keeping it hidden can make it harder to explain why previously manageable tasks suddenly become difficult.

When pain persists or recurs for longer than three months, it’s generally considered chronic pain. Many people continue working while experiencing it, and may have chronic pain-related needs. As Duygu’s earlier work argues, understanding these needs requires looking at how employees experience their jobs and what they need to participate fully.

Our new research examines the role supervisors play in shaping that experience. The findings suggest supportive leadership may help employees’ psychological well-being, but this pathway weakens as pain becomes more intense.

Pain is not only about intensity

Two concepts are key to understanding our results. Pain intensity describes how much pain hurts, while pain interference describes how much pain disrupts activities. At work, interference can mean difficulty concentrating, completing physical tasks or interacting with others.

The distinction is important because working conditions can affect how the pain limits activities, even when its intensity changes little.

In Duygu’s earlier interviews mentioned above, employees described adjusting their pace, rescheduling meetings or changing tasks to reduce pain’s impact. But those options depended on how much control their jobs allowed.

The interviews also showed why standard solutions may miss the mark. Employees all have different needs, even when they have similar conditions. Sitting aggravated one person’s back pain, while standing was difficult for another. Understanding what helps requires listening to the person doing the job.

How supervisors affect experiences

For our recent study, we followed 195 full-time employees in the United Kingdom who were living with chronic pain. Participants worked in occupations ranging from nursing and construction to office management and information technology, and completed three surveys one month apart.

We asked about pain intensity, psychological well-being, pain interference at work and supervisors’ transformational leadership behaviours. This type of leadership includes taking employees’ needs seriously, expressing confidence in employees and encouraging them to approach problems in new ways.

Employees who reported more of these leadership behaviours tended to report better psychological well-being a month later. Better well-being, in turn, predicted less pain interference at the final survey. The analyses accounted for initial well-being and pain interference, as well as age.

However, this pattern depended on pain intensity. We found evidence of this pathway among employees reporting lower and average levels of pain intensity within our sample, but not higher intensity. That does not establish that leadership is unhelpful for people experiencing severe pain; it suggests this pathway has limits.

Supportive leadership has limits

We did not find evidence that supervisors’ leadership behaviours directly predicted less pain interference later, once psychological well-being and other factors in the model were taken into account.

Instead, the pattern we observed was indirect: supportive leadership was associated with better psychological well-being, which in turn predicted less interference from pain at work.

Because this was a survey study, it cannot establish cause and effect. Other working conditions, such as flexibility, could help explain the pattern. The findings therefore suggest a possible pathway through psychological well-being, rather than showing that managers’ actions directly reduce pain interference.

One possible explanation is that supportive relationships help people maintain the emotional resources needed to handle work alongside pain. When pain is more intense, those resources may be harder to sustain.

Support requires action

For managers, the findings highlight the importance of everyday interactions. Showing employees their contributions are important, taking their needs seriously and inviting ideas about problems can help sustain well-being while they manage pain.

However, these behaviours should accompany practical workplace support. An encouraging conversation cannot make an unsuitable workstation comfortable or create recovery time in a rigid schedule.

We recommend asking employees what would make their work more manageable. Depending on the job and person, this might involve adjusting tasks, hours, duties or equipment. Managers should revisit arrangements as needs change.

We also recommend responding to requests without judgment. An employee’s ability to complete a task one day should not become grounds for dismissing difficulties on another. Fluctuating needs call for ongoing conversations.

Flexibility also needs to extend beyond office jobs. Working from home is rarely an option on a construction site or hospital ward. Employers should consider adjusting tasks, staffing or breaks.

Organizations need to give supervisors the resources and authority to respond. Access to accommodations, leave and health benefits should be part of the broader response, including when needs exceed what a supervisor can address alone.

The goal should be to make work more manageable for people living with pain. Encouraging employees to feel positive while leaving avoidable barriers in place would miss that goal. Supportive leadership should be part of a workplace prepared to act on what employees need.