The Smart Patient's Guide to
Managing Pain in the Workplace

How to Communicate Invisible Pain to Colleagues

You’re diligent and dedicated on the job, but chronic pain makes getting through the workday difficult. And since your aches and pains are invisible to your supervisor and co-workers, you may wonder what they think when you leave early for a doctor’s appointment, ask to work from home, or need to take a break. Perhaps you’re concerned that you’re perceived as unproductive or uncooperative at work, or that you’ll never get promoted.

You’re not alone. Many people living with chronic pain conditions feel that their pain impacts their career potential. In fact, approximately 7 out of 10 migraine sufferers say they have been less productive at work due to their intolerable headaches, according to a 2017 National Headache Foundation survey. Additionally, more than half of migraine sufferers (55%) say their headaches have negatively affected their career goals, and more than one-third (39%) say they have missed out on job opportunities.

“The impact that pain can have on someone’s career is a big problem,” says Timothy R. Smith, MD, RPh, vice president of the National Headache Foundation. “Over half of the people in the survey felt their goals were impacted. And many of these are people who are in their prime of working, from their 20s to their 40s.”

As chronic pain warriors know, experiencing pain in the workplace goes beyond migraines—there are many chronic illnesses that can take a toll. While holding down a job can be a challenge for those who suffer from chronic pain, there are ways to cope with the stress of handling your duties despite your discomfort. You can also devise a strategy for communicating with your manager and colleagues, and even reduce your pain by putting certain techniques into place. Help is out there—you just need to ask—and remember, you’re not alone. Some 100 million people in the US suffer from chronic pain.

Ignoring the Pain is not an Option

“Most people in chronic pain want to get back to work and are trying to figure out how they feed their family and meet their financial requirements in addition to working,” says Kevin Zacharoff, MD, FACIP, FACPE, FAAP, in the Preventive Medicine Division of SUNY Stonybrook School of Medicine in New York. “It can be very stressful.”

Attempting to ignore your pain at work, however, is not a good solution, he says. “Trying to be a good soldier doesn’t really help anyone at the end of the day. If your productivity has gone way down, people see this without knowing all the facts and when performance assessments come up, they will get dinged when in fact, they should not be.”

While many people think of chronic pain as something that leads to absenteeism, “presenteeism” is actually a larger problem, Zacharoff explains. “Presenteeism is coming to work but not being able to do your regular level of work,” he says. “For instance, a person with a migraine headache can be present at work but can’t work at full throttle. Others can’t see that the person has a migraine. It just looks like the person is malingering.”

“Work can be therapeutic,” says Gerald M. Aronoff, MD, medical director of Carolina Pain Associates in North Carolina, past president of the American Academy of Pain Medicine and author of Medication Management of Chronic Pain: What You Need to Know.  “A career can serve as a distraction from pain for many people,” adds Aronoff.

And while it is challenging to work when you have chronic pain, but for most people, holding down a job is a good thing in the long run, adds Smith. “Patients with chronic pain syndromes have much to offer to the workplace,” he says. “And many are very accomplished and talented workers.”

Understand Your Privacy Rights

Legally, an employee living with a chronic pain condition is not bound to share the facts and details of their condition with co-workers as this information is protected under the Americans with Disabilities Act, explains Curtis W. Reisinger, PhD, corporate director of Northwell Health’s Employee and Family Assistance Program and an assistant professor of psychiatry at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell in New York.

Since some managers may not be familiar with the Americans with Disabilities Act, you may be better off going straight to your HR department. “Pain is a bonafide disability, especially if you are being treated for it,” Reisinger says. Any information communicated between you and your HR department or supervisor is considered private under the act so you should not have to worry about your personal details floating around the office.

If your employer questions whether you have a particular condition, your doctor may need to submit a carefully worded note. Some companies use an external agency that functions as an intermediary to protect a person’s privacy and to make sure the person is actually ill or in pain, Reisinger explains. “These intermediaries may talk to your doctor directly,” he says.

As for letting your co-workers know, you don’t have to. “But if you have a co-worker who you feel close to, you may feel compelled to tell her your story,” Zacharoff says. It is up to you if you decide to share the details of your condition with the individuals in your office.

If you do decide to share, Reisinger suggests that you be honest without sounding entitled, especially as some officemates may need to fill in for you on certain occasions. “You may simply want to say to your co-workers, I have a condition that causes me a lot of pain.”

Communicate Effectively

If you would like to request some accommodations, such as time off for doctors visits that may go beyond the typical number of annual checkups, or an ergnomically correct chair, it’s key that you communicate your needs to your supervisor, or to your human resources department, he says.

This conversation may not be easy. “The whole idea of having to prove to people that this invisible condition exists can be really draining and depressing, and can result in diminished self-esteem,” Zacharoff says. “But communicating with the right level of discretion to the appropriate people can be very beneficial to the person suffering from pain.”

When you speak to your supervisor or HR director, maintain a positive tone of voice, Zacharoff advises. “Being defensive and negativistic is not advisable. Be cooperative. If you work in a supervisory capacity, suggest to your manager others whom you think can lead in your absence.”

Speak in a non-demanding way, advises Gerald M. Aronoff, MD, medical director of Carolina Pain Associates in North Carolina and a past president of the American Academy of Pain Medicine.

Start with Small Requests

“Recognize that the employer does need to have some work done,” advises Aronoff. “If you feel that you can do the work with some minor accommodations, suggest them.” For example, if your arthritis is worst in the morning and it’s difficult to move around during that time, ask if you could come in at 9:30 am rather than 8:30 am and leave at 5:30 pm rather than 4:30 pm. If you need to make frequent trips to the bathroom, ask if your workstation could be located near a bathroom, Aronoff suggests.

Adds Smith, “If light and noise can make headache pain worse, for instance, then you may need to dim the lights in your area and protect yourself from certain sounds and smells or whatever it is in your sensory nervous system that can negatively impact your performance.”

If you are asking for specific accommodations, expect to be asked to produce proof of your diagnosis from your healthcare provider, Zacharoff adds.

Try Little Tricks to Help Yourself

Keep in mind that there are things you can do to help yourself that don’t require asking for anything special. “People are surprised at the things that are open to them that don’t require any direct communication with your manager or HR,” Zacharoff says. “For instance, you can use your lunch hour to walk around and get some exercise because it will make you feel better,” he says. Consider enjoying a healthy snack and spending the remainder of your break time walking or stretching, he says.

If your job is such that you are sitting at a desk for several hours at a time, take a work break every hour or so, advises Smith. “Get up and move around, even if it is just to go to the copy machine.”

Consider counseling with a psychologist who practices behavioral medicine or a clinical health psychologist, Reisinger says. Finding someone who truly understands chronic pain may be better than a clinician who treats everything from kids to geriatric patients. “Counseling has evolved from the commiseration, sympathy, and going through your past to actually giving you specific techniques on how to manage pain.” So, find a counselor who will offer evidence-based treatments to reduce pain. “Evidence-based means that there is published literature that people get better and their functioning gets better,” Reisinger explains.

You might also check out any Employee Assistance programs that your company may offer; these may include counseling.


Helpful Resources

Chronic pain does not mean the end of your work-life. Check out how one woman used condition to launch a new career. In additon, the following resources may be useful.

The Job Accommodation Network (JAN) offers free, confidential guidance on workplace accommodations and disability employment issues. JAN is one of several services provided by the US Department of Labor's Office of Disability Employment Policy

Frequently asked questions regarding the Americans with Disabilities Act, from the Civil Rights Division of the US Department of Justice, posts answers to questions such as “Who must comply with the ADA?” and “Where can you call to ask questions about the ADA?”

The Disability Legal Rights Center, the oldest disability advocacy program in the country, provides free legal assistance to people with disabilities who are experiencing discrimination in violation of their civil rights. You can ask related questions on their website.

Updated on: 06/17/20
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