Image by Getty Images Workplace expectations around performance can push people with chronic pain into a cycle of overexertion and decline, according to a new study co-authored by Manning School of Business Associate Professor of Management Elana Feldman.
Many workplaces assume that employees can do things like sit, stand, type and stay focused for long stretches without physical limitation.
But for millions of workers living with chronic pain, that assumption doesn’t hold, and trying to meet it can make their condition worse. According to the Centers for Disease Control and Prevention, about one in four U.S. adults experience chronic pain (pain that lasts for at least three months), making it a significant and often overlooked workplace issue.
That tension is at the center of new research by Manning School of Business Associate Professor of Management Elana Feldman, who studies how people experience work and how organizational norms shape behavior. Feldman says her interest in the topic grew over time, guided in part by her own experiences and conversations with colleagues.
“I’ve struggled with different types of chronic pain, and it was something I talked about with others,” Feldman says. “We’d be standing in the back of a room because we couldn’t sit through a full day of meetings, and we kept saying, ‘We should really study this.’”
In a study published in the Academy of Management Journal, Feldman and her co-authors — Beth Schinoff of the University of Delaware, Kimberly Rocheville of Creighton University and Njoke Thomas of Boston College — conducted in-depth interviews with 66 workers across a wide range of professions.
They examined how workplace expectations around performance, and how employees physically show up to work, can push people with chronic pain into a cycle of overexertion and decline.
Associate Professor of Management Elana Feldman and her co-authors interviewed 66 workers across a wide range of professions for their research.
“We had to pause our data collection and rethink how to continue, but we did manage to make it work in the end,” Feldman says.
The research introduces the concept of the “ideal worker body” and explores how failing to meet that unspoken standard can affect both employee well-being and organizational performance.
Feldman spoke about the findings and what organizations can learn from them.
You write about the idea of an “ideal worker body.” What does that mean?
There’s a broader concept in management research called the ideal worker — the idea that employees should always be available and put work ahead of everything else. What hasn’t really been examined is what that means for the body. To meet those expectations, your body also has to always be on and ready. There are unspoken expectations about how you use your body and how your body looks at work. It’s not just about doing your job — it’s about appearing physically capable of doing it at all times.
Your research describes a cycle of pain and shame. What does that look like in practice?
For people with chronic pain, that expectation of an ideal worker body creates a cycle. Pain starts interfering with their ability to work, and then they feel ashamed that their bodies aren’t meeting those expectations. That shame pushes them to hide what they’re experiencing and push through anyway. They overexert themselves, which makes the pain worse, and then the cycle continues. What helps some people break out of that is validation. Chronic pain is often invisible, and people are told, “You look fine,” or “I get headaches too.” When a medical professional validates that their pain is real, it allows them to say, “I can’t live up to this ideal, and I need to find a different way to work.”
Why is this an organizational issue, not just a personal health issue?
People with chronic pain are already doing everything they can to manage it — doctor’s appointments, physical therapy, medication. But trying to seem like their bodies were ideal actually made their pain worse. They’re trying to fit into these narrow expectations, and over time, their bodies start breaking down. Eventually, their pain becomes intolerable, and they can’t function at work or outside of work. These are people who are good at their jobs, but organizations are losing them because they’re not being supported in the right ways. Some leave their jobs or even their careers. There was one person in our study who left a corporate path and went into goatherding because it allowed her to move around. If organizations could focus less on what people look like while they’re doing their work and more on whether the work is actually getting done, and have real conversations with employees about what they need, that would benefit everyone.
You also introduce the idea of a “sufficient worker body.” How is that different from lowering standards?
It’s not about lowering standards — it’s about accepting difference. It’s recognizing that my body is not the same as everybody else’s, and that’s OK. I can still be a very good worker, but I might need to do things differently. For example, I might stand during a meeting instead of sitting the whole time. That shift releases the pressure to fit a very narrow mold and allows people to find ways of working that are more sustainable.
What do organizations often get wrong when trying to accommodate employees with chronic pain?
A lot of organizations rely on one-size-fits-all solutions, like ergonomic chairs or sit-stand desks, but that didn’t work for the people in our study. Everyone’s body and pain experience is different, and it can change from day to day. What managers need to do is partner with employees to figure out what works for them. When people are given that flexibility, they often come up with creative ways of doing their work. We had a sonographer who taught herself to scan with both arms instead of one to reduce strain. A deli worker figured out how to use a cart so she didn’t have to lift heavy items. Others used dictation instead of typing. Those solutions can benefit other workers too.
What should managers and organizations take away from this research?
About one in four U.S. adults have chronic pain, and that number is rising, so this already affects a large portion of the workforce. But this isn’t just about chronic pain — it’s about the wide range of human bodies. The findings and practical takeaways can help far more people, including those with acute pain, different health conditions or different body sizes. It’s not a narrow set of conclusions. If organizations can get this right, they’ll be helping a much wider range of employees be effective at work and have more sustainable physical lives.