Chronic Pain & Work: Managing Job Demands When Your Body Won’t Cooperate

You sit at your desk and the pain flares. You have three more hours to go.

You call in sick again. You know your boss is frustrated. You're frustrated too.

You used to be the reliable one. Now you're the one who can't keep up.

Living with chronic pain affects every part of your life. And work might be one of the hardest parts to navigate.

You need the income. You want to contribute. But your body isn't cooperating.

Chronic pain therapy can help with many aspects of managing work with pain. Including strategies for bad days and how to ask for what you need without shame.

How does chronic pain affect work performance and attendance?

Chronic pain makes everything at work harder. Not because you're not trying. But because pain takes up mental and physical energy you need for your job.

Focus becomes difficult. When you're managing pain, part of your brain is always attending to it. That leaves less bandwidth for work tasks.

You might read the same email three times before it sinks in. Or forget what someone just told you. Or make mistakes you wouldn't normally make.

This isn't about intelligence or capability. It's about cognitive load. Pain uses up cognitive resources.

Physical tasks become challenging too. Even desk work requires stamina. Sitting for hours. Typing. Looking at a screen. All of these can trigger or worsen pain.

And when pain flares, attendance suffers. You have to call in sick. Or leave early. Or work from home when that's possible.

This creates a pattern you hate. You're unreliable. You're letting people down. You're not the employee you used to be.

The guilt compounds. You feel guilty for missing work. Guilty for not performing at your usual level. Guilty for needing accommodation.

And underneath the guilt is fear. Fear that you'll lose your job. Fear that you can't support yourself or your family. Fear that chronic pain will take this from you too.

These concerns are real. And they deserve attention.

What are micro-wins when working with pain flares?

When pain flares at work, your instinct might be to push through. To ignore it and keep going.

But pushing through often backfires. It makes the pain worse. And it uses up reserves you'll need later.

Micro-wins are a different approach. They're small adjustments that add up.

Micro-win: Take a two-minute break. Stand up. Stretch. Look away from your screen. This tiny reset can help more than you'd think.

Micro-win: Adjust your position. Change how you're sitting. Put your feet up. Use a cushion. Small postural changes reduce strain.

Micro-win: Do the easiest task first. When pain is high, start with something simple. Build momentum with small completions.

Micro-win: Ask for one small accommodation. Can you take this call sitting instead of standing? Can you reschedule that meeting by an hour? One small change helps.

Micro-win: Communicate proactively. "I'm dealing with a pain flare. I can finish this but it might take me a bit longer." Setting expectations prevents stress.

Micro-win: Leave on time. Don't stay late to "make up" for working slower. Rest is productive. It helps you show up better tomorrow.

These wins seem small. But they prevent the cycle where pain causes stress, stress makes pain worse, and everything spirals.

Working with pain flares instead of against them means noticing when pain is high and adjusting accordingly. Not giving up. Just adapting.

How do I ask for workplace accommodations without shame?

Asking for accommodations feels vulnerable. Like you're admitting you can't do your job.

But accommodations aren't about weakness. They're about setting yourself up to succeed.

Here's how to ask:

Be specific about what you need. Vague requests are hard to grant. "I need flexibility" is less effective than "I need to work from home two days a week."

Frame it as performance-focused. "I can do my best work if I have a standing desk option" or "I'll be able to meet deadlines more consistently if I can adjust my start time."

Know your rights. Under the ADA, employers must provide reasonable accommodations for disabilities. Chronic pain can qualify. You're not asking for a favor. You're asking for what you're entitled to.

Put it in writing. Email your request. This creates a record. And it gives you time to craft your message carefully.

Don't apologize excessively. "I need to request an accommodation for my chronic pain condition" is better than "I'm so sorry to be a burden but I was wondering if maybe..."

Expect negotiation. Your employer might not grant exactly what you ask for. But they should work with you to find something that helps.

If you're not sure how to navigate this conversation, we've written a guide about how to speak up about chronic pain that includes more detailed strategies for workplace discussions.

The shame you feel about needing accommodation is understandable. Our culture values independence and "toughness." But needing support isn't weakness. It's reality.

And employers who can't accommodate basic needs aren't employers you can thrive with long-term.

When does chronic pain lead to job changes or career shifts?

Sometimes accommodations aren't enough. Sometimes the job itself isn't compatible with chronic pain.

This is a huge loss. And it deserves to be treated as such.

You might need to reduce your hours. Go from full-time to part-time. That means less income. Less professional identity. Less structure to your days.

You might need to change roles. Move to something less physically demanding. Or with more flexibility. Even if it's not what you want.

You might need to leave your career entirely. Retrain for something else. Or stop working altogether.

All of these changes are grief. The career you built. The trajectory you were on. The professional identity that mattered to you.

People might not understand. They might think you're giving up. Or being dramatic. Or not trying hard enough.

But you know the truth. You're making impossible decisions with limited options.

This is part of what therapy helps with. The grief of losing work. The identity shift. The financial stress. The fear about the future.

Therapy also helps you figure out what's still possible. What kind of work might fit your current reality. What gives you meaning when traditional employment isn't an option.

Talking to family and friends about these career changes can be especially hard. They want you to be okay. And you don't want to burden them with your struggle.

But isolation makes everything harder.

How can therapy support work-related pain challenges?

Therapy helps with work and chronic pain in several ways.

First, it helps you manage the stress that makes pain worse. Work stress is constant for most people. When you have chronic pain, that stress amplifies everything.

Therapy gives you tools to regulate your nervous system even in stressful work environments.

Second, therapy helps with the emotional toll. The guilt about missing work. The fear about losing your job. The grief about who you used to be professionally.

These emotions are real. And they affect how you show up at work.

Third, therapy helps you communicate. About accommodations. About bad days. About what you can and can't commit to.

Communication at work is different than communication with family or friends. The stakes are different. The power dynamics are different.

Therapy helps you navigate those differences.

Fourth, therapy addresses the parts of you that conflict about work. The part that wants to push through. The part that knows you need rest. The part that's terrified of being seen as weak.

When these parts are fighting each other, decision-making gets harder. Therapy helps them work together.

And finally, therapy helps you grieve career changes if they become necessary. And helps you rebuild identity and purpose when work changes.

This isn't about making pain go away so you can work more. It's about figuring out how to work in ways that don't make everything worse.

Finding support for work challenges in Lee's Summit or Missouri

If chronic pain is affecting your work life, you don't have to navigate it alone.

At Aspire Counseling, we help people throughout Missouri manage the complex intersection of chronic pain and work. We offer therapy both in person at our Lee's Summit office and through telehealth.

We understand the guilt, the fear, and the grief that come with these challenges. And we have tools that can help.

You can reach out online or call us at (573) 328-2288. We'll talk about what's going on and how therapy might help.

Work with chronic pain is hard. But you're not failing. You're dealing with something genuinely difficult. And there are ways to make it more manageable.

Related reading:

• Living With Chronic Pain: Therapy for the Emotional Toll and Daily Challenges

• How to Talk to Family and Friends About Your Chronic Pain (Without Feeling Dismissed)

• How to Speak Up About Chronic Pain—Even When You Feel Doubt or Shame

About the Author: This post was written by Jessica (Tappana) Oliver, LCSW, founder of Aspire Counseling. Years ago, Jessica worked with many clients who felt like they were failing at work because of chronic pain—watching capable people grieve the loss of careers they'd built and identities they valued. These days, she focuses her clinical work on offering trauma therapy intensives at Aspire, but she remains passionate about helping people navigate the impossible choices chronic pain creates around work. After countless conversations with Adam White, LPC, one of Aspire's chronic pain specialists, she's convinced he's the go-to expert in the Kansas City metro area for treating chronic pain through therapy. This post reflects Adam's clinical wisdom about micro-wins and working with all the parts that show up around work—including the part that's terrified of losing everything. Adam practices at our Lee's Summit, Missouri location and also offers online therapy throughout Missouri.