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Advice for Managers


Workplace Barriers

An employee with chronic pain and fatigue may experience the following workplace challenges and barriers:

  • Reduced ability to perform physical tasks and inability to perform certain tasks, such as driving or operating heavy machinery.
  • Difficulty completing tasks that require memory and concentration.
  • Difficulty travelling to and from the workplace.
  • Need for more frequent breaks.
  • There may be times when the employee may have to take time off work or work from home due to their symptoms, or they may benefit from temporary additional adjustments.

Workplace Adjustments

The symptoms, triggers and severity of chronic pain and fatigue will vary for each individual. Any proposed workplace adjustments to address barriers in the workplace should be discussed and agreed with the employee. Many employees will already be very proactive in managing their condition and may require few adjustments. Consulting with other departments and services (such as HR, Occupational Health, Estates, Health and Safety, Staff Counselling, IT) can help managers decide what adjustments to consider putting in place. The information on the following webpages provides further details about relevant departments, services ,  external organisations and funding available:


The following are examples of the types of adjustments to consider:

  • A workstation assessment can reduce unnecessary pain, stiffness, and fatigue by ensuring an ideal ergonomic posture and regular position change. Furniture such as a standing desk or an ergonomic chair may be helpful, as well as equipment such as an ergonomic mouse, keyboard or laptop stand.
  • Assistive software and technology. For example, dictation software to reduce pain and fatigue caused by typing.
  • Pacing and regular breaks can be very helpful in reducing fatigue.
  • Time allowances and private space to carry out any exercises or relaxation techniques that can help with symptom management.
  • Flexibility of working times and location can allow individuals to pace themselves and manage fluctuating symptoms. If a person typically experiences significant fatigue in the morning, a later start time may be helpful. Working from home, especially on days when symptoms are worse, can also be beneficial in promoting recovery. Be flexible with start / finish times and workloads. If it would be helpful for the individual, allow them to work from home wherever possible.
  • If excessive physical activity triggers symptoms, then adjustments to allow for the pacing of physical exertion and recovery time may be needed. Be considerate when planning meetings and events. Have regular breaks and time for people to move around, get some fresh air, use the bathroom, and time to drink or eat.
  • People with chronic pain and fatigue may require time off work to attend appointments related to their condition. For example, routine check-ups or treatment appointments.
  • Managers should support employees with time off work which is due to the severity of their symptoms. A transitional return to work plan with phased duties will often be helpful.
  • Any support and adjustments in place should be reviewed regularly. It would be good practice to periodically ask the employee how they are, particularly if you know they may be struggling or have symptoms which fluctuate. Be proactive about contacting employees and providing opportunities for them to tell you about the support they may need. A compassionate “how are things going at the moment?” can really help.

Sensitivity and Understanding

  • An empathetic and non-judgemental approach is essential. Avoid pity, as this can be patronising.
  • Offering reassurance to colleagues with chronic pain and fatigue can be really helpful. Guilt is often experienced by those with these illnesses, worrying that they are not doing well enough/are not producing enough/are not good enough. Reminders of what they are achieving despite the difficulties may be welcomed.
  • Let the individual decide what they can and cannot do, as they will know their condition better than anyone. What works for one person does not necessarily work for everyone.
  • Do not make assumptions about the symptoms an individual may be experiencing and do not assume that their appearance is an accurate indication of how they are feeling. Someone with chronic pain and fatigue may look well even when they are experiencing difficult symptoms or having a challenging day.
  • Be careful with language when providing suggestions and advice to someone about how to manage their own symptoms. Avoid phrases such as “I know exactly what you mean – I’m exhausted” as this can seem as though you are diminishing their lived experience.
  • Research the condition if you are not familiar with it, but remember that everyone’s lived experience is unique so do not make assumptions about what someone can or cannot do, or how they may be feeling. Even if you know someone else with the same condition, remember that these illnesses and conditions often affect people very differently and can vary in terms of severity.
  • The “Spoons Theory” provides a useful metaphor for what it can be like to live with chronic pain and/or fatigue.