Presentation T O11

T O11 (Oral Presentation):
Struggling to negotiate work with chronic musculoskeletal pain - a synthesis of qualitative research

Presented by: Karen Louise Barker


Toye F1, Seers K2, Alcock N3, Briggs M4, Carr E5, Barker KL1,6

  1. 1 Physiotherapy Research Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, UK
  2. 2 RCN Research Institute, University of Warwick, Coventry, UK
  3. 3 Glasgow Caledonian University, glasgow, UK
  4. 4 Leeds Metropolitan University, leeds, Uk
  5. 5 Faculty of Nursing, University of Calgary, Canada
  6. 6 Nuffield Department of orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK



People in chronic pain are seven times more likely to give up their jobs, are more likely to report poor general health and have mental health well being scores comparable with the lowest 10% in a pain free population . Many days of work are lost because of musculoskeletal pain and many do not return to work. Our aim was to review and integrate the findings of qualitative research in order to increase our understanding of the complex process of biographical reconstruction at work in the face of chronic pain. Importantly, although there is good evidence that work facilitates recovery, there is an is an inherent tension between the benefits of a timely return to work and the barriers. Qualitative research can help us to understand the complexity of social situations and how patients negotiate such complex tensions.


We used meta-ethnography to explore the relationship between work and chronic musculoskeletal pain. We included reports of qualitative studies that explored adults’ own experience of chronic pain. We searched five electronic bibliographic databases, supplemented by citation tracking and hand-searching. We used meta-ethnography to synthesis our findings. Central to meta-ethnography is identifying ‘concepts’ and developing a conceptual model. Three team members read each paper to identify concepts. Concepts were compared and organised into categories and a conceptual model developed.


We screened 24,992 titles, 676 abstracts and 321 full texts of potentially relevant studies. Nineteen papers reporting 15 qualitative studies related to experience at work. We synthesised the key concepts to develop a model of the experience of work with chronic musculoskeletal pain. Our findings incorporate the following categories: [1] struggling to affirm myself as a good worker; [2] balancing life and work in the face of unpredictable symptoms; [3] my work colleagues don’t believe that I am in pain;[4] the system does not facilitate return to work; [5] the battle for legitimacy.


Our innovation is to present an internationally relevant model based on a conceptual synthesis. This model highlights the adversarial work experience of people with chronic MSK pain and suggests that systems in place to benefit those with chronic pain can actually impair return to work.

Schedule Details

Tuesday September 30
10:45 - 12:15 Morning Concurrent Sessions (T O1 - T O12 and Seminar 4)
Session: Work disability in ageing workers
Room A