Women Working in Pain: Accommodating Fibromyalgia 

By Kathy Espinoza

Did you know that in 2025, approximately 2% of the adult population in the United States is estimated to have fibromyalgia?  This translates to around 4 million adults. It has a higher prevalence in women, particularly between the ages of 20 and 55.  Individuals with other rheumatic diseases or chronic pain conditions typically have an increased risk of developing fibromyalgia. 

According to the Center for Disease Control (CDC), fibromyalgia is a condition that causes pain all over the body, and can cause sleep problems, fatigue, and emotional and mental distress. People with fibromyalgia may be more sensitive to pain than people without fibromyalgia. Researchers at the Mayo Clinic believe that fibromyalgia amplifies painful sensations by affecting the way the brain processes pain signals.  

As an ergonomist, I have encountered more and more women performing their jobs in pain.  Women are much more likely to work in office, administrative and clerical environments. During the ergonomics evaluation, they disclose they have fibromyalgia.   The stories I hear from these women are heartbreaking.

“At first, I thought I was coming down with the flu. I ached all over. I would wake up in the middle of the night from the pain. I didn’t know what was wrong with me. I was so tired most days that I would be in bed by 6:00, but I couldn’t sleep. And I didn’t even have the strength to open my eyes and watch TV.  As a single working mom, I had 2 children to take care of.  But there I would be in bed, and my kids would sit on the edge of the bed and just look at me. I finally went to a rheumatologist and was diagnosed with Fibromyalgia.” – CP

Fibromyalgia can also be described as widespread muscle pain accompanied by fatigue, sleep, memory and mood issues.  Many women with fibromyalgia may also have tension headaches, irritable bowel syndrome, anxiety and depression. 

“I stooped down to open a file cabinet and couldn’t get back up. I saw a doctor, who sent me to see an orthopedist, who sent me to physical therapy. No one could figure out what was wrong, and I just got worse.  A friend said, “You know, you might have Fibromyalgia.” And I replied, “Oh, I know people with Fibro and I’m not that bad.” Well, it turns out I was.  There’s a stigma about Fibromyalgia. People are afraid it’s all in their head. But it’s not.” – VB

According to the CDC, the cause of fibromyalgia remains elusive, but there can be triggering events thought to precipitate its onset.  A few examples would be an infection (viral or bacterial), an automobile accident or the development of another disorder, such as rheumatoid arthritis, lupus, or hypothyroidism. These triggering events probably do not cause fibromyalgia, but rather, they may awaken an underlying problem.  While there is no cure for fibromyalgia, a variety of medications can help control symptoms, as well as a daily routine of exercise, relaxation and stress-reduction. 

“For me, it began when I had problems with my neck. My whole body just started aching. I probably saw 10 or 15 different doctors. Finally, I went to a rheumatologist and he said I had Fibromyalgia. It’s hard. Your life changes with Fibromyalgia. It just takes over your whole body. I’ve always been an independent person as far as doing my job, housework and yard work and I can no longer do that. You just can’t do the things you used to do. Everybody has a different way of dealing with the pain, with this illness. I’m just a very strong-willed person and I’m the type to just get up and go regardless of the pain. I just keep moving. I try to exercise, swim, and such. And I know when to sit down and rest.”- SG

Working with Fibromyalgia

Working a full-time job with fibromyalgia can be difficult, to say the least.  I often hear that what frustrates many women is that fibromyalgia is an ‘invisible’ illness, where afflicted women feel like the walking wounded.  They function, but with great difficulty.  On the outside they look good, but they function on extremely low energy reserves and in constant pain that migrates around the entire body.  Most want others to know that even though they’re functioning, they are doing so at low capacity, and everything they do is twice as hard as it is for others, and three times as hard as it was before they became sick.

For women working in an office environment, the working postures and movements dictate how well they function daily.   If the workplace is set up with ergonomic interventions in place, it can reduce some of the pain and spasms that can ruin the day.  For example, if an office worker’s monitor is too far back on the desktop, it can lead to the worker leaning forward from the waist in order to see the monitor screen, which can debilitate the lower back muscles causing spasms.

If you are a working woman with fibromyalgia syndrome (FMS), it is important to know that there are ways to accommodate you.  I recommend openly discussing fibromyalgia with your supervisor and coworkers.  Talking about the symptoms of pain, fatigue, and stiffness can help coworkers understand why you may have good days and bad days from this “invisible” illness.  

Here are a few accommodations for women working with limitations from fibromyalgia, provided by the Job Accommodation Network (JAN) (jan@askjan.org).  This is a free service from the Department of Labor’s Office of Disability Employment.  For a more in-depth discussion, access JAN’s publications at http://AskJAN.org/media/atoz.htm.  

The following suggestions can be a good start in the interactive process with your supervisor.  Together, you can find a successful accommodation that helps you work without fibromyalgia pain.

Concentration Issues:

• Get written job instructions when possible 
• Prioritize job assignments 
• Ask for flexible work hours 
• Use memory aids such as schedulers or organizers 

Fatigue/Weakness:

• Identify, reduce or eliminate excessive physical exertion 
• Take advantage of work breaks, away from the workstation
• Consider asking to work from home on bad days
• Ask for an ergonomic evaluation to set up your workstation properly

Headaches:

• Eliminate fluorescent lighting
• Use task lighting
• Use computer monitor glare guards
• Ask management for a “fragrance-free” workplace policy
• Place an air purification device in your office

Here are a few accommodations from some of my ergonomics evaluations done for women working in pain from fibromyalgia.

Case 1:  An administrative assistant with fibromyalgia working for a utility company reported neck pain and upper body fatigue. Her duties included typing, answering the telephone, and taking written messages.  She was accommodated with a telephone headset to reduce neck pain and eliminate the repetitive motion of lifting the telephone from the cradle, a portable angled writing surface and writing aids to take written messages, a copy holder to secure documents, and forearm supports to use when typing.

Case 2:  A nurse with fibromyalgia working in a county health clinic experienced a great deal of fatigue and pain at work.  The nurse typically worked evening shifts but her doctor recommended a schedule change so she could regulate her sleep patterns.  Accommodation suggestions included changing her shift from evening to day and restructuring the work schedule to eliminate working two consecutive twelve-hour shifts.

Case 3:  A guidance counselor for a large high school experienced severe bouts of irritable bowel syndrome, depression, and fatigue as a result of fibromyalgia.  She experienced difficulty in opening the heavy doors to the entrance of the school and had to make frequent trips to the bathroom.  The employer moved her office to a location closer to the restroom and added an automatic entry system to the main doors.

Case 4:  An individual employed as a patient rights advocate had carpal tunnel syndrome and fibromyalgia. She had difficulty keyboarding, writing, and transporting supplies to presentations.  The employer installed speech recognition software for word processing, provided her with writing aids, and gave her a lightweight portable cart to assist with transporting materials.

Accommodations can be as simple as taking a break to stretch, move around the room, get some fresh air, have a drink of water, adding a fan or heater to the office or moving your office to a quieter part of the building.  As mornings tend to be the toughest time of day for fibromyalgia sufferers, perhaps you can ask for a flexible start time.  Getting a parking space closer to the office or having a modified door-assist mechanism installed can limit fatigue before the day starts.  This will allow you more energy for the workday. 

My pain and fatigue started after a traumatic experience. My life literally changed in every way. It’s hard for me to even put into words what that was like. I can’t even guess how many doctors I saw. I was in flares more often than I wasn’t. It was pretty devastating. Doctors thought I might have chronic fatigue syndrome or depression. In 2020, I decided to see a rheumatologist. After giving me a pressure point exam, he said, “T, you have Fibromyalgia.”  Altogether, it took 25 years for me to get diagnosed. I have learned to work hard at managing my Fibromyalgia. My life is such now that I accept my diagnosis and am at peace with the situation. So, it’s pretty nice, pretty wonderful.     – TH