Staying at Work with Musculoskeletal Pain in a Physically Demanding Job: A Qualitative Exploration of Workers' and Managers' Perspectives.

Purpose: Staying at work despite recurrent or persistent musculoskeletal (MSK) pain offers mental and physical health benefits in addition to financial security for workers. This study explores worker and manager experiences and perspectives on stay-at-work practices to nuance our understanding of what drives successful or unsuccessful practices.

Methods: We conducted a vignette-based qualitative exploration of workplace practices of managers and workers from three medium-sized workplaces with physically demanding jobs. Data collection included five focus group interviews and two workshops. Data were analysed using reflexive thematic analysis inductively and deductively.

Results: We identified three themes relating to workplace cultures (Theme 1. Pain is an accepted part of working life), conflicting perceptions of responsibility in managing health impact on stay-at-work practices (Theme 2. Stay-at-work responsibilities and practices), and the importance of trusting communication and the precarious balance between support and pressure to stay at work within the workplace (Theme 3. En route to dismissal).

Conclusion: The identified themes describe helpful and unhelpful beliefs and practices involving individual workers, their co-workers and managers. Shared and unshared cultural norms, understandings of what MSK pain is and means, and perceptions of responsibility drive stay-at-work practices, with trust being an important factor for the precarious balance between workplace support and pressure to stay at work.