‘A little bit of support really, that's all I was looking for’ a qualitative study of the biographical disruption of fibromyalgia at work in the UK

Fibromyalgia is a chronic condition which can have a detrimental impact on a person’s interaction with work. Biographical disruption is a lens through which people’s experiences of many chronic conditions have been described. We applied this lens to experiences of work amongst people with fibromyalgia to better understand what support they required to continue to work. We conducted semi-structured interviews in 2019/20 with 31 people who have fibromyalgia. Data were analysed using reflexive thematic analysis. In our study people often experienced fibromyalgia at work as a biographical disruption which can include a non-specific decline in work ability. Diagnosis of fibromyalgia and/or the symptoms becoming less compatible with their job role can further disrupt, creating additional challenges as managing a chronic, often invisible condition conflicts with workplace systems such as sickness absence policies. As the person responds to the disruption, they may feel they either need to move on from their current role or continue with appropriate modifications/support. An overarching theme indicates declining self-esteem because of disruption to working lives. Biographical disruption experienced by workers with fibromyalgia can be mitigated or repaired, however even if resolved it does not follow that work outcomes are positive. Disruptions may be more fully repaired if people with fibromyalgia are able to access support earlier to remain in work. Employers should consider the impact of fibromyalgia and how its fluctuating and contested nature can conflict with workplace systems. Early, symptom-focused work support is essential to help people with fibromyalgia stay in work and navigate challenges. • Workers with fibromyalgia experience biographical disruption in working lives • The impact of fibromyalgia on work often occurs early, long before diagnosis • Workers with fibromyalgia often experience a loss of self-esteem. • Workplaces can mitigate or repair the disruption, but this is not always happening. • People with fibromyalgia require early access to support to remain in work.