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Understanding Presenteeism:

Updated: Jul 20, 2022

Its emotional toll on employees, and direct cost to business.


More than 1 in 2 employees experience body pain, every week. Are you one of them? Maybe your coworker? Perhaps someone in your family struggles with aches, pains and tension regularly.

Think about how you’ve felt when you’re sore. Not just the pain, but the emotional impact. Were you frustrated? Were you distressed? Were you less patient with the family? Did you spend the whole day staring at your computer, constantly shifting positions to try and get comfortable?

Did you soothe the discomfort yourself, self-medicating with pain killers and an extra glass of wine, trying to soldier on?

If you answered yes to any of the above, then you’re not alone.

For this article, I went back through some of the scientific literature, looking for papers measuring the impact of presenteeism. It’s tricky, because measuring the cost of distracted workers is much harder than measuring the days a worker has been physically absent.

One of the earlier papers (from 2003¹) was trying to find ways to accurately record the cost to employers in the U.S.. The authors describe the problem succinctly:

“Many studies on the work-related impact of pain focus on lost time due to absenteeism; few have estimated the pain-related impact of reduced performance while at work. This limitation is important because increasing evidence indicates that reduced work performance due to pain, not absenteeism, is the dominant cause of lost productive time.”

While 2003 seems like a long time ago, in the context of research application, it’s actually fairly recent. Since then, more effort has gone into articulating the size of the problem. Deloitte’s 2019 Pain in Australia report puts the cost of lost productivity due to pain at $48B, each and every year. This equates to roughly $3,490 costs per employee per year… buuuut salaries aren’t exactly equal, so I wanted to dig a bit deeper.

One paper I found² paints a more direct picture. According to the authors, we can do some back of the envelope math and arrive at:

9.6 hours lost productivity due to pain, per employee, per month.

This is the average across each employee in your organisation, not just the ones with known issues. Whether you’ve got 10, 100, or 100,000 employees, it’s a lot of lost opportunity.


Pain and productivity: How different industries fair

Once upon a time, we thought of pain as being an industry issue. That physical jobs create more pain than sedentary jobs. The assumption was that while construction workers are struggling, office workers are fine. Well, studies suggest it’s not so clear cut. ³

While industries have wildly different claim rates, the actual presence of pain appears to be somewhat uniform. There are some obvious reasons for this, as well as some less obvious reasons that I will save for another article! Back to the task…

Just as we make assumptions about industry, we also make assumptions around age and pain… that pain and age go hand in hand. Again, it seems logical… but it may not be the case. ³

I will point out that a couple of studies I came across acknowledged that headaches were driving up pain stats for younger people (16-24). That said, over my 10 years running a clinic, I definitely noticed younger and younger people attending with sore backs and necks and knees. Perhaps we can blame phones and laptops… but that is the reality for all of us.


The incubation period

For many of us, we’ve accepted aches, pains and tension as a part of life. It’s easy to see why. We’ve rarely been taught about our bodies, so we struggle to self manage effectively. The alternative to doing nothing is to book an appointment. Appointments are expensive, they’re time consuming, and for many of us, aren't available for days or weeks. It’s no wonder 2/3rds⁴ of us try to ignore pain rather than deal with it.

It’s this period of inaction that I term the incubation period. Not sore enough to be off work, not bad enough to go to an appointment. It’s the period in which aches and pains go unaddressed, until they escalate, and suddenly we’re ready to book that appointment. It’s urgent.

This is the point that we click over from presenteeism, into absenteeism. Traditionally, employers think of this as being the start of the issue. That’s because it’s the first time they’re told about it - unaware that there were weeks or months prior in which they could have helped.

Pricing Prevention

As our understanding of this space matures, and as new technologies emerge, we’ll see more and more resources invested in addressing presenteeism.

The language around wellbeing and wellness budgets will start to shift, and the words prevention and presenteeism may well become synonymous. This will in turn make the ROI involved clearer, and give employers the confidence required to invest in health, not just recovery.

Happy moving, Matt

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¹ Stewart WF, Ricci JA, Chee E, Morganstein D, Lipton R. Lost Productive Time and Cost Due to Common Pain Conditions in the US Workforce. JAMA. 2003;290(18):2443–2454. doi:10.1001/jama.290.18.2443

² Chronic pain and reduced work effectiveness: The hidden cost to Australian employers. European Journal of Pain Volume 10, Issue 2, February 2006, Pages 161-166

³ GSK 2020 Global Pain Index Report Vol 4.

GSK 2017 Global Pain Index Report Vol 3.

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