Chronic Struggle: An Institutional Ethnography of Chronic Pain and Marginalization

The researchers used institutional ethnography to understand how individuals with chronic pain manage their condition alongside inequities that stem from marginalization. Narratives from 23 participants provided insights into the work of managing chronic pain while living in poverty and subsistence. Participants shared instances of making themselves appear “legitimate” to providers and institutions, adhering to biomedical models, and navigating multiple diagnoses. This paper introduces a new concept of chronic struggle as an analytical tool for understanding chronic pain from a social rather than solely medical lens. Shifting the approach may enable primary care providers and policymakers to understand and attend to how people manage chronic pain alongside social conditions.