Invisible Needs – Barriers with Chronic Pain and Fatigue within Tourism

Invisible Needs – Barriers with Chronic Pain and Fatigue within Tourism

Abstract
This discussion paper looks at how current accessibility frameworks overlook invisible disabilities such as chronic pain and fatigue within the tourism industry. Topics such as perception of disabilities, stigma, ableism, and the barriers faced are discussed to argue a more informed, understanding, and flexible approach is mandatory to achieve barrier-free tourism.

Key Words:
Invisible Disability, Chronic Pain, Chronic Fatigue, Accessibility, Overlooked


Planning a holiday is supposed to be fun - a break designed to be enjoyable and relaxing. However, imagine having to calculate the distance between your accommodation and the nearest activity, then having to decide if your body can tolerate it - or hoping there is a place for you to rest so you don’t have to spend the rest of your day exhausted because you stood too long. This is the reality for those with invisible disabilities - particularly chronic pain and fatigue. Difficulty doesn’t stop at the planning stage, but also extends to arrival, where you might have to explain your condition and needs repeatedly, only for it to be overlooked or downplayed. The whole situation is stressful and anxiety inducing.

Accessibility within the industry is consistently growing more important, but the accessibility frameworks in place continue to prioritise those with visible disabilities, and often overlook those with invisible disabilities such as chronic pain and fatigue.

Current accessibility models are too narrow, catering primarily by providing wheelchair access, elevators, visual and hearing aids, and other similar adjustments. Meanwhile, staff within the industry are left with a lack of understanding regarding invisible disabilities, and while training has shown to improve attitude, it is only a baseline (McKercher and Darcy, 2018). In other cases, invisible disabilities are purposely overlooked with travel agents acknowledging that the inflexible nature of packages can result in being unable to participate or forced to compromise in order to do so (McKercher and Darcy, 2018). Instead of adjusting to accommodate these individuals, they are brushed off as ‘too complicated’, or it is assumed that they can find ways to cope themselves. In reality, chronic pain and fatigue sufferers face many barriers when it comes to tourism such as unpredictable and fluctuating symptoms that can get worse with stress, poor sleep, or lack of rest, which means they need to pace themselves carefully through the day and calculate what their bodies can tolerate. Not pacing can cause exhaustion or for symptoms to worsen, which makes travelling with a lack of accessibility difficult and unrealistic.

Goffman’s stigma theory suggests that individuals will try to hide what makes them different, and often feel anxious in social situations which makes them appear avoidant or aggressive (Goffman, 2007). As a result, individuals feel a pressure to ‘look well’ or adhere to ‘normative’ standards as to not receive any stigma or be treated unfairly. Especially since other factors such as age, race, gender, class, etc can add more stigma - which is seen commonly with women. Their pain is often dismissed as emotional or sensitive to pain, leading to misunderstandings and longer diagnosis times.

The barriers are seen deeply rooted into how organisations communicate with the public regarding accessibility needs. The information they offer is vague, sticking to the narrow accessibility frameworks, which leaves a lot of guessing for other accessibility requirements. Without sufficient information on if their needs can be met and if the location is accessible, it will deter individuals from travelling, resulting in missed opportunities (Eichhorn et al., 2008). This showcases how stressful a holiday can be when planning for chronic pain and fatigue, and how impossible it is to prepare for unpredictable symptoms with a lack of information and inclusion.

Accessibility should be more than just compliance. It should be cantered around flexibility, inclusion, and well-being. By implementing small changes such as more rest spaces, more in-depth accessibility information, and offering pacing itineraries it is a strong start to fighting the hidden exclusion. More rooted changes will take time, but it can create accessibility that is inclusive as opposed to informative. By widening the frameworks and providing training, staff can not only be prepared and educated, but these accommodations become the norm, therefore reducing exclusion and the stress surrounding travel with an invisible disability.

Creating a barrier-free environment means recognising not all disabilities are visible, and to become inclusive, the fluctuating and unpredictable symptoms of chronic pain and fatigue needs to be acknowledged. New practices need to be implemented to create a barrier free environment as this is the reality of many people with invisible disabilities.

References
Eichhorn, V., Miller, G., Michopoulou, E. and Buhalis, D. (2008) Enabling Access to Tourism through Information schemes? Annals of Tourism Research, 35(1). Available from https://www.sciencedirect.com/science/article/pii/S0160738307001053 [accessed 25 May 2026].

Goffman, E. (1986) Stigma Available from https://books.google.co.uk/books?hl=en&lr=&id=zuMFXuTMAqAC&oi=fnd&pg=PA1&ots=Rb1tJn3GNe&sig=v3lWhP9JsuURI_bKvmnaVuzITX4&redir_esc=y#v=onepage&q&f=false [accessed 26 May 2026].

McKercher, B. and Darcy, S. (2018) Re-conceptualizing Barriers to Travel by People with Disabilities. Tourism Management Perspectives, 26 59–66. Available from https://www.sciencedirect.com/science/article/pii/S2211973618300035 [accessed 27 May 2026].

This paper answers Q4 and Q5, inviting readers to inhabit the position of a body that does not announce disability itself. This is compelling because it grounds theoretical concerns in individual reality.

The author argues visibility currently decides whose access needs count. Yet its focus group bear the burden of proving their invisible disability and fluctuating symptoms to untrained, skeptical staff. However, while illness fluctuates, the tourism industry's planning infrastructure remains static.
Nevertheless, I would argue this pattern is sustained by ableism, which structurally denies legitimacy to non-normative bodies, therefore placing the burden of proof on the individual.

Ljuslinder et al. (2020) introduce the concept of "cripping time" and argue that disabled people experience time fundamentally differently. In the paper, it refers to negative experiences that are shaped by fatigue, pacing, and unpredictability. However, when tourism planning operates on normative temporal assumptions, it inherently excludes those whose relationship with time does not conform. This makes participation for them structurally impossible.

Where the paper is less persuasive is in its solutions. This is because adjustments, such as increasing rest spaces and pacing itineraries, are reasonable but fragmented. In turn, meaningful inclusion requires systemic environmental change to push forward the change (Hua et al., 2025). Such a framework would have strengthened the author's concluding argument considerably.

To conclude, normalising rest zones and flexible itineraries for everyone removes the requirement that disabled travellers perform their stigma to be accommodated and reduces health disparities. More inclusive tourism requires a shift from compliance-based accessibility toward structural service innovation.


Reference list
Hua, C., Jordan, E.J. and Rutkowski, L. (2025) Conceptualizing Ableism in Tourism and Hospitality: Health and Inclusion Implications for Travelers with Disabilities. Journal of Travel Research, 65(3). Available from https://journals.sagepub.com/doi/10.1177/00472875251370387?utm_source=researchgate.net&utm_medium=article#sec-4 [accessed 28 May 2026].
Ljuslinder, K., Ellis, K. and Vikström, L. (2020) Cripping Time – Understanding the Life Course through the Lens of Ableism. Scandinavian Journal of Disability Research, 22(1) 35–38. Available from https://sjdr.se/articles/10.16993/sjdr.710 [accessed 28 May 2026].

I chose to comment on this paper because it closely mirrors my discussion paper on invisible disabilities in sports tourism. Both highlight the same uncomfortable truth: accessibility in tourism continues to focus on visible disabilities, leaving those with chronic pain and fatigue navigating systems not designed for them.

The paper makes a strong and well-structured argument. One strength is the use Goffman’s stigma theory to explain why individuals with invisible disabilities feel compelled to hide their condition. Linking this to the expectation to “look well. It also draws on Eichhorn et al. (2008) providing insight into how vague accessibility information deters people from travelling, grounding the argument in current existing literature rather than assumption.

There are weaknesses in a couple of areas. Whilst rest spaces and paced itineraries are valuable starting points, the acknowledgement that “more rooted changes will take time” feels underexplored. Engaging with frameworks like Universal Design or the Social Model of Disability would have clarified what those changes entail and strengthened the recommendations (Sadecka, 2024). Additionally, although the paper highlights race and gender can compound stigma, this feels underdeveloped given how central intersectionality to social justice in tourism.

Overall, I thought that this paper is a thoughtful and engaging topic that contributes meaningfully to the conversation surrounding hidden exclusion in tourism. It reinforces the argument I make in my work, that the industry’s definition of accessibility is not only a practical failure but a social justice issue. Broadening frameworks to include whose needs are not immediately visible is not optional, but necessary.

Sadecka, I. (2024) Universal Design, Accessibility, and Inclusive Design in Digital Product Development Available from https://medium.com/@irmina.tak/universal-design-accessibility-and-inclusive-design-in-digital-product-development-key-concepts-315a8192650d [accessed 22 May 2026].

Eichhorn, V., Miller, G., Michopoulou, E. and Buhalis, D. (2008) Enabling Access to Tourism through Information schemes? Annals of Tourism Research, 35(1). Available from https://www.sciencedirect.com/science/article/pii/S0160738307001053 [accessed 25 May 2026].