Overview and Commentary: The Hidden Consequences of Pandemic-Related Chronic Stress and Its Potential Role in Workplace Burnout

October 19 2026 Boris Prilutsky

By Boris Prilutsky

As the General Public Health Landscape Changes, Corporate Wellness Programs Must Adapt as Well

Abstract

The COVID-19 pandemic exposed large segments of the population to prolonged stress, creating conditions that have contributed to persistent stress-related symptoms and increased vulnerability to subsequent occupational demands. Individuals respond differently to prolonged stress.

Some develop tension in the muscles of the neck, upper back, and respiratory muscles, while others experience varying combinations of sleep disturbances, anxiety, fatigue, headaches, and cognitive difficulties. Stress-related responses involving the nervous, immune, and endocrine systems also vary among individuals. For some, these effects may develop gradually, potentially affecting recovery and the ability to cope with additional workplace pressures.

Drawing on more than 50 years of clinical experience in medical and sports massage, the author examines the potential connection between pandemic-related chronic stress and workplace burnout. A central element of this approach is a structured self-massage program derived from practical clinical protocols developed through the author's experience working with Olympic athletes experiencing burnout and overtraining. These protocols were subsequently adapted and expanded to address the physical manifestations and multiple symptoms associated with chronic stress.

Based on extensive hands-on clinical practice and repeated observations of patients, the author presents structured self-massage as a practical, independently performed approach for managing selected chronic stress-related symptoms. The program emphasizes techniques addressing muscular tension in the neck, upper back, head, jaw, and respiratory regions, combined with theoretical instruction and safety precautions. In the author's clinical experience, patients have sometimes reported noticeable symptom improvement after the initial several sessions. These observations provide the clinical foundation for the program and its further application to workplace wellness.

The article argues that structured self-massage deserves serious consideration as a complementary component of corporate wellness programs, with potential applications in managing existing symptoms, supporting employee well-being, and contributing to burnout prevention and workplace productivity. It is not proposed as a replacement for healthy organizational working conditions, psychological support, or appropriate medical care. Rather, the author advocates incorporating practical self-care education into comprehensive workplace wellness strategies while encouraging systematic evaluation of outcomes, including perceived stress, sleep quality, muscular discomfort, fatigue, and work-related functioning.

From the Author

Throughout my 50 years of clinical practice and teaching medical and sports massage, I have occasionally treated patients experiencing workplace burnout and multiple symptoms associated with prolonged, chronic stress.

As an independent massage practitioner, I have always worked within integrative healthcare settings, receiving referrals from medical doctors. Consequently, my clinical practice has, to some extent, reflected the changing conditions of the broader healthcare system, including public health.

Approximately five years ago, however, my practice changed dramatically. I began receiving a substantial increase in physician referrals for patients experiencing multiple symptoms, including anxiety, clinical depression, sleep disorders, and brain fog. The conventional massage therapy protocols I had previously used were no longer producing the results I had come to expect.

Fortunately, I recalled my earlier clinical experience with chronic stress-related disorders and the specialized protocols we had developed for these conditions while working with Olympic teams. Athletes exposed to extreme psychological stress and intense physical workloads sometimes developed conditions we described as burnout or generalized overtraining. These experiences provided a valuable clinical foundation for approaching the complex, multisymptoms presentations I was now encountering in a different patient population.

The growing number of patients presenting with multiple symptoms potentially associated with prolonged stress fundamentally changed the direction of my professional interests. Over the past five years, this subject has become the primary focus of my clinical practice, teaching, and educational development. During the past three years, I have also observed what appears to be a substantial increase in patients presenting with workplace burnout and related multisymptom complaints.

Everything I write and teach on this subject is grounded in my decades of hands-on clinical experience, direct patient observations, and the practical application of massage protocols—not merely in the collection or interpretation of research data.

Workplace Burnout: What the Data Show, 2020–2026

My clinical observations have developed against a background of persistently high workplace burnout. Gallup's U.S. employee tracking data provide a useful perspective on this problem.

According to Gallup, the percentage of U.S. employees reporting that they felt burned out at work always or very often was approximately:

January 2020: 28%
During 2021: approximately 29–30% in several survey waves
During 2022: approximately 27–30%
During 2023: approximately 26–29%
During 2024: approximately 26–28%
During 2025: approximately 24–28%

These figures demonstrate that workplace burnout remained a substantial and persistent problem throughout the period.

The data should not be interpreted as proof that pandemic-related stress caused workplace burnout, but they provide important context for considering the relationship between prolonged stress, recovery, and subsequent occupational demands. [1]

Other research reinforces the importance of this issue. In its 2023 Work in America survey, the American Psychological Association (APA) reported that 77% of workers had experienced work-related stress during the previous month, while 57% reported negative effects sometimes associated with workplace burnout. These included emotional exhaustion, reduced motivation, and a desire to quit. [2]

In the APA's 2024 survey, 67% of workers reported experiencing at least one outcome commonly associated with burnout during the previous month, including low energy, reduced motivation, or feelings of isolation. [3]

These surveys used different questions and measures, so their percentages should not be treated as directly interchangeable. Nevertheless, they demonstrate the continuing importance of workplace stress and employee well-being.

1. Widespread Exposure, Different Individual Responses

During the COVID-19 pandemic, the American population was exposed to widespread sources of prolonged stress. Fear of infection, uncertainty about the future, social isolation, economic concerns, restrictions on daily life, and continuous exposure to alarming information created an unusually stressful environment for millions of people.

However, exposure to the same general stressors did not produce the same consequences in everyone.

Some individuals developed noticeable combinations of symptoms, including anxiety, depression, sleep disturbances, headaches, dizziness, fatigue, muscle tension, and difficulties with concentration and memory. Others experienced only a few symptoms, while some appeared to tolerate the prolonged stress relatively better and continued their daily activities without significant impairment.

The absence of obvious symptoms, however, does not necessarily mean that every physiological system has remained unaffected by prolonged stress.

Individual responses depend on many factors, including genetic predisposition, previous experiences, age, general health, individual physiological potential, and the ability of the nervous and endocrine systems to regulate stress and recover afterward.

Consequently, people exposed to similar stressors may experience different degrees of physiological adaptation, different symptoms, and different levels of resilience.

This distinction is important because the visible symptoms of stress may represent only part of a much more complex biological response.

2. The Difference Between Obvious Symptoms and Less Visible Physiological Changes

When discussing chronic stress, we should distinguish between three possible situations.

First, some individuals develop pronounced symptoms that interfere with their daily lives. They may experience persistent anxiety, sleep disorders, fatigue, headaches, cognitive difficulties, or multiple physical complaints.
Second, some individuals experience less obvious symptoms. They may continue working, caring for their families, and meeting their responsibilities, even though they are experiencing disturbed sleep, increased muscle tension, irritability, or reduced concentration.
Third, some individuals may show no clinically significant symptoms and may continue to function well. Others may experience physiological changes that are not apparent from their outward behavior but have not been demonstrated in their individual case.

My experience working with Olympic athletes has shown me that prolonged stress can affect several biological systems, including hormonal regulation, autonomic nervous system activity, immune signaling, and sleep. However, these changes do not occur in the same way in everyone, and the presence of chronic stress does not establish that a person has brain inflammation or another specific biological abnormality.

Nevertheless, this raises an important question:

Could some individuals maintain apparently normal functioning while experiencing stress-related changes that reduce their ability to tolerate additional demands?

This is a reasonable question.

For example, a person may continue to work effectively despite gradually worsening sleep, persistent muscular tension, or increasing fatigue. These changes may not initially be severe enough to interfere with work performance. However, they may reduce the person's capacity to recover from additional stress.

In such circumstances, the individual may appear resilient while actually experiencing increasing difficulty maintaining that resilience.

It is important to consider the possibility that this process does not necessarily involve hidden brain inflammation. It may involve several possible mechanisms, including inadequate recovery, altered stress regulation, sleep disruption, psychological exhaustion, and physical discomfort.

3. The Possibility of a Gradual, Less Visible Development of Stress-Related Symptoms

One of the most important questions is whether the effects of prolonged stress always become apparent immediately.

They do not.

Some stress-related difficulties develop gradually. A person may initially experience occasional sleep disturbances, mild anxiety, increased muscle tension, or difficulty relaxing. Over time, these problems may become more persistent, particularly when the original stressors continue and opportunities for recovery remain limited.

In most, if not all, cases, prolonged stress may also be associated with changes in hormonal regulation, autonomic activity, and immune signaling. However, there is no single biological progression that applies to everyone. We cannot conclude that all individuals who experienced pandemic-related stress developed a slowly progressing, low-grade brain inflammatory condition.

The more defensible argument is that prolonged stress may produce effects that are initially subtle, cumulative, and difficult to recognize, while the individual's capacity to cope with further demands may change over time.

This possibility deserves attention because people often recognize a problem only after it begins to interfere with their sleep, health, relationships, or ability to work.

4. When Workplace Stress Becomes an Additional Burden

Now consider what happens when a person who has already experienced prolonged pandemic-related stress returns to a demanding workplace or continues working under sustained professional pressure.

Workplace stress may include excessive workloads, deadlines, insufficient staffing, conflicts with colleagues, job insecurity, long working hours, and limited opportunities for rest and recovery.

For an individual who has recovered adequately from previous stress, these demands may remain temporarily manageable.

For another individual who is already experiencing sleep disruption, fatigue, anxiety, or reduced stress tolerance, the same demands may be more difficult to manage.

The workplace does not necessarily create the entire problem. Instead, it may add another source of stress to an already demanding situation.

For example, consider an employee who experienced prolonged uncertainty and disrupted routines during the pandemic. The employee continued working and did not develop severe or obvious symptoms. However, sleep quality gradually declined, muscle tension increased, and recovery after demanding days became more difficult.

Later, the employee encounters a period of increased workload, organizational changes, or staffing shortages.

The additional demands may exceed the employee's available coping resources. Fatigue, irritability, difficulty concentrating, emotional exhaustion, and reduced work performance may then become more apparent.

This is one plausible pathway through which previously manageable stress may contribute to the development of workplace burnout.

The process is not inevitable, and pandemic-related stress is not the only possible explanation. Workplace conditions themselves, personal circumstances, pre-existing health problems, and other factors may independently or jointly contribute.

Nevertheless, the interaction between previous stress exposure and subsequent occupational demands deserves serious consideration.

5. Why Workplace Burnout May Be More Complex Than Workplace Stress Alone

Workplace burnout is generally associated with chronic occupational stress that has not been successfully managed. The World Health Organization describes burnout in terms of three dimensions: exhaustion, increased mental distance or cynicism toward one's job, and reduced professional efficacy. It is classified as an occupational phenomenon rather than a medical condition. [4]

However, employees do not enter the workplace with identical physiological, psychological, or social circumstances.

Therefore, the same workplace environment may produce different outcomes in different employees.

High probability ,that every employee experiencing burnout has an underlying chronic stress-related disorder, as well as a high probability that every case of burnout originates in pandemic exposure.

Rather, it suggests that the effects of workplace stress should be considered in the context of the individual's broader circumstances and capacity for recovery.

The distinction is particularly important for corporate wellness programs. If an employee's difficulties involve several interacting factors, an approach that addresses only one aspect of well-being may not be sufficient.

In my opinion, effective prevention and management should consider organizational working conditions, manageable workloads, adequate rest, psychological support, sleep, and physical activity. In the current public health environment, these measures remain important, but they may not be sufficient on their own for every individual.

6. The Potential Role of Medical Massage and Structured Self-Massage

My professional interest is in the physical component of this problem, particularly muscular tension in the neck, upper back, and respiratory muscles.

The first reaction to stress includes an accumulation of tension in these muscles. The clinical interpretation, this muscular tension interfere with adequate venous and cerebrospinal fluid drainage, contribute to disturbances in metabolic waste disposal, and reduce cerebral perfusion, potentially limiting the delivery of oxygen and glucose through arterial blood.

Restoring adequate blood supply to the brain may reduces the physiological factors associated with brain dysfunction, such as brain fog, dizziness, headaches and more.

According to my clinical observations, my personal experience providing myself with self massage, during the first five to seven self-treatments, patients often experience a significant reduction in symptoms.

I believe that structured self-massage for managing the side effects of chronic stress is a practical complementary option for individuals, particularly when it is designed to be learned and performed independently.

The potential value of such a program is that employees do not merely receive information about stress. They learn specific techniques that they can practice as part of their regular self-care routine.

Nevertheless, a structured self-massage program could be evaluated as one component of a broader workplace wellness strategy.

A pilot experiment could examine whether employees who participate in the program experience measurable improvements in perceived stress, sleep quality, muscular discomfort, fatigue, and work-related functioning.

Such an approach would allow clinical experience to be translated into testable questions.

7. A Broader Perspective for Corporate Wellness

If we want to address the consequences of prolonged stress more effectively, we must look beyond the moment when symptoms become severe enough to interfere with work.

We should also consider the factors that influence an employee's ability to recover from stress, maintain daily functioning, and cope with new demands.

This does not mean assuming that every employee has a hidden disorder. It means recognizing that stress exposure, symptom development, and recovery are individual processes that can and must be addressed, with the aim of slowing or preventing further deterioration.

Corporate wellness programs can contribute by encouraging early recognition of difficulties, supporting healthier working conditions, promoting adequate sleep and physical activity, and making appropriate resources accessible.

Structured self-care education may provide an additional practical option, particularly when employees can learn techniques and use them independently.

My position is that medical massage and structured self-massage deserve more serious consideration within this broader discussion. Their value should be assessed through clearly defined outcomes, appropriate safety measures, and controlled clinical observation wherever possible.

About My Self-Massage Program for Chronic Stress-Related Disorders

The program contains the necessary theoretical explanations about chronic stress, as well as the physiological effects of massage on the human body.

Most of the program consists of hands-on demonstrations. I continue explaining what my hands are doing while teaching the techniques and discussing contraindications. The program covers the neck and upper back, TMJ muscles, massage of the head, self-abdominal massage, techniques intended to facilitate cerebrospinal fluid drainage, and appropriate pressure for tension headaches.

The third part of the program provides a conclusion and overview. I explain precautions related to physical activities, including stretching, and the importance of a gradual return to activity using a “listen to your body” approach.

Conclusion

I believe that comprehensive corporate wellness programs are very important and beneficial. They should include, but not be limited to, meditation, yoga, physical activity, and other approaches to stress management.

However, in my clinical opinion, none of the existing approaches to corporate wellness directly replaces specific hands-on techniques designed to address tension in muscles and fascia. In cases of chronic stress-related disorders, I consider addressing this physical component an important starting point for improvement.

I recommend reading the numerous articles related to this subject. I also encourage readers to consider the clinical experience represented by the videos below, which I posted long before the COVID-19 pandemic exposed large segments of the general population to prolonged stress. The comments may provide additional perspectives on how these techniques have been experienced by viewers.

Examples of My Earlier Self-Massage Instructional Videos

The following videos illustrate selected self-massage techniques from my earlier educational work and demonstrate my longstanding commitment to making practical self-care instruction available to the public.

These videos represent selected techniques rather than the complete instructional sequence offered in my current self-massage program. The current program provides a more structured learning experience, including introductory instruction, guided demonstrations, and safety precautions.

The videos may serve as an initial introduction to my teaching approach. The comments posted by viewers also offer evidence of their experiences with these self-massage techniques and may help illustrate their perceived benefits.

Summary

The self-massage program for chronic stress-related disorders and workplace burnout should be viewed as a preventive approach that may help address contributing factors before symptoms progress to more severe burnout. It may serve as an important resource for improving well-being and productivity, as well as supporting people already experiencing multiple stress-related symptoms in their efforts to improve their health.

These are not empty words. My confidence in this approach is based on repeated positive clinical outcomes observed in practice. For at least the past four years, I have personally applied these techniques at least four times a week.

In addition to improvements in my sleep quality, I have maintained blood pressure readings of approximately 125/65 for the past several years—a level comparable to my readings about 40 years ago.

My clinical experience and personal observations reinforce my belief that structured self-massage deserves serious consideration as a complementary approach to chronic stress management and workplace well-being.

References

Gallup. Global Indicator: Employee Wellbeing. U.S. employee burnout data, including historical survey results from 2020 through May 2026. https://www.gallup.com/394424/indicator-employee-wellbeing.aspx
American Psychological Association. (2023). 2023 Work in America Survey: Workplaces as Engines of Psychological Health and Well-Being. https://www.apa.org/pubs/reports/work-in-america/2023-workplace-health-well-being
American Psychological Association. (2024). Work in America 2024: Psychological Safety in the Changing Workplace. https://www.apa.org/pubs/reports/work-in-america/2024
World Health Organization. (2019). Burn-out an “occupational phenomenon”: International Classification of Diseases. https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases
World Health Organization. Burn-out an occupational phenomenon. Definition and classification of burnout in ICD-11. https://www.who.int/standards/classifications/frequently-asked-questions/burn-out-an-occupational-phenomenon
CDC (2020). Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic — United States, June 24–30, 2020. The survey documented substantial mental and behavioral health difficulties during the pandemic. Read the report.
Vahratian et al. (2021). Symptoms of Anxiety or Depressive Disorder and Use of Mental Health Care Among Adults During the COVID-19 Pandemic — United States, August 2020–February 2021. The CDC reported an increase in the percentage of adults reporting recent anxiety or depressive symptoms during that period. Read the report.
Mueller et al. (2022). Structural and functional connections between the autonomic nervous system, hypothalamic-pituitary-adrenal axis, and the immune system: a context and time dependent stress response network. Neurological Sciences, 43, 951–960. Read the research.
National Institute for Occupational Safety and Health (2024). An Urgent Call to Address Work-related Psychosocial Hazards and Improve Worker Well-being. This resource discusses workplace factors such as job insecurity, long hours, excessive demands, and limited control. Read the report.
Slavich (2020). Social Safety Theory: A Biologically Based Evolutionary Perspective on Life Stress, Health, and Behavior. This research framework helps explain how social threats and prolonged stress may interact with biological processes. For a related review of stress and inflammatory mechanisms, see this review in Frontiers in Psychiatry (2023)