The aim of the present research was to understand how office workers cope with back, neck and upper limb musculoskeletal disorders at work (and their implications for work). A small (N= 120) questionnaire survey collected information about potential participantsí background and history of musculoskeletal disorders. These data were used to inform a sampling process for a qualitative study of 18 office workers who had a back, neck or upper limb musculoskeletal disorder. Each participant was interviewed one-to-one.  Interviews were audio-taped, transcribed verbatim and analysed using NUD*IST (N6) qualitative data analysis software. Data were analysed using a grounded theory approach and a conceptual framework that was developed based on pre-specified themes derived from the literature. The results demonstrate that office workers use an extensive range of both cognitive and behavioural strategies to cope with musculoskeletal pain at work. Cognitive strategies include techniques such as distraction, visualization, self-talk, and blocking thoughts. Seeking-social support, exercise/stretching, exposure management, self or accompanied treatment, eating/drinking have emerged as categories that made up the behavioural coping strategies. Many of these had the potential to either further exacerbate the problems or lead to new problems including accidents or impaired work performance. The present study indicates the dangers inherent in the haphazard and trial-and-error nature of many of the coping strategies. Improved guidance and better evaluation of existing advice are required for those who remain at work but in pain.