Continuing to Work With Arthritis

How to Manage Work Challenges When You Have Arthritis

Painful knee at work.
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Arthritis can affect your ability to work. Because pain and physical limitations cannot be ignored, people with arthritis may need to adapt their work environment or modify their work schedule in order to continue working. As arthritis becomes more severe, significant changes may be necessary.

Relationship With Employer Is a Factor

There are various circumstances that determine if you can continue working despite having arthritis.

Some circumstances and factors may be controllable, while others are not. Two of the most important factors are somewhat tied together -- the severity of your arthritis coupled with the support you get from your employer. If the employee-employer relationship is strong, communicative, respectful, and honest, difficulties are more likely to be overcome. In contrast, a relationship with an employer or supervisor that is antagonistic or disinterested will not foster a cooperative effort to find solutions.

Should You Be Honest About the Challenges?

How much you should tell your employer about the challenges of living with arthritis has been debated. After all, an employer has one primary goal and that's productivity. Would knowing the truth about your struggles threaten that goal? 

Some people fear losing their job and choose to not divulge the whole truth about their arthritis. They minimize the struggles by:

  • not confessing the actual severity of pain and other symptoms
  • going to work when they should not
  • not wearing splints, supports, or braces when they should

Other people believe that hiding the truth ultimately backfires. Lack of full disclosure becomes more difficult as arthritis worsens. Simply put, it becomes harder to fake it.

 

Type of Work Must Be Considered

A certain level of productivity is expected of any employee. That said, the ability to complete tasks and meet deadlines naturally becomes more difficult as the level of disability increases. A large company that has many employees may not be as concerned about individual productivity as a smaller company. The large company may have a sufficient work force whereby employees tend to balance each other out. Not that they don't expect performance, but a large company may be able to allow for additional sick days more easily or handle temporary setbacks. Because there are more people available to cover for you, the burden is less to the larger company.

The exact nature of a job determines how much arthritis may affect performance. A physically demanding job which involves lifting, carrying, walking, or a lot of standing would certainly be impacted more than a desk job. A job that is physically demanding may become difficult or impossible to keep over time.

Flexibility Helps

Whether or not your job must be performed according to a precise schedule is another consideration.

If arthritis has caused you to miss a lot of work, or unexpected flares have made you less dependable, a job that operates on a tight schedule is not optimal.

Adapting Your Work Environment

If it is possible for specific adaptations to be made in the workplace, it may help you to continue working and maintain the expected level of productivity. That should certainly be considered and discussed. Some adaptations may cost money, but a company will be more eager to spend money on modifications and adaptations if your work record is good,  you intend to stay employed by them, and they feel you would be hard to replace.

There is a wide range of possible adaptations or modifications. Some are quite simple. Others, more extensive and expensive. It could be as uncomplicated as changing your chair or desk height, changing the location of supplies, or using ergonomic equipment. The necessary modifications may not even involve your physical work environment, but instead, it may involve requesting a later start-time, or a change to the lunch or break schedule.

An occupational therapist can be consulted to help assess your work area and offer valuable suggestions. It is also important to understand the Americans With Disabilities Act and to know your rights and understand the reasonable efforts your employer must make to accommodate your needs. Familiarize yourself with the law.

Disability Statistics Are Daunting

Studies have shown the impact of rheumatoid arthritis on employment. Over 50% of individuals with rheumatoid arthritis who worked before the onset of the disease stop working within 10 years of diagnosis (Yelin et al.,1980). Those individuals with work autonomy and flexibility are more likely to remain in employment after the onset of rheumatoid arthritis (Yelin et al.,1980). A study published in the Journal of Rheumatology (1999) concurred that at 10 years after disease onset, the prevalence of work disability among rheumatoid arthritis patients was 44% despite early treatment with DMARDs (disease-modifying anti-rheumatic drugs). Another study, published in the journal Clinical and Experimental Rheumatology (2003), found that 20-30% of patients with rheumatoid arthritis become permanently work disabled during the first 2-3 years after disease onset. A study published in Rheumatology (Oxford), in 2000, suggested that many people stop working early in the disease course.

A move towards early and aggressive treatment seemed not to demonstrate a positive effect on rates of work disability in the early 2000s. However, a report in Annals of the Rheumatic Diseases (2012) suggested that biologic therapy, as well as aggressive use of traditional DMARDs, was associated with "substantial gains in disability outcomes".

The Bottom Line

In order to continue working, you must be compliant with your treatment to keep the disease well-controlled. You must be working at a job where you can still function and be productive within your set of physical and functional limitations. It is also imperative to have the support and understanding of your employer and co-workers.

It is a fact that with a diagnosis of rheumatoid arthritis, there is an inherent risk of work disability. The risk is greater with a physically demanding job, older age, lower level of education, and greater functional disability with activities of daily living.

Sources:

Disability in rheumatoid arthritis in the era of biological treatments. Annals of the Rheumatic Diseases. Krishnan E. February 2012.
http://www.ncbi.nlm.nih.gov/pubmed/21953343

Work disability in early rheumatoid arthritis. Sokka. T. Clinical and Experimental Rheumatology. Sept.-Oct. 2003.
http://www.ncbi.nlm.nih.gov/pubmed/14969054

The impact of rheumatoid arthritis on employment status in the early years of disease: a UK community-based study. Rheumatology (Oxford). Barret EM et al. December 2000.
http://www.ncbi.nlm.nih.gov/pubmed/11136885

Work disability in rheumatoid arthritis 10 years after the diagnosis. Journal of Rheumatology. Sokka T et al. August 1999.
http://www.ncbi.nlm.nih.gov/pubmed/10451062

Work Disability in Rheumatoid Arthritis: Effects of Disease, Social, and Work Factors. Yelin E., et al. Annals of Internal Medicine. October 1, 1980.
http://annals.org/article.aspx?articleid=694303

Understanding Rheumatoid Arthritis, 1996, Stanton Newman et al.

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