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MOST COMMON CAUSE OF DISABILITY

Working with arthritis

Employees may have limitations, but accommodations can help

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Key points

  • In the United States, arthritis is the most common cause of disability, the CDC states.
  • Arthritis can affect workers in a number of jobs, and a variety of activities can contribute to or aggravate the condition.
  • Accommodations can include flexible hours, ergonomic tools and frequent breaks.

Additional resource

Approximately 50 million adults have been diagnosed with arthritis, making it the most common cause of disability in the United States. And Centers for Disease Control and Prevention statistics show that nearly one-third of people with arthritis who work experience on-the-job limitations. Workers with arthritis – a chronic disorder that involves inflammation of a joint – often deal with symptoms such as pain, stiffness and fatigue. But experts say accommodations from employers can help workers stay on the job.

“We want to really help them be able to do whatever they need to do in the workplace and at home in their life with less pain and less stress on their joints,” said Carole Dodge, occupational therapist and certified hand therapist at the University of Michigan Health System in Ann Arbor. “We try to get them not to give up things, but maybe do things in a different way or for less time or in a different manner.”

Types and their effects

The most common types of arthritis are osteoarthritis and rheumatoid arthritis, according to the National Institutes of Health. Osteoarthritis, which can arise with age or after an injury, typically affects the knees, fingers and hips. Rheumatoid arthritis is an autoimmune disease that can affect bones and organs, and may include fatigue or fever. A 2015 study from pharmaceutical company Janssen Scientific Affairs concluded that workers with rheumatoid arthritis are 30 percent more likely to miss work than those without the disorder.

And CDC research has found that among adults diagnosed with arthritis, 14 million have difficulty stooping, bending or kneeling; 11 million are limited in walking one-quarter mile; and 8 million have trouble climbing stairs.

“They might not be able to open a door, turn a doorknob, push open a heavy door, and that happens a lot,” Dodge said. “They may not be able to sit for as long as they need to utilize a computer. They may not be able to keyboard long enough or mouse. We have many who work in the hospital in materiel services or housekeeping who have trouble lifting bags full of laundry, vacuuming or using a broom because of arthritis in their hands.”

‘A workforce issue’

Arthritis can affect workers in a number of occupations, and a variety of activities can contribute to or worsen arthritis, notes Kristina Theis, epidemiologist with the CDC Arthritis Program. Such activities include sitting or standing in awkward postures; repetitive motion; prolonged bending, kneeling or reaching; working in extreme temperatures; or use of vibrating tools such as jackhammers or dental drills.

“We certainly hear that people who work in jobs that are more physically demanding have more difficulties, jobs like manufacturing, where you might have to stand for a long period of time, or if you have to lift,” said Monique Gignac, associate scientific director and senior scientist with the Toronto-based Institute for Work and Health. “Other occupations like health care workers, nurses or teachers, they often can report problems because you have to be there. You can’t necessarily sit down when you want to or take breaks. There can be a fair bit of activity associated with those kinds of jobs.”

Theis said arthritis also can be found among farmers, construction workers, carpet layers, law enforcement officers and administrative assistants. “This is a workforce issue. It’s actually everywhere,” she said.

Helping workers with arthritis

Arthritis is one of the most common conditions that Dodge sees as an occupational therapist.

She learns what is causing the patient’s pain, analyzes that person’s activity, and looks to change technique or use a device to reduce stress on the affected joint. For example, a computer user can be given a more ergonomic mouse that transfers stress from the fingers.

Dodge also “builds up” handles with materials such as pipe insulation to make them easier to grip, and she teaches patients to lift with two hands instead of one. She encourages patients to vary their tasks to help reduce stress and repetitive motions, rather than opening 30 pill bottles at once, for example.

Many accommodations can help workers with arthritis, and they can be inexpensive and readily available, experts say. The Job Accommodation Network offers the following example: A social worker who has arthritis in her hands was having trouble note-taking, handling papers and reading case summaries. To help her perform these tasks, the woman received a book holder, a page turner and writing aids, along with the opportunity to read reports to other workers.

Benefits and accommodations can help workers with arthritis maintain concentration and work pace, according to IWH research. In one study, workers said they needed and used extended health benefits, special equipment, flexible hours, short-term leave, work-from-home policies, and modified schedules. Many of the participants said accommodations especially help during symptom flare-ups.

“Arthritis symptoms were often variable or fluctuated, intermittent. On a very bad day, they might need to work from home, and that would really help,” Gignac said. “Other times, just coming in a little bit later or leaving earlier – flexible hours – that made enough of a difference. We found there wasn’t a single type of accommodation that worked best for everybody. It really seemed to be about the fit between your job needs and what you had available to you and finding that right fit.”

Many people with arthritis want to work – participants with the condition in another IWH study planned to retire no sooner than healthy workers.

However, some workers avoid disclosing their disability to their employer, worried they will be passed over for an opportunity or viewed as a bad or demanding worker. Experts suggest that workers evaluate their needs and their workplace culture to determine if they should disclose.

“I want people to recognize arthritis is everywhere, but it’s treatable and it doesn’t mean you have to stop working,” Theis said. “I want employers to know not to be afraid of these employees, and I want employees to know there are tools and resources they can [use].”

How employers can help

Through its national healthy worksite program, the Centers for Disease Control and Prevention offers the following ways employers can assist workers with arthritis and other chronic conditions:

  • Provide a fitness facility. Physical activity can help ease arthritis symptoms and improve mental health.
  • Display nutritional information about food in the cafeteria and vending machines.
  • Fund or provide discounts for use of exercise facilities (onsite or offsite).
  • Display signs encouraging use of stairs.
  • Offer physical activity programs.
  • Supply or fund fitness assessments, counseling and physical activity recommendations.

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