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by Laurie Wertich, Medically Reviewed by Dr. C.H. Weaver M.D. 12/2021

Individuals with autoimmune and inflammatory conditions may face some unique challenges in the workplace—namely that stress, fatigue, or repetitive motions can exacerbate your symptoms and leave you feeling depleted. Living with these conditions means learning to make adjustments to balance the disease with the requirements of your daily life. You do not have to derail your career. It may seem overwhelming to find a balance between the two, but it can be done. So before you hand over your resignation, make sure you’ve evaluated all of your options. You might be surprised by the possibilities.

Know Your Rights

The American with Disabilities Act (ADA) requires that all companies with 15 or more employees make reasonable accommodations for people with disabilities. Accommodations may include rest breaks, modifications to workstations, or even changes in duties. It’s up to you and your employer to work together to find modifications that allow you to perform your duties. One excellent resource is the Job Accommodation Network (JAN), which provides free, confidential guidance on workplace accommodations and disability employment issues.

The Family Medical Leave Act (FMLA) entitles eligible employees of covered employers to take unpaid, job-protected leave for specified medical reasons with continuation of group health insurance coverage. Check with your human resources department—FMLA may enable you to take time off for appointments or flare-ups.

Assess Your Options

The pain and fatigue that are characteristic can make it challenging to work. As you navigate life, it’s important to take an honest assessment of your abilities and challenges. Is it realistic to continue working? If so, what modifications will you need to help you perform your work responsibilities? Be realistic, but optimistic. Yes, you may need to make some adjustments, but don’t sell yourself short. People are working successfully in all kinds of careers.

As you investigate your options, here are a few steps you may want to take:

Discuss your condition: It’s important to keep your employer in the loop regarding your health status. Talk with your supervisor (and if appropriate, your coworkers) about your diagnosis – you may have to educate people about the condition in order to help them understand your need for accommodations. No one will know you need help if you don’t ask for it. Having an open dialogue is the first step to striking an optimal balance between your condition and work.

Provide documentation: Sometimes it’s helpful to provide documentation in the form of letters from your healthcare team. This can establish credibility as well as educate your employer about the seriousness of the diagnosis. Often, a letter from a doctor will help your employer understand the necessity of accommodations.

Review benefits: Talk with a representative from the human resources department to determine what benefits are available to you. In the event you have to stop working, will you be covered by disability insurance? Can you sign up for short-term disability? What is your long-term plan? Over time, work may become more challenging—are you prepared for the future? Your local Social Security Administrationoffice can provide numerous publications and other resources about benefits.

Set up an evaluation: If you plan to continue in your job, it’s important to set up a professional evaluation of your working conditions. Some employers will provide this service or you can perform your own evaluation using checklists available online from the Occupational Safety and Health Administration(OSHA). Your occupational therapist and/or physical therapist may also be able to perform an evaluation of your workspace and conditions. The evaluation should include an ergonomic evaluation of your workspace as well as an evaluation of your activities—and should result in suggestions for improving the layout and design of your work area as well as tips for alleviating pain and joint load.

Ask for what you need: Communication is key. No one will know what you need if you don’t ask for it. If you need modifications to your workspace, ask for them. If fatigue is an issue, find out if flex time is a possibility.

Successful Strategies for Working

Set yourself up for success in the workplace with these strategies:

Ergonomics: Create an ergonomically friendly workspace to minimize stress on your joints. Ergonomics help support your body in a neutral posture. Ideally, you want to create a workspace that allows you to have your feet flat on the floor (or on a small riser), your thighs parallel to the ground, your hands and forearms neutral (or angled slightly downward), and your eyes straight ahead. Some ergonomic adjustments might include:

  • An adjustable chair with low back support (or a strategically placed pillow)
  • Ergonomic keyboard (placed at the appropriate height)
  • Keyboard wrist rest
  • Keyboard tilted down and slightly away to relieve stress on wrists
  • Computer monitor directly in front of you at eye level
  • Telephone headset (to prevent cradling the phone between shoulder and ear)

Stretch Breaks: Sitting for long periods of time can cause stiffness and discomfort. Take frequent breaks to stretch and move around. Aim for getting out of your chair at least once every hour. If it’s not possible to take frequent breaks, perform small stretches in your chair—move your feet, ankles, toes, wrists and hands. Trips to the restroom, copy machine, or water fountain can be crucial for preventing stiffness. Consider taking a longer walk at lunchtime to break up the monotony of sitting.

Variety: Repetitive movements can exacerbate many symptom. If you can, break up your tasks throughout the day. Alternate between light and heavy tasks and sitting and standing.

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Posture: Proper posture is important. Poor posture places strain on the joints and increases fatigue. For healthy posture, keep the head stacked above the shoulders and hips. Imagine a string pulling the top of your head toward the ceiling and relax the shoulders. When standing, tuck the pelvis and avoid locking the knees.

Stand properly: If you stand at work, vary your position throughout the day. Sometimes it helps to place one foot on a step or low stool to keep the pelvis aligned. Wear comfortable shoes with good cushioning and support and with heels no higher than one inch.

Assistive Devices: There are a variety of assistive devices designed for people with RA and joint problems. Talk with your occupational therapist to identify devices that might help you at work.

Balance: Balance activity and rest. If you have a big project or important deadline to meet, be sure to build in some downtime once it is completed. If you travel for work, be sure to rest before and after the trip. Manage your schedule so that physically exhausting tasks are buffered by some rest.

Healthy Choices: Take care of yourself with proper rest, nutrition, and exercise. Optimizing your health will make working easier.

Flex Time: Some employers allow flex time, which can be really helpful for those living with RA. If you are experiencing fatigue or a flare-up, a flexible schedule can make all the difference.

Telecommute: Many employers have become more flexible about allowing employees to work from home. If it’s feasible, working from home—even for part of the time—might make working with easier.

Living with RA is a full-time job—it doesn’t take a rest, even when you need to go to work. By modifying your workspace and developing good habits, you can continue to successfully work. You may have good days and bad days, but with healthy communication and some modifications, you can strike a successful balance between work and your condition.

Managing Business Travel

Heavy business travel can be particularly difficult. Travel carries the risk of stress and fatigue, both of which can aggravate symptoms. This does not mean you have to abandon business travel altogether, but you will likely need to make some adjustments. Some tips for successful business travel with RA:

  • Allow an extra day of travel time prior to the trip to provide an opportunity to rest upon reaching your destination.
  • Book direct flights whenever possible to minimize your travel time and prevent fatigue.
  • Develop strategies for ample rest and sleep. You may want to talk with your doctor about sleep aids to help you get proper sleep when you travel.
  • Simplify as much as possible. If you’re visiting clients in another office, book a hotel nearby. Alternatively, see if it’s possible to have meeting onsite at your hotel to prevent extra running around and the fatigue that can result. Many hotels provide access to conference rooms.
  • Create an agenda that provides breaks throughout the day.

Learn more about traveling with for business and pleasure.

Exploring Other Options

If you find yourself struggling with your job responsibilities, you may need to shift to plan B. Sometimes employers will allow employees to transfer to a less demanding position within the same company. If this is not an option, you may be able to train for a new career. Most states offer free vocational rehabilitation programs, which provide counseling for people with RA and additional training for a new job.

Finding a Balance

It can be frightening to face the prospect of downsizing or losing your career altogether. Keep in mind that the severity of waxes and wanes. You may feel more actively ill or disabled at certain points, especially the outset of your disease. However, with time, you will find coping strategies that work for you. Upon initial diagnosis, you may feel like you cannot continue to work long hours or travel for work—but it’s important to remember that this can change. Living and thriving means adapting to your changing symptoms and disease activity.

In other words, it’s important to stay optimistic. All hope is not lost. Many people continue to thrive and enjoy their careers.

For more information, contact the Arthritis Foundation for copies of the free pamphlet Arthritis and the Workplace.