Nancy Hardin, age 71, of Dyersburg, Tenn., was diagnosed with rheumatoid arthritis (RA) 11 years ago. A few months after her diagnosis, she quit her teaching job at a local high school because she could barely walk. Then she started taking the biologic drug Remicade and became nearly symptom-free. Nevertheless, she decided that going back to the classroom would wear her out. She did, though, become a volunteer translator for local Spanish-speaking immigrants and a member of the Tennessee Council on Developmental Disabilities. "To tell you the truth," she says with a laugh, "I work almost as much as I did when I was teaching. My doctor thinks my disease is in remission."
Hardin's working experience is not atypical. Close to one out of every three employees with rheumatoid arthritis (RA) leaves the workforce. That statistic may sound daunting, but the percentage of people with RA who quit working because of the condition is nearly half of what it was just 20 years ago. What's more, Hayes Wilson, MD, chief of rheumatology at Piedmont Hospital in Atlanta, tells WebMD that fewer people experience the same level of disability that once was common with RA. "Not only have I seen more people keep working" he says, "I've also seen people who've gone from being almost crippled to leading normal lives."
The rheumatoid factor test is a commonly ordered test to help diagnose rheumatoid arthritis. This test measures rheumatoid factor, which is an antibody in the blood that's present in many people with RA. In fact, the rheumatoid factor blood test is eventually positive in 70% to 80% of people with RA, although in early arthritis the percentage may be much smaller. Rheumatoid factor may also be elevated in other autoimmune diseases besides RA.
What has brought about such a dramatic change in RA's impact on people's ability to work? One factor, doctors say, is the use of newer, more effective medications that slow the progress of the autoimmune disease and often suppress its symptoms. Biologic medicines, such as the one Hardin takes, and disease-modifying antirheumatics like methotrexate have made it possible for people to go about their day at work with fewer problems. Still, though, it isn't easy to manage a job when you have rheumatoid arthritis.
That's because even with the newer, more expensive therapies, people with RA may still experience symptoms like fatigue and pain. And these symptoms can significantly interfere with job performance. If you have RA, here is information experts shared with WebMD that you can use to reduce the effect RA can have on your working life.
How does RA interfere with a person's ability to work?
Richard Pope, MD, is a rheumatologist and professor at the Feinberg School of Medicine at Northwestern University in Chicago. He tells WebMD that measuring how much time employees take off work can show how effective their therapy is.
In one recent survey of people with RA, researchers found that over a three-month period, employees with rheumatoid arthritis took off an average of two to three weeks from work. In an earlier study, researchers noted that many employees with RA not only altered their working hours but also either changed their job or pursued a different career altogether.
According to Pope, the newer medicines for rheumatoid arthritis seem to work best for employees who have been diagnosed for less than 10 years and don't have joint deformities. But medication isn't the only factor. Pope says that age, occupation, education level, and duration of the disease are all predictors of work disability among people with rheumatoid arthritis.