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Ankylosing Spondylitis and Your Job

Regardless of whether your job involves desk work or physical labor, managing your ankylosing spondylitis from 9 to 5 can be quite challenging.

Roughly 300,000 Americans have ankylosing spondylitis (AS), also known as Bechterew’s disease. It’s a type of arthritis that can make some of your vertebrae fuse so that you hunch forward and lose flexibility. Other common symptoms include pain or discomfort in your ribs or your hip and shoulder joints, and uncomfortable inflammation in your eyes.

With symptoms like those, you can’t just assume that medication and physical therapy will keep an AS flare-up from interfering with your job. Being proactive is key. You’ll want to take steps on your own to maximize your physical comfort on the job, and you also may need to ask your employer for certain accommodations to do your work. You are legally entitled to do that.

What Studies Show

Trying to stoically push through an AS episode without any adjustments at work is almost certainly a bad idea. Consider that:

  • Half of people with AS manage some type of instability on the job.
  • Between 10% and 20% of people with AS encounter some kind of work disability, especially if their jobs are physically demanding.
  • Nearly one in seven AS patients must scale back or change their work due to the disease.
  • One-third of people who need to go to the hospital for AS symptoms eventually need to stop working before retirement age.

Improvements You Can Make

One study found that creative solutions by AS patients resulted in fewer disruptions at work. Here are some tips for changing your work environment to help manage your AS, regardless of your job:

  • Adjust your chair. If you work at a desk routinely, the chair back should be aligned to support your spine vertically, with shoulders straight. Its seat should be adjusted so that when your feet are flat on the floor, your knees are even with your hips or slightly higher. It’s important to avoid slouching.
  • Improve back support. If your chair doesn’t give enough support, then try adding a rolled towel or small pillow or investing in a lumbar support pillow.
  • Keep moving. If your job keeps you sitting for long periods, try to structure your day to include times when you stand and walk around. Take regular breaks from your desk, and be disciplined about walking during those breaks and lunchtime.
  • Check your posture. During bathroom breaks, look in the mirror to see if your spine is straight. Enlist a co-worker to signal if you slouch during meetings.
  • Arrange your desk. When sitting, your forearms should rest horizontally without effort. When you use a computer, your wrists should be straight and fingers relaxed, and your eyes should be level with the top of the screen.
  • Use stretching exercises diligently. Your physical therapist can recommend easy exercises regardless of whether you sit at a desk all day, constantly drive, or lift heavy objects. Reputable medical organizations also post videos of helpful exercises.
  • Take care lifting heavy objects. Use both palms to lift, or when possible, use your arms rather than hands. Hold the object close to your body to take pressure off your joints. Whenever possible, slide the object rather than lift it.

Workplace Accommodations for Ankylosing Spondylitis

What if the steps you take on your own to manage AS at work aren’t enough? You may want to tell your boss about your AS. Under the federal Americans with Disabilities Act (ADA), businesses with 15 or more employees must make “reasonable accommodations” (for example, ergonomic workstations or adjusted schedules) needed for people with disabilities to do their jobs.

Tips: Before approaching your boss, keep an activity log for a week or so to help pinpoint the work-related issues that may trigger your AS symptoms. Put your request for accommodations in writing, and include a letter from your doctor verifying your AS.

What if your AS pain and discomfort make working just too difficult right now, and you’ve used up your vacation and paid sick time? The federal Family and Medical Leave Act (FMLA) entitles employees in private-sector companies with 50 or more workers to ask for up to 12 weeks off in a year to deal with chronic and incapacitating health problems, among other conditions. Time off is unpaid, but your employer cannot hold your leave against you, and you can maintain your health insurance.

Seeking Disability Insurance Payments

In a worst-case scenario, you may be unable to work at all because of AS. Fortunately, the federal Social Security Administration lists AS as a disability under an “inflammatory arthritis” category. This means you can apply to the government for disability insurance payments. You should consider hiring an attorney who specializes in disability requests.

Change Your Work to Handle Your AS

It takes a lot of effort to manage AS well. Don’t just grit your teeth and put on a brave front at work. Be assertive about making improvements to your job conditions, and don’t be shy about asking for help. You deserve to feel rewarded by your work life.

WebMD Medical Reference

Sources

SOURCES:

University of Washington: “Ankylosing spondylitis.”

Spondylitis Association of America: “Overview of Ankylosing Spondylitis.”

Mayo Clinic: “Ankylosing spondylitis.”

Best Practice & Research Clinical Rheumatology: “The impact of ankylosing spondylitis/axial spondylitis on work productivity.”

Arthritis Foundation: “Arthritis by the Numbers,” “Tips for Taking Care of Your Joints at Work,” “Know Your Workplace Rights if You Have a Disability.”

National Ankylosing Spondylitis Society (U.K.): “Ankylosing Spondylitis -- Managing your AS at work -- answers and practical advice.”

Annals of the Rheumatic Diseases: “Employment perspectives of patients with ankylosing spondylitis.”

U.S. Department of Labor: “Need Time? The Employee’s Guide to the Family and Medical Leave Act.”

U.S. Social Security Administration: “Disability Evaluation Under Social Security -- Section 14.00 Immune System Disorders -- Audit.”

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