How to Handle Rheumatoid Arthritis at Work

From the WebMD Archives

Your rheumatoid arthritis (RA) doesn't have to stand in the way of a satisfying career. The right office set-up, helpful gadgets and tools, and support from your manager are some of the key ingredients to success on the job.

"I was diagnosed with RA when I was 26, and I have always worked full-time," says Kelli Schandel, a 43-year-old senior geoscience technologist and mother of two in Denver. She says medication, some tweaks at the office, and a good relationship with her boss have made all the difference.

Set Up Your Workspace

You spend a lot of time at work, so you want your desk and chair arranged so there's less tension and strain on your joints. The goal is to organize things so the furniture supports your body in a relaxed, neutral position.

"It takes a bit of setup in the beginning, but it's worth it in the long run," says Mary Ann Wilmarth, a physical therapist at Back2Back Physical Therapy in Andover, MA.

You'll need a chair that supports your lower back. Make sure it has arm rests you can move so that you can put your forearms on them with your elbows bent at 90 degrees. Adjust the armrests so that they allow you to get as close to the desk as you need.

A wheeled, swivel chair cuts down on the amount of twisting and reaching that you do during the day. Make sure the seat isn't too deep. When your knees are bent and your feet are flat on the floor, there should be about an inch between the backs of your knees and the edge of the seat.

And, yes, your feet should be flat on the floor. It reduces strain on your joints. If they don't reach the floor, use a short footrest.

"Make sure the keyboard and mouse are at the same height," says Karen Jacobs, EdD, a professor of occupational therapy at Boston University.

Position the mouse as close to the keyboard as possible. Make sure your wrists, forearms, and elbows are in the same plane. Don't work with bent wrists.

Your eyes should be level with the top of a regular-sized computer monitor. An oversized monitor might sit a little higher.

"Make a fist, stretch out your arm, and that's how far your monitor screen should be," Jacobs says.

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Helpful Tools

A bunch of devices can make office work a whole lot easier.

Take the computer mouse, for instance. Don't limit yourself to the traditional style. There's a verticalversion that's shaped like a video-game joystick. It's wide, so you don't need a tight grip. Trackballs and track pads let you move your cursor with a more open, relaxed hand. Or set up keyboard shortcuts that get rid of your need for a mouse altogether.

Alternatives to standard typing are available, too. Keyboards come in shapes that might be more comfortable for hands, wrists, and fingers.

"Some people find it easier to type with a stick than their fingers," Jacobs says. You can use rubber-tipped sticks with grip aids, similar to rubber pencil grippers. Or you can try a hand strap that attaches a stick to your middle finger. That way you don't have to bend your real finger so sharply to type. And voice recognition software could replace typing completely.

Try gel pads that raise and cushion your wrists in front of your keyboard and mouse. They're not for everyone, though. "For me, it was more uncomfortable," Schandel says. She prefers a drugstore wrist guard from time to time. "Whenever I have a flare-up, I just throw on my wrist guard, and off I go."

Try a document stand. That way you don't have to bend your neck to read pages on your desk. An automated page turner, or one that straps to your hand, takes pressure off your achy fingers.

Work With Your Manager

A good desk setup and some tools go a long way, but you'll need support from your employer and some flexibility, too.

It might be best to let your boss know as soon as possible that you have RA. "Then your supervisor knows, you're less likely to hurt yourself at work, and you won't overdo something that you shouldn't," Wilmarth says.

Schandel agrees. "Don't wait until you're at your worst and you're ready to quit because you can't work," she says. "Be open so that when you have a flare-up or a bad day, it's not news to them." And they can prepare for when you need to work differently from your colleagues.

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The Americans with Disabilities Act calls for employers of 15 or more people to provide "reasonable accommodations" for workers with disabilities. Here are some workspace tweaks that people with rheumatoid arthritis might need:

Frequent breaks. Joints get stiff when you sit still or stay in the same position for too long. Stand up and walk around or change tasks every 20 to 30 minutes.

A standing desk. It's not for everyone, Jacobs says, but for some people with RA it makes work easier by letting you alternate sitting and standing.

The right chair. Get one that's a good size for you and gives you the support you need.

Nearby parking space. Get one close to the building to cut down on the distance you walk on days that your RA flares up.

Flexible work time. Non-traditional hours could help you avoid sitting in rush-hour traffic. Or, if stiff joints slow you down in the morning, you might need some extra time to get to the office some days.

Work away from the office. You may need the option to work at home when you have a flare-up.

Flexible dress code. Your feet might not always feel like squeezing into your best shoes. "I have tennis shoes and flip-flops in my desk," Schandel says. "I just tell my boss, 'I have flip-flops on today because my feet are killing me.'"

"Know your body, know what you need," Jacobs says, "and be forthright with your employer about it."

WebMD Feature Reviewed by David Zelman, MD on May 20, 2016

Sources

SOURCES:

Mary Ann Wilmarth, DPT, OCS; CEO, Back2Back Physical Therapy, Andover, MA.

Karen Jacobs, EdD, OTR/L, CPE; Clinical Professor, Boston University, Boston, MA.

Arthritis Foundation.

University of California Los Angeles: "4 steps to set up your workstation."

National Rheumatoid Arthritis Society: "Rheumatoid arthritis and computing."

RheumatoidArthritis.org: "Living with RA."

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