Feel Your Best on the Job With Rheumatoid Arthritis

Struggling to keep up with job demands due to the aches and pains of RA? These strategies will help you balance your career and your condition.

Jean Weiss
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There’s no doubt rheumatoid arthritis (RA) can cause pain on the job and make some of your workdays tougher than usual. But take heart! A study in Arthritis Care & Research found that although arthritis pain caused periodic difficulties at work, the problems didn’t make folks less productive or cause them to miss work more often. In fact, the biggest problems were with specific tasks—like working with their hands or lifting and carrying—as well as standing for long periods. And those are problems you can do something about!

To help you find smart workplace solutions, we asked for advice from lead study author Monique Gignac, PhD, an arthritis researcher and associate professor at the University of Toronto. Here are her expert on-the-job tips:

If you sit all day...
Think 90-degree angles. This is the key to eliminating back, neck and shoulder strain, says Dr. Gignac. If you work at a computer, here’s what to do with your:

  • Monitor: Keep your chin at a 90-degree angle to your neck when you look at the screen. The top of your screen should be just below eye level, so you’re looking straight ahead, not up or down. If needed, use a book or two to raise your monitor.
  • Chair: Adjust the armrests so your forearms and elbows are at 90-degree angles. Likewise, adjust the height so your knees and legs are at 90-degree angles.
  • Feet: Keep them flat on the floor to maintain the 90-degree angle at your knees. If this is difficult or causes strain, use a footrest; a small cardboard box will do the trick, too.

Do a posture check. Slouching can strain your muscles, sap your energy and cause fatigue. An easy way to straighten up: Picture a string attached to the top of your head, pulling you up so your head and torso are aligned and eyes are straight ahead. 

Fidget! Take a break every 20 minutes or so to stand up or move in your chair. Shake your arms, bounce your legs, flex your wrists and ankles—anything to keep your muscles loose and joints lubricated. Extending each leg and pointing and flexing your feet can keep your knees and ankles from stiffening.
Another tip: Set the alarm on your computer or smartphone as a reminder that it’s time to take a “fidget” break. 

If you do repetitive movements...
Plan for daily break-ups of your tasks. “Pace yourself,” notes Dr. Gignac. “Change up the routine, take little breaks and rearrange the workflow so you don’t put repetitive strain on any one joint.” For example, break up long bouts of typing with other tasks, like returning phone calls. If your job requires assembling parts, ask if you can switch periodically with someone who does a different movement. If it’s feasible, using your non-dominant hand to do simple assembly can be helpful.

Brace yourself. Using hand, wrist or back braces can relieve pressure on muscles and nerves and act as a subtle reminder to maintain good posture.

Check your typing. When at the keyboard, your wrists should be in a neutral position, not flexed up or down. To check: Place your hand flat, palm down, on the desk. Adhere a adhesive bandage lengthwise (i.e., vertically) over the top of each wrist, and then move to your keyboard and type. If the bandage stretch or go slack, your wrists aren’t in a neutral position. 

Try a trackball mouse. If arthritis is affecting your hands and wrists, get a mouse with a tracking ball, says Dr. Gignac. This allows you to use your finger rather than your whole hand to move the cursor, reducing stress between your hand and forearm.

If you lift or carry heavy items...
Let wheels do the work! Use a trolley or pushcart and roll the items to where they need to go. Even a rollable desk chair can serve as an impromptu pushcart!

Batch it. Instead of waiting until you have a lot to carry at once, make more frequent trips and carry smaller batches. It’s also a great way to take a break from sitting or standing!

Outsource it. Don’t be shy about asking for help, Dr. Gignac says. Most of the people in her study enlisted co-workers to help with especially difficult lifting. 

If you stand all day...
First priority: a shoe check! “Make sure your shoes have good arch support,” says Dr. Gignac. “Look for a shoe made from leather that can stretch in all four directions, has cushioning and is comfortable for standing and walking around.” Have knee pain? A study in Arthritis Care & Research suggests the best option may be a light, flat sneaker or shoe with a flexible sole (the one tested by study participants was the Puma H Street sneaker). And skip the clogs and athletic shoes with thick soles or ones designed as “stability shoes”; those actually exert more weight on the knees.

Get a leg up. Raising one foot up on a stool, footrest or empty box, even for a few minutes, helps a lot of people who stand while they work, says Dr. Gignac. Alternate your feet every 15 minutes or so.

Extend your reach. If you have to do a lot of reaching, reorganize the workspace so the things you use most are at waist level, recommends Dr. Gignac. And use a grabber or reach extender (easily found with a web search) to retrieve the items that are on high or low shelves.

April 2013