Holding down a job while dealing with the physical, emotional and psychological challenges of arthritis can be a serious issue. While some jobs and some jobsites may appear overwhelming to the newly diagnosed arthritis patient, most employers are open to adaptations and modifications to job duties for their employees.

Listed below are a number of practical tips for dealing with work place issues. They are grouped in five general categories: Activities to build into your routine; Ergonomics; Task management or re-definition, Attitudinal aspects and Interactional aspects. Taken as a whole, the tips are meant to help you to not just survive, but to thrive.

Activities to build into your routine

• Stretch frequently if you sit at a desk
• Wear sensible clothing and shoes for comfort, particularly if you are on your feet much of the day
• Be diligent about taking your medication regularly and making time for exercise. The less inflammation and more fitness, the better you will be able to handle your workday
• Make time to take care of joints, which are hurting by the end of the day, whether that is with ice/heat, compression to take down swelling, or resting splints/wraps. Often we come home and are too tired to pay attention to ourselves
• Take short breaks. Walk around the block once in the morning and once in the afternoon. If you can, try to lie down for a brief rest
• Manage your pain and fatigue levels by pacing yourself and taking breaks
• Practice a healthy lifestyle of eating whole foods, getting plenty of sleep, exercise and relaxation to offset stress
• If you have Sjögrens Disease and you work in a sealed building, ask your employer if you may bring a humidifier to keep by your desk. Keep shifting the location of the humidifier in order to lessen any chance of mildew build up in your office or cubicle. Even a bowl of water in close proximity to your desk will help moisten the air.
• Dry, sealed rooms require extra moisturizing for your eyes. Use drops/gels liberally. Also use nasal and oral lubricants frequently.  Sip water routinely.  Sit by a window that opens if possible.

Ergonomics

• Make sure your desk and chair are ergonomically appropriate. A general rule of thumb is 90/90/90 (90 degrees at the knees, 90 degrees at the hips, and 90 degrees at the elbows)
• Wear your braces and splints during the day to protect your joints, especially if you are doing a lot of repetitive motion
• Stand up occasionally during meetings
• Allow time for breaks and schedule some fresh air and exercise time
• Ensure you have good lighting at your desk
• If your eyes are irritated by your computer screen, check to see if the computer can adjust glare. If not, ask your employer for some sort of screen filter. Remember to stop every twenty minutes or so and look away from computer at an object across the room
• A modern, ergonomically designed chair will allow adjustments in the seat height, seat angle, armrest height and sometimes the lumbar support. Don’t be afraid to ask for a new chair if your job requires a lot of sitting

Task management/redefinition

• Find somewhere quiet to rest for 20 minutes during your lunch break. This works best if you can find somewhere to lie down and take some of the load off of your joints. You will also have more energy to continue the rest of your day
• If you can arrange to have flexible work hours, use those to break up your day and take rest breaks as needed, or work from home if you can.
• Use a tracking device such as Fitbit (or any one of several Android or IOS apps on a smart phone) to track your activity/sleep. Aim to spread your activity throughout the day (not one hour of exercise and then resting the remainder of the day)
• If possible and you can afford it, work part time, or a reasonable number of hours that you know you can handle. Often there is a point where working more doesn’t pay off because your well-being becomes compromised.
• Try to vary/alternate/mix up your home activities, such as doing some cleaning, then some reading, and then some cooking rather than completing one activity before moving to another
• Put the items you use most often or are heaviest or most awkward in the places that are easiest to access
• If your hands hurt, consider using a headset for your phone and/or voice recognition software (e.g. Dragon Professionally speaking)
• Try to vary your work activities, such as alternating filing, typing, phoning rather than doing all your typing and then all your filing
• Keep healthy snacks handy
• If you eat out, choose healthy food and limit “decadent” lunches to once in a while
• For meetings, if you have difficulty keeping track of information, and have difficulty organizing and remembering, I find it valuable to use a lined journal/notebook to keep track. You can use the same journal for many subjects, and because notes are always filed in chronological order it makes for easy record keeping and reference
• Whenever possible, avoid repetitive activities to protect the joints
• Whenever possible, avoid sitting or standing for long periods
• Try to use an ergonomic workstation and tools
• Try to use proper body mechanics and be aware of correct posture
• Wear supportive shoes
• If necessary, use splints
• If cognitive functioning is an issue ask for repetition and clarification and use post it notes and technology reminders
• Try to ensure you have a “ quiet workspace” with limited distractions
• Make sure you have other interests and diversions outside work to help maintain a healthy balance
• Find and have on hand good information sources for explaining about your disease
• Establish a good relationship with human resources personnel in general and the health and safety officer in particular
• If possible set or negotiate limits on your overtime and work at home
• If you are able to telecommute to work, seize the opportunity, even if only for a small portion of your job

Attitudinal aspects

• Tell your co-workers that sometimes you may have a “pain day”, when you may move a little more slowly, may be quieter, and may be conserving your energy to perform your most important tasks. But stress that your goal is to maintain the best quality work you can, as often as you can
• Pace and prioritize your work; stay on top of your tasks at work and try to manage your time wisely. Start early with projects so you are not piling up long work hours prior to deadlines.
• Think beyond the moment. Plan for the whole day, next day and next few days (i.e. the spoon theory) http://www.butyoudontlooksick.com/articles/written-by-christine/the-spoon-theory/.
• Identify the things that are most important to you. Do these first and whatever energy remains can be used for the things that are less important to you.
• Take one or more of the education sessions available through the Mary Pack Arthritis Program, (or a program offered by another, local arthritis agency) such as how to manage fatigue or how to manage pain
• If you must travel, ensure you manage jet lag, and schedule meetings to be as good to your body as possible. This means no 7:00 am breakfast meetings three time zones away.
• Assess your work situation with respect to making changes to how your work can be performed
• Evaluate your work options, which may include working from home, flextime, part-time, later start time or a change of job duties
• Do your best to look on the bright side, even when pain and fatigue are grinding you down. To a certain extent, arthritis can exert control over your physical essence, but a positive attitude can work wonders

Interactional aspects

• Try to bring your co-workers to the point of understanding that having arthritis doesn’t mean you have an excuse to do less work, or work of lesser quality. Stress that you still have a contribution to make
• Look for an employer who prioritizes health and wellness in the workplace
• Seek a referral or an appointment with an occupational therapist to help you identify things you can do to improve your work experience with arthritis
• Be aware of your limitations and communicate to those you have an open trusting relationship with at work
• Recognize that the work place has a different “value system” that may not necessarily be “patient-aligned”. There will be those at work who view any kind of disease involvement as unwelcome in the workplace. Do your best to work around these dinosaurs
• Try not to take things “personally” at work when there may be performance issues related to your work.
• Don’t be reluctant to politely ask for assistance from your employer and co-workers if you feel you need it