Arthritis can’t be cured, but workplaces can help sufferers overcome obstacles

The prevalence of this chronic disease will increase in the workplace as the population ages. Sufferers are reluctant to tell supervisors and get help functioning at work

The pain started in Randy Rath’s fingers. Then the stiffness and fatigue spread to his other joints. When his doctor diagnosed him with psoriatic arthritis, a debilitating form of inflammatory arthritis, he was devastated.

As a cameraman for the Ontario Provincial Legislature, Rath’s job required daily lifting, standing and agility. As his symptoms worsened, it was impossible for him to make it through the work day. Knowing the disease was chronic and incurable was almost more than Rath could handle. “It was difficult not to be fearful of what the future might bring with this disease,” he says.

Arthritis is a very complicated disease with more than 100 forms, which can be split into two categories: inflammatory arthritis (such as psoriatic arthritis and rheumatoid arthritis) and degenerative or osteoarthritis. The former can affect people of any age while the latter tends to affect individuals later in life. However, an occupational therapist with the Canadian Arthritis Society says she now has more clients in their 40s who have osteoarthritis.

“Inflammatory and degenerative arthritis are becoming more and more prevalent and will be even more prevalent as the baby boomers age,” says Ilene Cohen Ackerman, who teaches clients to manage the disease on their own.

The magnitude of the problem

Four million Canadians suffer from arthritis, 60 per cent of whom are of working age (20 to 64 years old). This number is expected to double by 2030 and will represent one-third of the population.

Within three years of the onset of arthritis, 27 per cent of patients are disabled, according to the British Journal of Rheumatology. The World Health Organization estimates that half of rheumatoid arthritis patients in developed countries are unable to hold down a full-time job within 10 years of the onset of the disease. In Canada, arthritis is the number one cause of long-term disability, disabling 600,000 individuals, and accounting for $700 million and $5.1 billion annually in short-term and long-term disability costs respectively, according to the society.

The disease causes inflammation in joints and the surrounding tissues, leading to symptoms that range from pain and stiffness to joint swelling, deformity of the joints and loss of mobility. While there’s no cure, there are several medical treatments to control the symptoms.

In 2002, Rath started taking a new biologic treatment, which blocks the autoimmune response that attacks the joints and causes inflammatory arthritis. He quickly regained his ability to work and get through the day with less pain and fatigue.

Emotional support and understanding is another important factor that helps people with arthritis manage their symptoms, says Cohen Ackerman. With the right support and assistive devices, people can overcome a lot of the daily obstacles they face at work.

Lack of employer awareness keeps sufferers from confiding in bosses

Unfortunately many people who don’t have arthritis don’t understand the disease.

“People don’t realize how devastating the effects can be,” says Cohen Ackerman. “The thing with arthritis is that unless it’s really advanced and people have noticeable deformities, you can’t see the pain, you can’t see the stiffness and you can’t see the fatigue.”

This lack of understanding makes many people unwilling to talk to their supervisors about their disease. According to a four-year study on arthritis, funded by the Canadian Arthritis Network and the Canadian Institutes of Health Research, one-third of respondents didn’t discuss their arthritis with colleagues for fear that it might affect their job security. “They’re really afraid to let anyone know they have a problem,” says Cohen Ackerman.

Instead, many arthritis sufferers struggle on without assistive devices or flexible work arrangements. An understanding and supportive boss, someone employees feel comfortable approaching about their symptoms, is absolutely imperative to someone with arthritis being able to continue working, says Cohen Ackerman.

Arthritis affects everything a person does, at home and at work, regardless of the type of job. Workplace accommodations need to be made in all work environments, from office to retail to industrial settings. Someone who has arthritis in her hands would have extreme difficulty doing something as simple as stapling paperwork, says Cohen Ackerman.

What employers can do

Employers can help workers with arthritis by ensuring that arthritis medications are covered by the company’s drug benefit plan, moving important files to shelves workers are able to reach, and providing footstools, better chairs, phone headsets, electric staplers and split keyboards.

An ergonomic assessment of an employee’s workstation, performed by an occupational therapist or an ergonomic specialist, is essential, says Cohen Ackerman.

“You can have the best keyboard and the best mouse but if the mouse is on the desk and your keyboard is on the keyboard tray and you’re having to reach for that mouse all the time, you’re going to get symptoms from it,” she says. “It’s not just having ergonomic equipment — it’s making sure it’s properly set up for that particular person.”

Other strategies employers can incorporate to help employees manage symptoms and be more productive include:

•allowing frequent stretch breaks;

•educating employees on proper posture to alleviate strain on muscles;

•providing accessible parking spots so people use less energy walking to the office and have more energy to use at work; and

•providing bags on wheels or trolleys to minimize joint strain from carrying.

Employers can also offer flexible work arrangements and encourage employees to delegate tasks that are too difficult for them to complete.

“Our goal is to keep people functioning to their highest level,” says Cohen Ackerman. “We want to keep them working and being an active participant in their family and their social life.”

A study conducted by the arthritis society found that nearly one-quarter of employees suffering from arthritis don’t take on new projects or responsibilities because of their disease, possibly limiting their career aspirations. The study also found that many arthritis sufferers are giving up breaks to complete tasks, sacrificing sick days and taking vacation time to recuperate at home in order to continue working.

These sacrifices take a toll on an individual’s health and personal life. “Sometimes people put all their efforts into work and then they get home and crash,” says Cohen Ackerman. “They can’t have any family life because they’re so exhausted. They spend the evenings recovering from the work day and spend the weekends recovering from the week.”

Education in the workplace about the symptoms and effects of arthritis is important for early diagnosis and treatment, which benefits both the individual and the company. Patients who receive early treatment for inflammatory arthritis halt the progression of the disease, alleviating the inflammation, which is what causes joint deterioration and pain, says Cohen Ackerman. By halting the disease’s progression, early treatment can reduce the overall cost that employers pay in disability.

The arthritis society launched a workplace program to help people with arthritis and their employers better manage the disease. The program includes simple tips on everything from adjusting posture to assessing the work environment. The society also has a therapy program in Ontario, the Arthritis Rehabilitation and Education program, whereby physiotherapists, occupational therapists and social workers visit people with arthritis in clinics, in their homes, workplaces and schools to teach them how to manage the disease. For more information about the program or how to help employees in the workplace, people can visit the website at www.arthritis.ca or call (800) 321-1433.

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