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Psoriatic Arthritis in the Workplace

Learn how you can prevent your condition from derailing your career.

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Every job comes with its own unique sets of challenges — long hours, demanding bosses, tedious or overwhelming responsibilities. When you live with psoriatic arthritis (PsA), you can also add painful, swollen joints and fatigue to the list of occupational challenges. Every person with psoriatic arthritis is different. Some have mild symptoms that have little impact on their career. Others can barely make it through the workday — or get to work at all.

“So much of what we do at work — in so many different occupations — is based on hand function. If your hands don’t function properly, that’s a problem,” says Arthur Kavanaugh, MD, professor of clinical medicine in the University of California, San Diego Division of Rheumatology, Allergy, and Immunology. Simple job functions like typing on a computer keyboard, gripping a pen or holding the phone to your ear can become major hurdles when your joints hurt.

Psoriatic arthritis has another component, above and beyond sore joints. Plaques on the skin and scalp add self-consciousness or potential embarrassment to each workday.

“I think psychologically it can be a fairly devastating condition, particularly for those who work with many different people,” says Stratos Christianakis, MD, assistant professor of clinical medicine in the division of Rheumatology, Keck School of Medicine at the University of Southern California. “A lot of people may look at the skin and think it’s contagious. Patients are very attuned to that, and they may develop insecurities about having exposed skin.”

Missed Work, Lowered Productivity

“Sometimes people have such severe arthritis that they can’t go to work,” says Dr. Kavanaugh. “But there’s also presenteeism — people show up to work, but they’re really not accomplishing what they would if they were feeling well.”

Presenteeism might be an even more pervasive problem than absenteeism, research suggests. A 2015 study from the UK found a 14% rate of absenteeism among employees with psoriatic arthritis. Yet the presenteeism rate was close to 40%, and productivity loss approached 50%. Those whose disease was poorly controlled fared the worst at work.

Manage Your PsA to Stay on the Job

If you want to remain a productive member of the workforce and continue moving forward in your career, getting your psoriatic arthritis under control is key. “Get a treatment plan with the help of a rheumatologist. That’s very important,” Dr. Christianakis says.

Research shows how good disease control can improve work performance. In a study published in BMC Dermatology in 2014, treatment with a biologic led to fewer sick days and less need to reduce job responsibilities due to psoriatic arthritis.

If the drug you’re on isn’t helping, go back to your doctor so you can try something else. “That’s the good thing about having so many new treatment options. It increases the odds we’ll find something that works,” Dr. Kavanaugh says.

In addition to taking the medicine your doctor prescribed, use home care to manage symptoms like flaking skin, which could be embarrassing at work. “Use ointments that help to minimize skin dryness,” suggests Dr. Christianakis. There are over-the-counter options, but your doctor can also prescribe something stronger, if needed.

Tell Your Employer

“I’ve heard over the years that some patients hide their disease from their employer because they’re afraid they’ll get fi red,” Dr. Kavanaugh says.

These fears are legitimate, but they’re not justified. Legally, your company can’t fire you for having a chronic condition. And under the Americans with Disabilities Act, any company with more than 15 employees has to make “reasonable accommodations” — modifications to help you perform your job more effectively. For example, you might ask for a more ergonomic workstation to keep you comfortable during the day. Or, you could negotiate a flexible or work-from-home schedule when you’re having joint pain, feeling fatigued or have an embarrassing skin flare.

While you’re under no obligation to reveal your condition to your employer, being open does have some advantages. Research finds that employer awareness helps people with psoriatic arthritis stay at their job.

A manager who knows what you’re going through might be more understanding of your absences and unintended project delays, and more willing to accommodate your condition.

If you’re not sure how to approach your employer, reach out to the Arthritis Foundation for resources and tips. Also check the Job Accommodation Network website, which offers ideas on accommodation options. Or join an Arthritis Foundation support group, where you can get advice from people living with arthritis who are successfully navigating the workforce.

Even if psoriatic arthritis is interfering with your job right now, it doesn’t have to have a long-term impact on your career. “Because of the newer treatments over the last decade, we’ve made great strides in keeping people at work,” Dr. Christianakis says. “I think the most important thing is awareness.” Not only do you need to understand your condition, but your coworkers also need to be made aware that psoriatic arthritis isn’t contagious or debilitating when treated correctly, he says.

Choose Wisely

It’s important to be honest with yourself about the challenges of your current job that may affect your PsA symptoms and cause you stress:

  • Are you on your feet all day?
  • Do you have a fast-pace, hectic schedule with lots of travel or late nights at work?
  • Do you have to wear a uniform with abrasive materials that may irritate your skin?
  • Does your supervisor make you feel vulnerable about keeping your job because you call in sick or have to take time off for doctors’ appointments?

It’s a good idea to develop a list of must-haves in your work space and environment. Items can range from flexible work hours to close access to an elevator or restroom. Think about your needs so you can thrive professionally, physically and emotionally at your current or next job.

Maximizing Comfort on the Job

Try these tips to minimize the impact of symptoms while you’re at work:

  • Ask your company for ergonomic tools like a chair, desk, mouse, mouse pad and computer. Put a footrest under your desk so you can prop up your feet when they ache.
  • Also stock up on arthritis-friendly work supplies, like an electronic stapler, easy-grip scissors and gel pens.
  • Use a voice dictation system to avoid having to type.
  • Avoid tight clothes that can put pressure on your sore joints. Choose breathable, natural fibers like cotton or silk, which are easier on the skin. Protect painful or swollen toes by choosing shoes with plenty of room in the front of the shoe.
  • Get up and walk or stretch for at least 5 minutes each an hour to keep your joints mobile.

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