Psoriatic Arthritis in the Workplace
Learn how you can make adjustments in the workplace to accommodate your PsA and prevent it from derailing your career.
Every job comes with its own unique sets of challenges — long hours, demanding bosses, and 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 while others have trouble making it through a workday. Having PsA doesn’t mean you have to give up your fulfilling career, but you may have to ask for help and make some adjustments.
How PsA Affects Work
“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.
Psoriasis plaques on the skin and scalp can add self-consciousness or 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.”
Absenteeism and Presenteeism
“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
Research shows how good disease control can improve work performance. One study found that treatment with a biologic led to fewer sick days and less need to reduce job responsibilities. If the drug you’re on isn’t helping, go back to your doctor so you can try something else. Because there are so many new treatment options, odds are you’ll find something that works for you.
In addition to taking the medicine your doctor prescribed, use home care to manage symptoms like flaking skin. Try over-the-counter ointments that help minimize skin dryness or your doctor can prescribe something stronger, if needed.
Tell Your Employer
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 a 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 more willing to accommodate your needs.
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.
- Are you on your feet all day?
- Do you have a fast-paced, 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?
Maximize Comfort on the Job
- 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.
- Stock up on arthritis-friendly work supplies, like an electric 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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