Arthritis Takes a Painful, Costly Toll on Workers

Sometimes, the physician's role on minimizing work limitations is direct, perhaps by prescribing traditional therapy regimens and even biologic therapy to patients early enough in the course of their disease to preserve function.

Other times, a physician may refer a patient to physical or occupational therapy, or to a hand surgeon for a customized thumb or wrist splint that permits normal workplace activities, said Diana Baldwin, who is an occupational therapist at the Missouri Arthritis Rehabilitation and Training Center.

“We've found that it isn't enough to tell people, 'Cut back on your hours,' or 'Be more flexible,' or 'Don't do things that hurt,' '' she said. “For the average working person with arthritis, that is not useful [advice].”

What does seem to make a difference is when physicians explain to arthritis patients early on that their joints are more vulnerable to common workplace conditions such as tendonitis or lower back pain, and provide a reasonable rationale for them to implement protective strategies, she said.

The Missouri Training Center in Columbia is currently completing a federally funded study that has randomized 84 adults with arthritis to receive either written materials about arthritis in the workplace or interventions conducted by Ms. Baldwin in the work setting, be it a manufacturing workshop, business office, or classroom.

She has spent 1.5–2 hours interviewing these workers with arthritis and then has studied them as they work, taking pictures that she will later diagram to show movements that stress the joints including twisting, grabbing, reaching, and bending.

She has investigated ergonomic surgical tools to aid an anesthesiologist, adapted the car of a traveling salesman, and added a step stool to ease a manufacturing specialist's reach to a drill press.

Making such changes early on appears to keep people in the workplace longer, working more effectively and in less pain, she said.

But economic realities have proved to be a barrier to early workplace interventions, particularly in the lower paying, rigorous jobs that put the greatest stress on joints.

No janitors have agreed to allow Ms. Baldwin to come to their workplaces to identify practices that might be exacerbating their arthritis, for example.

“They're not going to expose the fact that they have arthritis on the job,” she said.

Before the height of this cart was modified, the user had to bend forward to push it around the workplace.

With a raised handle on the cart, the user can stand upright and move it more easily. Photos courtesy Diana Baldwin