Rheumatoid Arthritis: Living And Working With An Invisible Challenge

Rheumatoid arthritis (RA) is more than just joint pain—it's a chronic autoimmune condition that can deeply affect every aspect of a person’s life, including their ability to work. As awareness grows around invisible illnesses, it's crucial to understand how RA impacts wellness and productivity, and what can be done to support those living with it.

RA is an autoimmune disease where the immune system mistakenly attacks the body’s own tissues, primarily targeting the joints. Autoimmune disease are thought to affect 1 in 10 people (University of Oxford) with the prevalence of RA being 1% of the UK population (NICE, 2025).

Common symptoms are inflammation, pain, stiffness, and swelling—often symmetrically in the hands, wrists, and knees. Over time, RA can cause joint damage and deformities, and may also affect other organs such as the lungs, heart, and eyes. Beyond the physical symptoms, RA often brings fatigue, low-grade fever, and weight loss. The condition is unpredictable, with flareups that can strike without warning, making daily planning and consistency a challenge.

The National Rheumatoid Arthritis Society (NRAS) has a number of publications to support individuals living with RA.

An essential part of management is for affected individuals to have their Disease Activity Score reviewed twice a year. The DAS28 covers all 28 joints and provides a personalised indication of how active the disease is. For those with high scores, or newly diagnosed they are advised to have monthly reviews until the disease is more controlled.

Treatment is different for each person and are often DMARDs (disease modifying antirheumatic drugs); biologics which are powerful anti-inflammatories and others, all of which need to be monitored for side effects. More information can be found HERE. Keeping active whilst pacing to manage fatigue is important as is a generally healthy lifestyle. Apps are being developed to support those living with RA.

For many, work is not just a source of income— it’s a part of identity and social connection. But for people with RA, the workplace can become a source of stress and limitation. According to a 2025 American report by the Integrated Benefit Institute, autoimmune diseases like RA contribute to significant productivity losses and healthcare costs, with up to 73 days lost annually due to short-term disability and nearly 287 days for long-term disability.

Common challenges at work include:

• Physical Limitations: such as tasks that require fine motor skills, repetitive motion, or prolonged standing/sitting can be painful or impossible during flare-ups.

• Fatigue and Brain Fog: Chronic fatigue and difficulty concentrating can reduce productivity and increase the risk of errors.

• Unpredictability: The fluctuating nature of RA symptoms makes it hard to maintain a consistent work schedule.

• Emotional Toll: The stress of managing symptoms, coupled with the fear of being misunderstood or judged, can lead to anxiety and depression.

Employers and colleagues play a vital role in supporting individuals with RA. Here are some strategies that can make a difference:

• Flexible Work Arrangements: Remote work, flexible hours, or part-time schedules can help accommodate fluctuating symptoms.

• Ergonomic Adjustments: Providing supportive chairs, adjustable desks, and voice-to-text software can ease physical strain.

• Open Communication: Encouraging a culture of empathy and understanding helps employees feel safe disclosing their needs.

• Wellness Programs: Access to physiotherapy, mental health support, and wellness initiatives can improve overall quality of life. All of which can be accessed via PAM Group should access via the NHS be problematic.

While RA presents real challenges, many people continue to lead fulfilling professional lives with the right support and treatment. As we move toward more inclusive and health-conscious workplaces, understanding conditions like RA is essential. By fostering empathy and flexibility, we not only support those with chronic illnesses but also create environments where everyone can thrive.