Arthritis

What is it?

Arthritis is a common condition causing pain and inflammation of the joints and bones; there are two main types of Arthritis:

Osteoarthritis – the soft tissue covering the ends of the bones (cartilage) in the joint wears away leaving the painful rubbing of bone on bone

Rheumatoid Arthritis – the body’s immune system attacks the affected joints causing damage to the cartilage and bone in the joint

Osteoarthritis is the most common form of arthritis.

How does it affect people?

Arthritis affects the joints; the main symptoms of arthritis are:

Pain

Stiffness

Restricted movements of the joints

Inflammation and swelling

Warmth and redness of the skin over the joint

Osteoarthritis most commonly affects the hands, spine, knees and hips, whilst Rheumatoid Arthritis can affect any joints but most commonly affects the hands, wrists and feet and usually affects joints on both sides of the body at the same time.

How is it treated?

There is not a cure for arthritis, but there are a number of treatments that can help slow down the disease process. Treatment is aimed at controlling symptoms such as pain, improving mobility and joint function. This can include:

Non Steroidal anti inflammatory medication

Physiotherapy

Steroid treatment

People in severe pain may require surgery to replace the affected joint(s)

People with Rheumatoid Arthritis are treated with a range of different types of medication to control their disease and reduce complications.

How might it affect work?

Most workers with arthritis are able to continue working, even if they have symptoms, although the work may require modifications to allow this. Arthritis can cause pain, stiffness and tiredness, all of which can vary – over the day or over months. The symptoms vary widely from one individual to another, making generalisation difficult.

However employees may experience discomfort with some or all of the following tasks:

Lifting and handling

Bending and twisting

Sitting for prolonged periods (may affect driving)

Standing for long periods

Walking long distances

Climbing up stairs

Repetitive movements of the hands or fingers

Employees may also find that:

There are some tasks that they are unable to do

They are unable to work at the same rate as they are used to, or that others can work at

They get tired easily

They feel fatigued and have less stamina and are unable to do the things that they want to do outside of work

What do I need to do as the Manager?

Discuss the problems with your employee specifically in respect of the tasks above and how they relate to work activities. Identify what tasks they can and cannot perform and the length of time that they can perform them. Where changes can be reasonably accommodated you should modify duties to enable the employee to return or continue at work. Arthritis is a chronic condition and it is unlikely that any improvement will happen quickly, the unpredictability of arthritis means that accommodating the employee at work can be quite a challenge. The symptoms can be better one day and worse the next with no apparent cause. Enabling the employee to work within their own limitations and allowing a degree of flexibility will help in accommodating them in the workplace.

You should review the work with the employee every 2-3 weeks. Make sure that they are able to cope and where possible increase their workload in stages to help facilitate their return to full duties.

Key points to consider when managing an employee with arthritis:

Focus on support; helping them to remain at work or to return to work as rapidly as possible

Employees do not need to be pain free before they return to work

Employees may have limitations on their rate of work and the activities they can undertake

The condition can be unpredictable, symptoms may improve or get worse

Modified duties should be a temporary measure and not normally last for more than 4 weeks

The condition may become progressive over time, if the employee requires modified duties for a prolonged period of time consider permanent redeployment

In case of an absence of more than 4 weeks, or difficulty in returning to normal duties after 4 weeks, refer to Occupational Health for advice

Points to Remember

Fit notes

If an employee produces a fit note indicating that they require modified duties, discuss this with them and consider if the modification recommended can be reasonably accommodated.

Job tasks and risk assessments

Review the risk assessment for the employee’s job role and work tasks including the ability to drive safely where required. Take into consideration any temporary modification that may be required to accommodate their reduced ability to undertake certain tasks.

General guidance

If you require further information, refer to the general advice on managing attendance.