Arthritis at Work

Arthritis

There are many different forms of arthritis that can be diagnosed from inflammatory issues like gout, which may affect one joint like the big toe, to whole body systemic types like Lupus, which can attack joints, connective tissue and effect organs. Perhaps though the two most common types of arthritis discussed in the media are osteoarthritis and rheumatoid arthritis. 

1. What is Osteoarthritis?

Osteoarthritis is the word used to describe the ‘wear’ of joint surfaces. These changes are a normal part of aging and can be seen on scans in all of us at some point in our lives, some earlier or more severely than others. While as many as 30% of all those over the age of 50 show some signs of ‘wear and degeneration’ on scans, only a small portion of those actually have any symptoms at all, and so it is more common to NOT experience any signs or symptoms. However, when you do have pain associated with your osteoarthritis, it can be a major cause of disability, pain, impaired mobility and decreased quality of life. 

Signs associated with arthritis are joint pains that are made worse by prolonged positions or with loading activity which is more than the joint is used to. Your joints also may feel hot and stiff, and you may see some variable levels of swelling around the effected joint. 

What Causes Osteoarthritis to ‘Flare up’? 

Osteoarthritis can become painful following a physical trauma (such as a road traffic collision or accident at work) or from a very slow, low-level feed of irritation from a combination of factors such as increased physical activities/ excessive static postures, period of weight gain or possibly from reactions going on in the body and manifesting at the effected joint after a virus for example.  

The likelihood of developing symptoms and the severity of symptoms depends on a combination of factors including 

  • Prolonged positions or activities that put excessive or repeated strain on your joints – such as through poor manual handling techniques at home or work, or poor work habits such as not rotating tasks, or not having regular stretch breaks. 
  • Individual factors – being female increases the likelihood of developing pain while increasing age increases the likelihood of ‘wear and tear’ of the joint surfaces. 
  • Physical wellbeing factors – smoking, obesity, poor general fitness and previous joint injuries all increase the likelihood of developing pain and the length of time it takes to recover. 
  • Psychological wellbeing factors – stress, depression and anxiety all increase the likelihood of developing pain and even increase the severity of pain and the length of time it takes to recover. 

How can I help myself? 

Unfortunately, there is no ‘cure’ for osteoarthritis, as in the joint surfaces will never return to their youthful state. However, the good news is two-fold: 1. You cannot worsen or speed up the degeneration of the joint surfaces, and 2. You can work to minimise the factors that have made your osteoarthritis become painful and minimise those risk factors, thereby potentially making the pain reduce to a manageable level or even go altogether! Therefore, your attitude and the actions you take are the most important factors in keeping your joints healthy and happy. The most effective way to manage symptoms of osteoarthritis are to 

  • Limit rest to 24-48 hours only after the onset of a flare, if able. Low impact exercise such as yoga, pilates and swimming can be a good starting point, but ‘little and often’ stretch breaks are important. Exercise is vital for long term joint health. 
  • Talk to your GP or pharmacist about what pain relief may be right for you. If your pain is controlled, you will be able to maintain more movement, while anti-inflammatory medication (such as ibuprofen), can help reduce inflammation within the joints. 
  • Apply gentle heat (such as a hot water bottle or microwaveable wheat-bag) to reduce stiffness, or ice (wrapped in a towel) to reduce pain and inflammation if your joints are feeling hot or swollen after activity. 
  • Ensure you are following all manual handling techniques correctly at home and work – keep the load close to your waist, use your legs to lift, lower or push loads as these are the most powerful muscles in the body, and work within your capability. 

2. What is Rheumatoid Arthritis 

Rheumatoid Arthritis is an inflammatory condition whereby the body’s immune mistakenly attacks itself at the lining of the joints (the synovium) typically at the hands, knees and ankles and on both sides of the body. The reaction can also go beyond the joints, some can develop issues with the eyes, heart, lungs and circulatory system. 

What are the symptoms of Rheumatoid Arthritis? 

Often the first symptoms of Rheumatoid Arthritis are that of pain and tenderness at the joints and then redness or swelling (particularly at the smaller joints like at the hands). With Progression other symptoms may include: 

  • Joint pain and stiffness/ swelling that may last 6 weeks or more, 
  • A pattern of morning pain and stiffness taking longer than 30-60 minutes to improve, 
  • Inexplicable fatigue is noted and sometimes you run a low fever. 

How can I help myself? 

If there is any suspicion of Inflammatory issues as with Rheumatoid Arthritis, then you will very likely need specialist medical investigations and support which will need to be referred in through your GP. This should typically be referred into a Rheumatology department for further investigation and opinion as specialist medication support will be required to try and help control the symptoms and minimise stress to tissue. 

Physiotherapy will also be of use as well to help you keep mobile and look at ways to improve your mobility, strength and function to help keep you active and minimise pain. 

As always important for recovery, keep a positive outlook on what you can do and take an active role making small, short-term goals to look ahead and progress. 

How can physiotherapy help?   

At Physiotherapy Matters, our physiotherapists can conduct a thorough assessment to confirm a diagnosis, signpost you to suitable care and work with you to help you manage your symptoms and return to normal activity by 

  • Helping you understand your condition 
  • Helping identify the factors that may have caused or be aggravating your symptoms and providing advice on how to minimise these, including manual handling 
  • Developing symptom management strategies so you always feel in control 
  • Completing ergonomic workplace assessments to minimise any work-related risk 
  • Providing an individualised exercise program to improve mobility and strength in order to address symptoms but also to prevent future episodes, including work-hardening 
  • Providing additional manual therapies that may help ease symptoms, such as 
  • Soft tissue massage to reduce any muscular tension in the surrounding muscles 
  • Mobilisation of the joints to reduce stiffness 
  • Acupuncture to reduce pain 
  • Referral for additional services if required including 
  • Ostenil injection – to improve joint health and lubrication and reduce pain to help you exercise as much as possible.

Speak with your line manager or HR department early on if you recognise any symptoms raised above and they can look to help adapt your work tasks and refer you on for support through your occupational health service. 

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