Navigating Work and Axial Spondyloarthritis: Strategies for Managing Symptoms at Work

Living with axial spondyloarthritis (axial SpA) presents a unique set of challenges, especially when it comes to balancing work life with the management of chronic symptoms. axial SpA is a long-term inflammatory condition that affects the spine and sacroiliac joints, causing pain, stiffness, and fatigue. However, with the right strategies, individuals with axial SpA can successfully manage their symptoms in a professional environment and maintain a fulfilling work life.

This post explores practical tips for navigating the workplace with axial SpA, from symptom management to ensuring ergonomic support, based on guidelines from the NHS and other evidence-backed sources.

Understanding Axial Spondyloarthritis and Work Challenges

Axial spondyloarthritis often causes morning stiffness, back pain, and fatigue, which can impact your ability to work comfortably. For many, prolonged sitting or standing can exacerbate symptoms, as staying in one position for too long often increases stiffness and discomfort. On top of the physical challenges, individuals with axial SpA may experience mental health strains, such as anxiety or depression, due to the chronic nature of the condition and its impact on daily activities.

The NHS emphasizes the importance of early intervention and individualized management plans, which are critical not only for reducing disease progression but also for maintaining quality of life in work settings​. This involves a combination of medication, physical therapy, lifestyle changes, and workplace adjustments.

Communicating with Your Employer

Open communication is essential when managing a chronic condition at work. Under UK law, axial spondyloarthritis may be considered a disability, entitling you to reasonable adjustments in the workplace under the Equality Act 2010. It’s crucial to discuss your specific needs with your employer to ensure you receive the appropriate support, such as flexible working hours or ergonomic adjustments to your workspace.

When talking to your employer, consider the following:

• Educate them about axial SpA: Many people are unfamiliar with the condition, so providing a clear explanation of how it affects you can help in advocating for your needs
• Request flexible work arrangements: This might include the option to work from home, adjust your start and finish times, or take breaks to move and stretch.
• Highlight the benefits: Emphasize that reasonable adjustments will enable you to remain productive and contribute effectively to the workplace.

Having this conversation may feel daunting, but it is a necessary step in ensuring your work environment supports your health and wellbeing.

Ergonomics and Workspace Modifications

One of the biggest challenges for individuals with axial SpA is maintaining comfort during extended periods of sitting or standing. To prevent exacerbating symptoms, you’ll need to assess your workstation for ergonomic support. The NHS recommends adjustable seating, sit-stand desks, and appropriate lumbar support to reduce strain on the spine.

Here are key workspace adjustments to consider:

• Ergonomic Chair: Choose a chair that offers lumbar support and allows adjustments for height, armrests, and backrest tilt. Proper posture can reduce pressure on your lower back and improve overall comfort.
• Sit-Stand Desk: Alternating between sitting and standing can alleviate stiffness. A sit-stand desk enables you to shift positions throughout the day, keeping your joints mobile and reducing pain.
• Monitor and Keyboard Positioning: Ensure your monitor is at eye level and your keyboard is positioned so that your elbows are at a 90-degree angle. This setup minimizes strain on your neck, shoulders, and wrists.
• Footrest and Cushions: A footrest can help maintain proper posture, while cushions may offer extra lumbar or seat support to alleviate discomfort during long periods of sitting.

According to the UK’s Health and Safety Executive (HSE), employers are legally required to assess the risks of musculoskeletal disorders in the workplace and make necessary adjustments to reduce these risks​.

When to See a Doctor

If you are experiencing chronic back pain that doesn’t improve with rest, or any combination of the symptoms mentioned above, it’s important to see a healthcare professional as soon as possible. The earlier axial spondyloarthritis is diagnosed, the better the chances of controlling the disease and preventing long-term damage.

Your GP may refer you to a rheumatologist, a specialist in inflammatory diseases, for further testing, which may include:

• Blood tests to check for inflammation markers and the presence of the HLA-B27 gene,
• Imaging tests like X-rays or MRIs to detect inflammation or joint damage.

Managing Fatigue and Energy Levels

Fatigue is a common symptom of axial SpA and can significantly impact your productivity. Unlike ordinary tiredness, axial SpA-related fatigue stems from the body’s inflammatory processes and can persist even with adequate rest. To combat this, it’s important to implement strategies that help you conserve energy and work efficiently.

Practical Tips for Managing Fatigue:

• Pace yourself: Break down tasks into smaller, more manageable steps. This allows you to maintain steady energy levels throughout the day and avoid burnout.
• ake frequent breaks: Regular movement is essential for individuals with axial SpA. Take short breaks every 30–60 minutes to stretch, walk around, or perform gentle exercises. This can reduce stiffness and improve circulation.
• Prioritize high-energy tasks: Schedule demanding tasks during the times of day when your energy levels are at their peak, often in the morning.
• Practice mindfulness: Mindfulness exercises and relaxation techniques, such as deep breathing or progressive muscle relaxation, can help manage both fatigue and the mental stress associated with chronic pain.

The NHS recommends working with a physiotherapist or occupational therapist to develop a personalized exercise program to manage fatigue and improve energy levels

Medication and Symptom Management

Medication plays a crucial role in controlling axial SpA symptoms and preventing flare-ups. The NHS and rheumatology guidelines recommend nonsteroidal anti-inflammatory drugs (NSAIDs) as the first line of treatment for reducing pain and inflammation​. In more severe cases, biologic therapies like TNF inhibitors (e.g., adalimumab) or IL-17 inhibitors (e.g., secukinumab) may be prescribed to target specific inflammatory pathways.

To manage your symptoms at work, consider the following:

• Set medication reminders: Keeping track of your medication schedule is essential for maintaining symptom control throughout the day. Use alarms or apps to remind you when to take your medications.
• Prepare for flares: Flare-ups can happen unexpectedly, so it’s helpful to have a flare-management plan in place. Keep essential items such as a heat pack, cold compress, or pain relief medication on hand at work.
• Stay hydrated and nourished: Dehydration and poor nutrition can worsen fatigue and inflammation. Drinking plenty of water and eating a balanced diet rich in anti-inflammatory foods can support your overall health.

Mental Health and Coping with Stress

The mental health impact of managing a chronic condition like axial SpA cannot be overlooked. Depression and anxiety are more common among individuals with chronic pain, which can, in turn, exacerbate physical symptoms. In a work environment, stress and pressure can also trigger flare-ups.

It’s important to build a support network and develop coping strategies to manage mental health challenges:

• Talk to someone: Whether it’s a trusted colleague, friend, or therapist, having someone to talk to about your condition can relieve emotional burdens.
• Practice stress-reduction techniques: Meditation, yoga, and mindfulness have been shown to reduce stress and improve mental well-being in people with chronic conditions.
• Set realistic goals: Accept that you may not be able to do everything, every day. Prioritize your well-being and set realistic, achievable goals for your workday.

The NHS encourages individuals with chronic conditions to seek support from mental health professionals if they feel overwhelmed or anxious due to their health challenges.

Conclusion: Empowering Yourself at Work

Managing axial spondyloarthritis in a professional environment requires careful planning, open communication, and proactive symptom management. With the right workplace adjustments, medical treatments, and self-care strategies, individuals with axial SpA can successfully navigate their careers while maintaining their health and well-being.

Empowering yourself with knowledge, advocating for your needs, and maintaining an active dialogue with your employer are key steps toward thriving at work despite the challenges of axial spondyloarthritis.

For more information on managing axial spondyloarthritis and accessing personalized health tracking tools, create an account with My Health PA today.

References

• NHS Guidance on Axial Spondyloarthritis (axial SpA) NHS Axial Spondyloarthritis Provides an overview of axial spondyloarthritis, including symptoms, treatments, and lifestyle recommendations.
• Health and Safety Executive (HSE) – Musculoskeletal Disorders HSE Musculoskeletal Disorders Discusses workplace ergonomics and legal obligations for managing musculoskeletal disorders.
• European Alliance of Associations for Rheumatology (EULAR) Guidelines EULAR Recommendations Offers guidance on the management of spondyloarthritis and related conditions.