Arthritis and Physical Work

For people employed in physical jobs, work is probably the most active part of the day. Some assume this must keep you fit and healthy compared to sedentary, desk-bound jobs.

Physical work can however involve repetitive actions such as kneeling, squatting, lifting, standing and climbing stairs, these all can feature in the development of knee osteoarthritis. Conversely, a combination of some active occupation and periods of rest may be protective against osteoarthritis. Looking after your joints, avoiding injury, especially to your knees and spine, and taking care of your body and mind can all help prevent and manage osteoarthritis.

Although many people blame hard physical work for their arthritis, having a physical job does not mean that it will inevitably happen, or that the only way to prevent worsening symptoms is to give up work.

Osteoarthritis is much more common in joints which have been injured, so avoiding preventable injuries such as falls and accidents, with suitable clothing, footwear, and risk assessments can make a big difference.

Self-management for those in Physical Occupations

Our self-management videos, diet and exercise advice can be used by all regardless of occupation type but if you are working in a manual occupation and already have osteoarthritis, here are some further tips on things you can do to maintain your fitness to work.

Exercise

Whatever your occupation, exercise is recommended to help prevent and manage the pain of osteoarthritis, especially muscle strengthening exercise.  You should also:

• Too much heavy lifting or manual loading of joints may tip the balance in favour of joint damage rather than protection, but varying position and task can help reduce strain on one area.
• Try to stay fit outside work with aerobic exercise to help stamina and cardiovascular health, resistance exercises especially on areas. that you do not use at work and flexibility to reduce muscle pain and help prevent injury.
• Try knee pads if you have to do a lot of kneeling to protect the knees from pressure.

Weight management and healthy eating

Physical occupations often involve more weight-bearing activity, so being overweight will carry more risk to joints than more sedentary jobs:

• For every kilogram that we weigh over an ideal body weight, another 4-5 kg of weight passes directly through the hips, knees and feet.
• Being overweight causes general inflammation in the body including a higher risk of osteoarthritis in the hands.
• Being overweight worsens joint pain and can worsen joint damage.
• Reducing body weight by as little as 10kg or about 10% can reduce joint pain by about a third which can help protect the joints from damage.
• Healthy eating can bring all round benefits, help support the body’s immune system, improve sleep, reduce inflammation and reduce the risk of osteoarthritis.
• Try to reduce red and processed meat and saturated fat for example butter and cream and increase white meat and fish, olive oil, whole grains for example brown rice, pulses and a large variety of vegetable and fruit.
• Try to reduce processed foods for example sugar, sugary breakfast cereals, processed meat such as bacon and too many takeaways, if possible, although occasional treats will be harmless.

Sleep and mental health

Lack of sleep and depression and anxiety all increase pain, reduce stamina and increase the risk of injury at work.   For further advice on both sleep and mental health are here but also:

• Pay attention to how you are feeling in your mood. Seek medical help if you are very low or anxious about work or other aspects of your life or try to share your worries with family or friends, or see if your employer offers any support services.
• Try to have some relaxation time every day to rest your mind as well as your body and try to have short breaks at work and a lunch break.
• Shift work, especially rotating shifts can be very bad for sleep and overall wellbeing, so see if you can work fixed shifts if possible, or have more rest days before a change in shift pattern.

Medication and osteoarthritis

Carrying on with a job when you have pain can be difficult and many people look to pain relief medication to help, please bear in mind:

• Although some medicines can help with arthritis pain and are useful for short-term treatment, many, especially non-steroidal anti-inflammatories (NSAIDs) such as ibuprofen and naproxen or opioids such as codeine can be harmful if taken for too long and are not recommended in current guidelines.
• If you have been taking pain-relieving medicines for a long time, speak to your GP or healthcare professional about ways which you might be able to stop the medicine or reduce the dose.
• Self-management including weight-management and exercise are as or more effective for arthritis pain than long term medication and are much safer.

Employers and the Workplace

While Health and Safety regulations govern workplaces, they may not always take into account the needs of those with osteoarthritis, so do make your employer aware of your condition and any specific needs you have:

• Employers need to be aware of the risks of heavy or repetitive tasks and must try to reduce this risk with support for manual handling training, machinery and equipment to reduce the load on joints, adequate rest breaks and paid time off work to attend hospital investigations or physiotherapy appointments. Rotating job tasks between workers may help.
• Employers are legally obliged to make “reasonable adjustments” for you if you have a disability to help you with stay at work, however this can be difficult in some environments with limited work opportunities.
• A reasonable adjustment might mean working in another setting or environment for a while, avoiding certain heavy jobs, offering late starts or flexible shifts, reducing working hours or working from home.
• Access to Work is a government scheme where employers can apply for money to help purchase equipment or support to help you stay at work or with your working tasks. This is free for employers and employees. Read more on Access to Work on the Government website.

Occupation and Osteoarthritis

We spend a large amount of our lives working, but does the type of occupation have an impact on developing arthritis? In this article we review current literature to determine if manual and physical labourers, such as people working in construction, farming, sport; and people who move a lot at work, including teachers, nurses, and hairdressers, are more or less likely to be affected by osteoarthritis.

The occupations at highest risk of knee osteoarthritis are floor-layers, bricklayers and carpenters, as well as agricultural workers, and building and construction workers. Cleaners and unpaid houseworkers are also at increased risk of knee osteoarthritis.

Several other manual jobs are now known to increase the risk of knee osteoarthritis but research has not shown consistent findings related to many other occupations. For example postal workers, plumbers and electricians are not at an increased risk of knee osteoarthritis.

Interestingly, farming is associated with an increased risk of hip osteoarthritis, with the highest risk for men who have been farming for more than 10 years, presumably due to heavy lifting.

Repetitive work is not associated with an increased risk of hand osteoarthritis, and sitting and walking occupations, are not associated with increased hip and knee osteoarthritis.