“I Would be More of a Liability than an Asset”: Navigating the Workplace as a Younger Person with Arthritis

  • Danielle Berkovic
  • Darshini Ayton
  • Andrew M. Briggs
  • Ilana N. AckermanEmail author


Purpose Over half the population in Australia with arthritis and other musculoskeletal conditions is aged 25–64 years. This reflects the peak income-earning years for most, yet little research has examined the influence of arthritis on work issues specific to younger people. The aim of this research was to examine the work-related experiences of younger people (defined as those aged 18–50 years). Methods A qualitative exploratory design was used. Participants with inflammatory arthritis or osteoarthritis were recruited from the community, including urban and rural settings. An interview guide was based on the World Health Organization’s International Classification of Functioning, Disability and Health. Deductive and inductive coding techniques were used to identify emerging work-related themes from the data. Results Semi-structured interviews were conducted with 21 younger people (90% female) with a mix of arthritis conditions, vocational backgrounds and career stages. Three themes were identified: (1) the perceived impacts of arthritis on career trajectories, (2) the impacts of arthritis on participants’ workplace environment, employers, and colleagues, and (3) the personal toll of working with arthritis. The personal toll of working with arthritis relates to the arthritis-attributable impacts of physical and psychological symptoms on productivity and presenteeism in the workplace. Conclusion Younger people with arthritis experience numerous challenges at key stages of their careers, from career planning through to productive working. This can be used to inform workplace accommodations for people with arthritis and increase awareness of likely barriers to work productivity among colleagues, employers and clinicians.


Arthritis Musculoskeletal diseases Employment Adult Qualitative 



DB received a PhD scholarship from Musculoskeletal Australia to conduct this research. AMB was supported by a fellowship from the Australian National Health and Medical Research Council (#1132548). INA was supported by a Victorian Health and Medical Research Fellowship from the Victorian Government.

Compliance with Ethical Standards

Conflict of interest

Danielle Berkovic, Darshini Ayton, Andrew Briggs, and Ilana Ackerman declare that they have no conflict of interest.

Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all study participants.


  1. 1.
    Ackerman IN, Kemp JL, Crossley KM, Culvenor AG, Hinman RS. Hip and knee osteoarthritis affects younger people too. J Orthop Sports Phys Ther. 2017;47(2):67–79.CrossRefPubMedGoogle Scholar
  2. 2.
    Australian Bureau of Statistics. National Health Survey: first results, 2017—2018—Australia. Canberra: Australian Bureau of Statistics; 2018.Google Scholar
  3. 3.
    Arthritis and Osteoperosis Victoria. A problem worth solving: the rising cost of musculoskeletal conditions in Australia. Elsternwick: Arthritis and Osteoperosis Victoria; 2015.Google Scholar
  4. 4.
    Schofield DJ, Shrestha RN, Cunich M, Tanton R, Kelly S, Passey ME, et al. Lost productive life years caused by chronic conditions in Australians aged 45–64 years, 2010–2030. Med J Aust. 2015;203(6):260 (e1–e6).CrossRefPubMedGoogle Scholar
  5. 5.
    Norton L, Harrison JE, Pointer S, Lathlean T. Obesity and injury: a review of the literature. Injury research and statistics series no. 60. Cat. no. INJCAT 136. Canberra: Australian Institute of Health and Welfare; 2011.Google Scholar
  6. 6.
    Arthritis Australia. Taking control of your ankylosing spondylitis: a practical guide to treatments, services and lifestyle choices. Malvern: Australian Rheumatology Association; 2009.Google Scholar
  7. 7.
    Schofield D, Shrestha R, Cunich M. The current and future burden of arthritis. St Leonards: The University of Sydney: Arthritis Australia; 2016.Google Scholar
  8. 8.
    Schofield D, Shrestha R, Percival R, Passey M, Callander E, Kelly S. The personal and national costs of lost labour force participation due to arthritis: an economic study. BMC Public Health. 2013;13:1–10.CrossRefGoogle Scholar
  9. 9.
    Lindsay S, Cagliostro E, Carafa G. A systematic review of workplace disclosure and accommodation requests among youth and young adults with disabilities. Disabil Rehabil. 2018;40(25):2971–2986.CrossRefPubMedGoogle Scholar
  10. 10.
    Australian Commission on Safety and Quality in Health Care. Patient-centred care: improving quality and safety through partnerships with patients and consumers. Sydney: ACSQHC; 2011.Google Scholar
  11. 11.
    Schofield D, Shrestha R, Cunich M. Counting the Cost 2—economic costs: the current and future burden of arthritis. St Leonards: The University of Sydney: Arthritis Australia; 2016.Google Scholar
  12. 12.
    Young A, Dixey J, Kulinskaya E, Cox N, Davies P, Devlin J, et al. Which patients stop working because of rheumatoid arthritis? Results of five years’ follow up in 732 patients from the Early RA Study (ERAS). Ann Rheum Dis. 2002;6(4):335–341.CrossRefGoogle Scholar
  13. 13.
    Laires PA, Canhao H, Rodrigues AM, Eusebio M, Gouveia M, Branco JC. The impact of osteoarthritis on early exit from work: results from a population-based study. BMC Public Health. 2018;18(1):472.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Westhoff G, Buttgereit F, Gromnica-Ihle E, Zink A. Morning stiffness and its influence on early retirement in patients with recent onset rheumatoid arthritis. Rheumatology (Oxford). 2008;47(7):980–984.CrossRefGoogle Scholar
  15. 15.
    Poh LW, He HG, Chan WCS, Lee CSC, Lahiri M, Mak A, et al. Experiences of patients with rheumatoid arthritis: a qualitative study. Clin Nurs Res. 2017;26(3):373–393.CrossRefPubMedGoogle Scholar
  16. 16.
    Jetha A, Gignac M, Bowring J, Tucker S, Connelly C, Proulx L, et al. Supporting arthritis employment across life course: a qualitative study. Arthritis Care Res. 2018;70(10):1461–1468.CrossRefGoogle Scholar
  17. 17.
    Allaire S, Li W, LaValle M. Reduction of job loss in persons with rheumatic diseases receiving vocational rehabilitation: a randomized controlled trial. Arthritis Rheumatol. 2003;48(11):3212–3218.CrossRefGoogle Scholar
  18. 18.
    Gignac MA, Badley EM, Lacaille D, Cott CC, Adam P, Anis AH. Managing arthritis and employment: making arthritis-related work changes as a means of adaptation. Arthritis Rheum. 2004;51(6):909–916.CrossRefPubMedGoogle Scholar
  19. 19.
    Mancuso C, Paget S, Charlson M. Adaptations made by rheumatoid arthritis patients to continue working: a pilot study of workplace challenges and successful adaptations. Arthritis Care Res. 2000;13(2):89–99.CrossRefPubMedGoogle Scholar
  20. 20.
    Oakman J, Kinsman N, Briggs AM. Working with persistent pain: an exploration of strategies utilised to stay productive at work. J Occup Rehabil. 2017;27(1):4–14.CrossRefPubMedGoogle Scholar
  21. 21.
    Packham J, Hall M. Long-term follow-up of 246 adults with juvenile idiopathic arthritis: education and employment. Rheumatology. 2002;41:1436–1439.CrossRefPubMedGoogle Scholar
  22. 22.
    Minden K, Niewerth M, Listing J, Biedermann T, Bollow M, Schontube M, et al. Long-term outcome in patients with juvenile idiopathic arthritis. Arthritis Rheum. 2002;46(9):2392–2401.CrossRefPubMedGoogle Scholar
  23. 23.
    Jetha A. The impact of arthritis on the early employment experiences of young adults: a literature review. Disabil Health J. 2015;8(3):317–324.CrossRefPubMedGoogle Scholar
  24. 24.
    Backman CL. Arthritis and pain. Psychosocial aspects in the management of arthritis pain. Arthritis Res Ther. 2006;8(6):221.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Slater H, Jordan JE, Chua J, Schutze R, Wark JD, Briggs AM. Young people’s experiences of persistent musculoskeletal pain, needs, gaps and perceptions about the role of digital technologies to support their co-care: a qualitative study. BMJ Open. 2016;6(12):e014007.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Ackerman IN, Bucknill A, Page RS, Broughton NS, Roberts C, Cavka B, et al. The substantial personal burden experienced by younger people with hip or knee osteoarthritis. Osteoarthr Cartil. 2015;23(8):1276–1284.CrossRefPubMedGoogle Scholar
  27. 27.
    Rahman N, Bhatia K. Impairments and disability associated with arthritis and osteoperosis. Canberra: Australia Institute of Health and Welfare; 2007.Google Scholar
  28. 28. WHS/OH&S Acts, Regulations and Codes of Practice 2019.
  29. 29.
    Liamputtong P. The science of words and the science of numbers: research methods as foundations for evidence-based practice in health. In: Liamputton P, editor. Research Methods in Health: Foundations of Evidence-Based Practice. Melbourne: Oxford University Press; 2010. p. 3–22.Google Scholar
  30. 30.
    Briggs AM, Jordan JE, Ackerman IN, Van Doornum S. Establishing cross-discipline consensus on contraception, pregnancy and breast feeding-related educational messages and clinical practices to support women with rheumatoid arthritis: an Australian Delphi study. BMJ Open. 2016;6(9):e012139.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Ackerman IN, Jordan JE, Van Doornum S, Ricardo M, Briggs AM. Understanding the information needs of women with rheumatoid arthritis concerning pregnancy, post-natal care and early parenting: a mixed-methods study. BMC Musculoskelet Disord. 2015;16:194.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    World Health Organization. International Classification of Functioning, Disability and Health (ICF) 2018 Available from:
  33. 33.
    Sverker A, Thyberg I, Ostlund G, Waltersson E, Thyberg M. Participation in work in early rheumatoid arthritis: a qualitative interview study interpreted in terms of the ICF. Disabil Rehabil. 2014;36(3):242–249.CrossRefPubMedGoogle Scholar
  34. 34.
    Novick G. Is there a bias against telephone interviews in qualitative research? Res Nurs Health. 2008;31(4):391–398.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Nowell L, Norris J, White D, Moules N. Thematic analysis: striving to meet the trustworthiness criteria. Int J Qual Methods. 2017;16:1–13.CrossRefGoogle Scholar
  36. 36.
    Saunders B, Sim J, Kingstone T, Baker S, Waterfield J, Bartlam B, et al. Saturation in qualitative research: exploring its conceptualization and operationalization. Qual Quant. 2018;52(4):1893–1907.CrossRefPubMedGoogle Scholar
  37. 37.
    Tobin G, Belgey C. Methodological rigour within a qualitative framework. J Adv Nurs. 2004;48(4):388–396.CrossRefPubMedGoogle Scholar
  38. 38.
    Hammond A, O’Brien R, Woodbridge S, Bradshaw L, Prior Y, Radford K, et al. Job retention vocational rehabilitation for employed people with inflammatory arthritis (WORK-IA): a feasibility randomized controlled trial. BMC Musculoskelet Disord. 2017;18(1):315.CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Lacaille D, White MA, Backman CL, Gignac MA. Problems faced at work due to inflammatory arthritis: new insights gained from understanding patients’ perspective. Arthritis Rheum. 2007;57(7):1269–1279.CrossRefPubMedGoogle Scholar
  40. 40.
    Barlow J, Wright C, Kroll T. Overcoming perceived barriers to employment among people with arthritis. J Health Psychol. 2001;6(2):205–216.CrossRefPubMedGoogle Scholar
  41. 41.
    Oldfield M, MacEachen E, Kirsh B, MacNeill M. Impromptu everyday disclosure dances: how women with fibromyalgia respond to disclosure risks at work. Disabil Rehabil. 2016;38(15):1442–1453.CrossRefPubMedGoogle Scholar
  42. 42.
    Munir F, Leka S, Griffiths A. Dealing with self-management of chronic illness at work: predictors for self-disclosure. Soc Sci Med. 2005;60(6):1397–1407.CrossRefPubMedGoogle Scholar
  43. 43.
    van Vilsteren M, Boot CR, Twisk JW, van Schaardenburg D, Steenbeek R, Voskuyl AE, et al. Effectiveness of an integrated care intervention on supervisor support and work functioning of workers with rheumatoid arthritis. Disabil Rehabil. 2017;39(4):354–362.CrossRefPubMedGoogle Scholar
  44. 44.
    de Buck PD, le Cessie S, van den Hout WB, Peeters AJ, Ronday HK, Westedt ML, et al. Randomized comparison of a multidisciplinary job-retention vocational rehabilitation program with usual outpatient care in patients with chronic arthritis at risk for job loss. Arthritis Rheum. 2005;53(5):682–690.CrossRefPubMedGoogle Scholar
  45. 45.
    Oakman J, Keegel T, Kinsman N, Briggs AM. Persistent musculoskeletal pain and productive employment; a systematic review of interventions. Occup Environ Med. 2016;73(3):206–214.CrossRefPubMedGoogle Scholar
  46. 46.
    Moayed FA, Daraiseh N, Shell R, Salem S. Workplace bullying: a systematic review of risk factors and outcomes. Theor Issues Ergon Sci. 2006;7(3):311–327.CrossRefGoogle Scholar
  47. 47.
    Fattori A, Neri L, Aguglia E, Bellomo A, Bisogno A, Camerino D, et al. Estimating the impact of workplace bullying: humanistic and economic burden among workers with chronic medical conditions. Biomed Res Int. 2015;2015:708908.CrossRefPubMedPubMedCentralGoogle Scholar
  48. 48.
    Gignac MA, Cao X, Lacaille D, Anis AH, Badley EM. Arthritis-related work transitions: a prospective analysis of reported productivity losses, work changes, and leaving the labor force. Arthritis Rheum. 2008;59(12):1805–1813.CrossRefPubMedGoogle Scholar
  49. 49.
    Saastamoinen P, Laaksonen M, Kaaria SM, Lallukka T, Leino-Arjas P, Rahkonen O, et al. Pain and disability retirement: a prospective cohort study. Pain. 2012;153(3):526–531.CrossRefPubMedGoogle Scholar
  50. 50.
    van Vilsteren M, Boot CR, Knol DL, van Schaardenburg D, Voskuyl AE, Steenbeek R, et al. Productivity at work and quality of life in patients with rheumatoid arthritis. BMC Musculoskelet Disord. 2015;16:107.CrossRefPubMedPubMedCentralGoogle Scholar
  51. 51.
    Husni ME, Merola JF, Davin S. The psychosocial burden of psoriatic arthritis. Semin Arthritis Rheum. 2017;47(3):351–360.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Danielle Berkovic
    • 1
  • Darshini Ayton
    • 1
  • Andrew M. Briggs
    • 2
  • Ilana N. Ackerman
    • 1
    Email author
  1. 1.School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
  2. 2.School of Physiotherapy and Exercise ScienceCurtin UniversityPerthAustralia

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