How do I keep working with eight swollen joints at 49?

Question

Hi doctor,

I need some real advice here. I work in project management, and it's mostly desk work, but my hands and wrists have gotten so bad I can barely type for more than 20 mins without wanting to cry. Right now I have eight swollen joints confirmed; my rheumatologist has me on methotrexate, and my CRP is at 34 and ESR at 68. The meds have not fully kicked in yet, I guess, but I cannot take leave forever.

How do I keep working with eight swollen joints at 49 without losing my job or my mind in the process?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com

I have read your query, and I am sorry for the discomfort.

I am truly sorry you are dealing with this situation because trying to keep up with a demanding desk job while living with active inflammatory arthritis can be incredibly difficult.

Based on what you have described, with eight swollen joints and elevated CRP (C-reactive protein) and ESR (erythrocyte sedimentation rate), it sounds like your disease is still quite active, so it is not surprising that typing is so painful.

Methotrexate often takes several weeks to a few months to reach its full effect, but you should let your rheumatologist know that your symptoms are still significantly limiting your ability to work.

They may recommend a temporary bridging treatment such as a short course of corticosteroids if appropriate, adjust your medication, or consider adding or changing disease-modifying therapy if your response is inadequate.

In the meantime, it is worth discussing workplace accommodations with your employer. These might include speech-to-text software to reduce typing and an ergonomic keyboard and mouse. Ensure your workstation is properly adjusted, take frequent short breaks to stretch your hands, work flexible hours, and temporarily modify tasks that require prolonged keyboard use.

Many employers are willing to make reasonable adjustments when they understand that you have a medical condition and that these changes can help you remain productive.

Avoid pushing through severe pain for long, as it can make functioning even harder. Gentle range-of-motion exercises recommended by a hand therapist or occupational therapist, using splints if advised, and pacing your activities can also help protect your joints.

Please try to follow up if you find this answer helpful.

And I hope you will feel better soon.

Thank you.