Working with rheumatism and musculoskeletal disorders

The European Agency for Safety and Health at Work has published a factsheet for employers on how to help staff who suffer from rheumatism and other chronic musculoskeletal disorders. What does it advise?

In context

Rheumatic and musculoskeletal disorders ( RMDs ) are commonly arising chronic health conditions, and are only set to increase in prevalence as the working population becomes older. RMDs include rheumatism, arthritis, osteoporosis and fibromyalgia, and although the conditions are not caused directly by work they can be aggravated by it, and may make certain tasks difficult or impossible. The European Agency for Safety and Health at Work (EU-OSHA) says that often those affected have to leave work early when this could have been avoided (see The next step ).

Tip. Employees with RMDs are protected by the Equality Act 2010 . This means that you are legally obliged to implement reasonable adjustments if these will enable them to stay in work.


The effects of these conditions vary between individuals and also change over time. RMDs may cause pain in the limbs, neck or back. There could be stiffness, particularly after a sedentary period. The severity of the conditions may also vary from day to day. Plus there may be side effects from medication. Other symptoms to be aware of are:

  • sleep disturbance which could cause additional fatigue
  • mental health may suffer, both due to the pain, and concerns about job security
  • being tired, stressed or depressed can also make it harder to ignore the pain.

How to adapt

The first stage in finding a way forward is to have an occupational health (OH) assessment of the employee. OH advisors are skilled in identifying precisely how someone’s condition is impacting or made worse by their work, and in determining the adjustments to make.

Tip. Request the employee’s permission to make an appointment with an OH advisor. The process will help all involved to map out the future for the individual in their role. You should also plan for repeat appointments. The advisor should be able to recommend a frequency.

Tip. As the employer you’re not entitled to receive personal medical confidential information. However, you should receive clear advice about whether the individual is fit for work at all and the kind of adaptations you might need to make.

Tip. Review your risk assessments for all the work activities the individual is involved in, taking into account the fact that they may be less agile and more vulnerable to injury. You should also consider whether you need to write a personal emergency evacuation plan to assist them to leave the premises in an emergency (see The next step ).

Tip. Adjustments you might consider in discussion with the employee include: (1) flexible hours to avoid commuting at rush hour, or to delay the start of the working day; (2) working from home; (3)  changes to their workstation; (4) enabling plenty of short breaks to be taken; (5) changing the job role to include fewer activities which the individual finds triggering such as prolonged sitting or standing.

New guidance describes the impact these conditions may have including ongoing pain, sleep disturbance, mental ill health and the effects of medication. You should work with the employee to establish the adaptations which are needed such as flexible hours or changes to their workstation. Seek occupational health advice at an early stage.

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