Work and a flare up

[Sore_but_smiling]

Hello everyone, I hope we are all well.I am new here but have had psoriatic arthritis for the last 4 years but only diagnosed in November 2024.

I was put on methotrexate and given a steriod injection to tie me over until the methotrexate kicked in and I can honestly say it worked amazing! I had no niggling pain and the inflammation vanished.

Then last month I developed a chest infection and had to come off the methotrexate and everything has gone to poo 🤨. Not only have the usual joints flared up but new ones, my spine in particular and I am in so much pain, the pain relief isnt touching it. My work place is as supportive as it can be but want to speak to me about my condition in more depth and my capability for the role. I am so worried about this.

I feel like a sitting duck at the moment, I don't want too lose my job but I am also aware that if I push myself through a flare up as I have done so in the past it makes it worse (I ended up in crutches for 2 months a few years ago due to a flare up).

Has anyone had a capability meeting? How did you explain yourself and your condition?

I am struggling with this bit as I am still newly diagnosed, and trying to figure it out myself.

Thank you all for reading x

[Hidden]

one of the arthritis charities, there are several UK ones, probably has a helpline. Google “arthritis charities “ and see what you come up with.

[Sore_but_smiling in reply to Hidden]

Thank you. I have taken your advice and they were very helpful.

[piglette]

Try Versus Arthritis versusarthritis.org

[Sore_but_smiling in reply to piglette]

Hello, thank you. I spoke to versus arthritis and they were really helpful to me x

[piglette in reply to Sore_but_smiling]

I am so glad. I used to be a Trustee of Arthritis Care who then merged with Action Arthritis to become Versus Arthritis so I have a soft spot for them.

[Ascidian]

I'm afraid that I can't really help with the work issue as I had already stopped work when I was diagnosed with PsA in nov19. However, I just thought it might be useful for you to know (and tell work) that once you get the meds right, you might be almost back to your old self for a long time. The methotrexate can take a LONG time to fully kick in. I was actually started on sulfasalazine which helped a little but not enough. Then methotrexate was added and helped a little more. But it took the best part of 11 months on the dual therapy before I quite suddenly felt fantastic. Now, about 4 years on, I only have occasional joint pain, and the fatigue really isn't a problem any more. Having to stop the methotrexate so early in your treatment has possibly just set you back a bit, but it may also be that you need another drug added in (often it is either sulfasalazine or leflunomide, I believe. You really need to talk to your rheumatology team. But, the key thing is probably to tell work that you think you just need a bit longer to get your meds right. Good luck

And it may be helpful for you to join the NRAS group on Health Unlocked if you haven't already. Although it is primarily aimed at RA sufferers, there are lots of psoriatic arthritis sufferers in the group, too. Both conditions can cause similar issues at work, and for life in general. And both conditions are treated with similar meds.

[Sore_but_smiling in reply to Ascidian]

Hello, Thank you for your advice.You are right, I think I was expecting to feel back to my old self once I was diagnosed and started on a treatment plan but I am now realising this may take a few months/years.

I have had a rheumatology nurse and OT warn me previously that my methotrexate will more than likely increase again plus another DMARD added in the mix.

My difficulty at the moment is learning to pace myself (so much easier said than done) but I am spotting a pattern now and I am accepting that I may need to slow down more.

NRAS and versus arthritis have sent me a few leaflets on my condition which will help me when I go back to work and discuss with my HR team.

[Ascidian]

It sounds like you are doing all the right things, and asking the right questions. One other thought - I don't know what pain relief you take but are you also taking any anti-inflammatories? Ibuprofen didn't work for me (and led to major blood pressure spikes), but many people take naproxen regularly. I have a prescription for Celecoxib, which works really well for me on those (now rare) occasions when I have a bit of a flare. GPs are reluctant to prescribe it until you've tried other options as it is expensive and they also don't like you to take any anti-inflammatories too often as they can cause their own issues. However, I think it is useful to know the various options. Hopefully your leaflets will help with all of this. Again, Good luck x

[Sore_but_smiling in reply to Ascidian]

I was on naproxen and codeine daily for 18 months straight before I was diagnosed and then my rheumatologist took me off them (well naproxen). I am only allowed to take naproxen when I have a flare up now which my GP has currently prescribed me for two weeks but is reluctant about prescribing any longer than this.Unfortunately I found codeine useless for my PSA, only naproxen was able to calm down my symptoms but it took 2 months for this to kick in.

Hopefully my rheumatology team will contact me today and the GP is phoning on Friday so I will see what they say.

[kirstyo]

It's probably a positive thing, calling it a capability meeting makes it sound bad but it's likely they are looking to find out what they can do to help. You absolutely want a referral to occupational health, they will recommend adaptations and adjustments that will keep you in work. An employer doesn't need to do what OH ask but they tend to because it's very hard for them in most cases to justify why something that would be helpful was recommended but they didn't do it.

I've got loads of equipment for work and I've another meeting in a couple of weeks to get them to get me a different mouse because my hands are getting worse and my wrists are now going too.

Remember you are protected by the equality act, your employer has to make reasonable adjustments unless they can prove that they can't or it would be hugely detrimental to them to do so.

[Sore_but_smiling in reply to kirstyo]

Hello. Thank you so much for your response, it has really put my mind at rest.HR did mention a referral to OH on my return to work.

Unfortunately my back has still not improved so my GP has signed me off for a further week but your post has reassured me and I am less worried about my return now.

Jessica

[kirstyo]

Honestly I think they just don't explain these things well at all! OH are usually very good, I've got a fancy chair, a keyboard that splits in the middle so you can change the position of both sections, a fancy mouse and speech to text software all at home, they have also been told to give me flexibility but to be honest my role is pretty flexible in terms of tasks so I rarely have to ask for anything to be changed in terms of workload as I can just move stuff about. It has made a huge difference and kept me in work. GP actually offered to sign me off this morning because my hands are so bad just now but there is no need since I can talk to type.

[Sore_but_smiling in reply to kirstyo]

I am so glad occupational health was good to you, it gives me a lot of hope.I do a physical job with a lot of manual handling, I am starting to accept now that I may need to reduce my hours (fortunately my work is very flexible with full and part time hours) until I am in full remission otherwise I will just keep burning my body out.

[kirstyo in reply to Sore_but_smiling]

It's so hard isn't it? I'm a nurse and had to leave the NHS for a desk job (although there were a lot of other factors too, it's the most toxic place to work). All my life I would have told you no way could I do a desk job, I would be so bored but thankfully I love it and they have been so supportive with equipment and things. I've been a bit down the last few days because my hands have been so bad and I realise what my conditions have taken from me but overall I'm really lucky, I have a great life and I try not to let it get to me but every time it takes something else it's impossible not to think about.