Manage Fibromyalgia at Work
Fibromyalgia is a complex mix of symptoms, most of which are painful and exhausting. Sufferers may experience one or more of these symptoms, and with a depressed immune system, other illnesses have an easy way in.
Doctors are still researching, but the current thinking is that it's most likely a neurological issue in which the pain receptors in the brain don't shut off, and other nerve-brain problems co-exist. It is no longer being considered a rheumatological (inflammatory) condition, although fibro does cause inflammation.
Fibromyalgia costs the economy
A 2003 study in the Journal of Rheumatology1 showed startling costs, both for employers and fibromyalgia patients:
- Medical costs for fibromyalgia patients were more than twice that of non-fibro patients.
- Disability rates were double for fibro employees than non-fibro employees.
- For each fibromyalgia medical claim, employers spent between $57 and $143 on direct and indirect costs.
It makes financial sense for both employees with fibromyalgia and employers to search for simple workplace and job modifications to reduce, prevent and improve symptoms, and subsequently improve productivity on the job.
How can fibromyalgia symptoms affect work?
- Brain fog - memory and concentration problems make it difficult to complete difficult tasks at work.
- Exhaustion and fatigue - possibly causing a lot of the brain fog, exhaustion slows work completion, and causes confusion when doing complex tasks.
Not sleeping well at night also increases tiredness the next day, which contributes to raised pain levels.
- Pain - the main and arguably worst symptom of fibro. When the pain systems of the body don't work properly, you feel much more pain, for longer, and sometimes for no apparent reason.
Pain can occur anywhere in the body - hands, feet, shoulders, back, chest, hips, knees, head, everywhere! It can be dull and background, or it can be very sharp and distracting.
- Depression and anxiety - these are common problems that the fibromite faces. Exhaustion and constant pain often cause depression and anxiety. This can interfere with the workplace, especially when needing to work in teams.
- Lowered immune system - when a cold virus sweeps through the workplace, healthy people are sick for up to a week, but then recover, and some even avoid catching the bug. Fibromyalgia sufferers have a weak immune system - they will catch most of the illnesses, and it will take much longer to recover.
- Medication - fibro patients are often prescribed a concoction of medications to deal with the pain, insomnia, depression, and other side-illnesses that fibromyalgia causes. Many of these medications contribute to the brain fog, and make operating machinery or driving dangerous.
Working with fibromyalgia
Much of the time I am able to deal with my fibromyalgia while working—but sometimes it gets the better of me.
I have had this condition for over 20 years, according to various specialists (neurologists and rheumatologists in two different countries). I had it through studying at high school and university, and subsequently at work.
My most difficult times were all high-stress periods:
- studying full time and working to support myself throughout school and university
- working full time and studying part time
- working in Fukushima during the 2011 earthquake and subsequent nuclear crisis
I reached a point where I couldn't use my hands to cook or clean, which is when I decided to make my life simpler and slower.
These days I work part time as a freelance writer and photographer, but I still have days where the fibro, along with other related and unrelated illnesses, knocks me out.
How to manage fibromyalgia at work
You can be productive at work with fibromyalgia. But you do need to experiment to find what combination of treatments and techniques work—every fibromyalgia patient is different!
Find a doctor who understands your diagnosis, who encourages you to manage the disorder yourself, but suggests different treatment options.
Never return to a doctor who tells you that fibro is not real.
Prioritize your health, even during your working day! From personal experience, it is not worth working in a company which does not take a fibromyalgia diagnosis and specialists' recommendations seriously.
Short breaks for stretching, a short walk, or meditation can be built into your workday. Yoga or tai chi classes can improve the health and productivity of all employees - it might be useful to start a semi-regular class at your workplace.
Limited number of spoons
The Spoon Theory is an easy, visual way to explain fibromyalgia to other people, especially in workplaces where teaspoons always seem to disappear!
If you decide to tell your boss, or if you are an employer with a fibromite employee, consider using this Spoon Theory, developed by Christine Miserando, to help explain fibromyalgia.
1. Monitor your symptoms
Notice when you are productive, and when your pain levels are at their lowest.
Watch to see which tasks cause more pain, and which ones are okay. There may even be a sequence of tasks, which in a different order cause less pain.
Try taking regular short breaks, get up, move around a little, drink some water, stretch, and see how this affects your pain levels and productivity.
Do different locations cause more or less pain?
When do you have the most fibromyalgia pain?
2. Develop a routine
Fibromyalgia patients have a limited amount of energy and a 'foggy' mind with forgets things easily. A routine reduces the amount of energy spent thinking about what to do next - you can do some things on auto-pilot.
Schedule in short rest breaks - perhaps after meetings, or every hour. A lunch break with a short walk, or even just simple stretches in the workplace bathroom can help reduce pain, clear a foggy mind and increase productivity, not just for fibromites!
Don't make the routine too rigid - there will be days with lower energy levels, or unplanned tasks and meetings to attend to. A flexible routine is most useful on tough days.
3. Look for flexibility at work
Some workplaces offer flex-time - you can come in later or leave earlier, as long as your hours for the week balance appropriately. If, like me, you find it easier to work through the bran fog with fewer distractions and people around you talking, this is useful.
Perhaps your workplace would consider telecommuting - working from home occasionally, or one day a week, where you have the flexibility to rest, set your own heating and cooling levels, can do great things for fibromyalgia symptoms.
You may want to consider downshifting - instead of a raise, ask for more annual leave. Or shift to a part time position.
If you have problems with sinus inflammation, see if your workplace allows you to use a humidifier, or open a window.
Move noise sources away from your position - working in or next to a room with a photocopier or printer can be very distracting, if everyone wants to use it!
Placing items that are regularly used in easy-to-reach locations can reduce the amount of energy spent during a work day. See if you can re-organize your workplace to be more efficient and less strenuous.
Try to avoid strenuous and painful tasks such as lifting heavy items, or standing in one spot for a long time.
Avoid perfectionism - get the job done well, but not necessarily 'perfect'.
Learn to ask for help, to accept help when offered, and also to say 'no' to extra tasks and responsibilities. Being a superhero is a recipe for a fibro flare!
4. Plan and make lists
Even healthy people need to plan and track their tasks, fibromites are no different. In fact, using lists and planning work is the best way to be productive despite brain fog, fatigue and pain.
- Have one or two short planning and review sessions during a work day, where tasks are listed and progress is evaluated. Most people find the best times are at the start or the end of their work day.
- Don't try to fit too much into each day - you'll end up disappointed with your progress, and less productive the next day.
- Break projects and larger tasks into smaller tasks. Write these in task lists or in a calendar. Crossing the completed tasks off increases motivation - something that is often low for fibro sufferers.
- Use one calendar for everything - tasks, appointments, meetings, project milestones, deliveries, communication records. An electronic calendar, that other members of your team can see or add events to, is great. Especially if it can send reminders to you (to your phone, or by email, etc.)
Teaching through the fibro fog
When I teach, I put my lesson outlines and a review of the class into my diary - I know which topics I have covered and when, and also what the homework is for the next week.
When I occasionally forget to update my plan immediately to match what we actually covered that lesson, the following class is much more stressful to plan for and teach!
5. Use helpful tools
In jobs where I had to type a lot, my hands and arms became dreadfully painful. Using a split contoured keyboard, wrist braces and speech-to-text dictation software allowed me to be productive, even when it hurt too much to type.
Look for tools that can help you. For example:
- A standing desk, different seat or balance ball to combat sciatica and back pain.
- A different light globe type to prevent headaches.
- A soft mat to stand on to help with foot pain.
- Earplugs to reduce noise and distractions.
- A backpack instead of carrying a briefcase or laptop bag lop-sided.
- Compression socks to prevent swollen feet and legs.
- Heat or cold packs, mentholated sports creams and capsaicin plasters can reduce pain, inflammation or tense muscles.
- Potted plants or even an aquarium to battle depression and anxiety.
- Supportive braces - back, knees, wrists, elbows, etc.
- Multi-page scanner - instead of scanning one page at a time.
- A digital whiteboard - better than chalk and a blackboard, with notes able to be saved and printed easily.
- A blanket - if, like many fibro sufferers, you feel very cold in air-conditioned offices.
There are many more tools, techniques and health aids that may help you - experiment to find the combination that works for you!
Look for areas to improve outside work
A streamlined and productive household is a great help when working, even without the complications of fibromyalgia. It saves energy, is less stressful, and allows fibromites to perform better at work.
Eating healthily, both at home and at work, is important to give the fibro body the best nutrients for daily energy, improving the immune system, and for dealing with the ongoing pain. Many fibromites have digestive issues - ask a GP to check for food allergies, and avoid processed foods and food additives. Try planning and cooking in advance to save energy on strenuous days.
Gentle exercise is important for maintaining mobility and strength in muscles. Many fibromyalgia patients report improved symptoms at a healthier weight, and exercise is important for reaching that. Tai chi, yoga, gentle swimming and walking are all good places to start, but check with your doctor first!
Mindfulness, meditation, stress reduction and other pain management techniques are fantastic for helping the fibromyalgia worker deal with and often reduce daily and severe pain.
Look at ways to improve your sleep - a better bed, a darker or quieter room, a relaxing before-bed routine, cutting out caffeine, nicotine and alcohol can all improve the quality of sleep. A good night's sleep enormously reduces pain levels the following day.
Tai chi at work
What other techniques and tools help you function at work?
If you have fibromyalgia or another chronic illness or pain condition, how do you remain productive at work?
Let us know in the comments below!
- Economic cost and epidemiological characteristics of patients with fibromyalgia claims, R.L. Robinson, et.al., Journal of Rheumatology, June 2003, 30(6):1318-25
- Employees with fibromyalgia: medical comorbidity, healthcare costs, and work loss, L.A. White, et.al., Journal of Occupational and Environmental Medicine, January 2008, 50(1):13-24