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Objectives To understand what we can learn from the impact of the COVID-19 pandemic and lockdown about what enables work participation for people with inflammatory arthritis and chronic pain conditions.

Design Qualitative interviews embedded within an observational questionnaire study of individuals with musculoskeletal (MSK) conditions.

Setting UK primary care (general practices), and secondary care-based rheumatology services.

Participants Individuals with axial spondyloarthritis, psoriatic arthritis and MSK pain from three established cohorts completed an online/paper-based questionnaire (July–December 2020). A subset of respondents were selected for semistructured interviews.

Primary and secondary outcome measures The survey quantified the effects of lockdown on work circumstances. Qualitative interviews explored the impacts of these changes and the advantages and disadvantages of changes in work circumstances.

Results 491 people (52% female, median age 49 years) who were employed at the time of lockdown responded to the questionnaire. The qualitative analysis included 157 free-text comments on work from the questionnaire and data collected within 18 interviews.

Participants reported impacts on mental and physical health, and significant financial anxieties. The impact of work changes varied depending on individual and home circumstances. Some felt forced to ignore advice to shield and continue working. The flexibility offered by home working and changes in commuting enabled greater physical activity for some, while others missed the exercise normally undertaken as part of their commute. Others reported a constant need to be ‘present’ online, which heightened anxiety and worsened MSK symptoms.

Conclusion Lockdown showed that flexible working arrangements, which consider the positive and negative aspects of commuting, posture, movement, and work environment matter for work participation, and can have wider benefits in terms of health and well-being for those with long-term MSK conditions. Incorporating these into new models of work will help make the workplace more equitable and inclusive for people with long-term MSK conditions.
Original languageEnglish
Article numbere057919
Number of pages9
JournalBMJ Open
Issue number4
Early online date7 Apr 2022
Publication statusPublished - 7 Apr 2022

Bibliographical note


This work was supported by versus Arthritis (grant number: 20748) and the British Society for Rheumatology. The funding for the original studies included were from versus Arthritis (MAmMOTH) and the British Society for Rheumatology (BSRBR-AS and BSR-PsA). LM is funded through the Medical Research Council/vs Arthritis Centre for Musculoskeletal Health and Work (vs Arthritis grant no. 20665). LM, Research Fellow, PhD; KS, Research Fellow, PhD; MB, Study Co-ordinator, PhD; GTJ, Reader, PhD; GJM, Clinical Chair in Epidemiology, Dean of Interdisciplinary Research and Research Impact, PhD; KW-B, Professor in Occupational Rheumatology, Honorary Consultant in Rheumatology, Director vs Arthritis/MRC Centre for Musculoskeletal Health and Work, PhD; RJH, Senior Clinical Lecturer, Honorary Consultant in Rheumatology, PhD.

Data Availability Statement

Data may be obtained from a third party and are not publicly available. The data within the article which relate to the collection of BSR register data are owned by the BSR—access to these data are subject to application being made to the BSR: Registers (rheumatology.org.uk).


  • Anxiety
  • COVID-19
  • Communicable Disease Control
  • Female
  • Humans
  • Male
  • Middle Aged
  • Musculoskeletal Pain
  • Pandemics


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