Chronic strain, daily work stress and pain among workers with rheumatoid arthritis: Does job stress make a bad day worse?

The structure of the job and the daily experience of work are challenges for workers with rheumatoid arthritis. Yet little is known about how these two factors interact to put workers with chronic pain at risk for worse pain on a given day. This exploratory 20 workday diary study of 27 workers with rheumatoid arthritis used hierarchical linear modelling to examine how the structure of the job and neuroticism moderate the relationship between daily undesirable work events (daily stressors), and pain reports within a day. On days with more undesirable work events compared to days with fewer events, individuals with jobs associated with job 'strain' (high demand/low control) reported greater midday pain, irrespective of neuroticism and negative mood, than workers with other combinations of demand and control. These findings demonstrate the utility of analysing fluctuating within-person relationships among pain, mood and daily work stressors within the context of the structure of the job, and helps to explain why daily work stressors result in worse health outcomes for some but not all workers with RA.