Living with an autoimmune condition means navigating a body that’s often unpredictable. Some days you’re capable and energised. Other days, even small tasks feel impossible. The challenge isn’t motivation — it’s managing a health condition that doesn’t follow a schedule.
As someone who lives with an autoimmune condition myself, I’ve experienced first-hand the fine balance between wanting to contribute fully and needing to respect the body’s limits. I’ve also seen, through my work in healthcare and coaching, how workplaces can transform an employee’s experience when they move from compliance to understanding.
What Are Autoimmune Conditions?
Autoimmune conditions occur when the immune system attacks healthy cells by mistake. There are over 80 known autoimmune diseases — from rheumatoid arthritis and lupus to multiple sclerosis and axial spondyloarthritis (the condition I live with).
These conditions share overlapping symptoms like pain, inflammation, fatigue, stiffness, brain fog, and fluctuating energy levels. The difficulty is — these symptoms are often invisible. You might look fine but feel like you’re walking through mud.
This invisibility often leads to misunderstanding — colleagues and managers might see inconsistency or unreliability when, in reality, the person is managing pain or fatigue that isn’t visible to others.
Why Pacing Matters — and What It Really Means
Pacing is a self-management approach that helps people with chronic conditions balance activity and rest to avoid burnout or flare-ups. It’s not laziness — it’s a clinical and evidence-based strategy used to stabilise energy levels.
Think of pacing as budgeting your energy like money. You only have so many “spoons” (a concept many with chronic illness use). If you spend them all at once, you go into debt — and your body will make you repay it with days of fatigue or pain.
Here’s what pacing might look like in a work context:
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Breaking big projects into smaller, spaced-out chunks.
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Alternating between sitting, standing, or walking tasks.
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Scheduling “recovery” periods after meetings or long tasks.
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Taking 5–10 minute breaks every hour to stretch or move rather than pushing through.
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Having the freedom to decline optional meetings or non-essential travel when in a flare.
From my own experience: staying in one position for long periods — even sitting at a desk — can increase pain and stiffness. I often set reminders to move every 30–45 minutes, or I take short standing breaks between calls.
A workplace that encourages pacing isn’t reducing productivity — it’s preventing burnout and supporting consistency.
Flexible Working: What It Really Means
The term “flexible working” is often thrown around but rarely defined. For people with long-term or autoimmune conditions, true flexibility is about adapting the work environment and expectations to align with fluctuating health.
Here’s what it might include:
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Flexible start and finish times – for example, allowing someone to begin later on mornings when fatigue or stiffness is worse.
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Working from home options – during flare-ups or treatment days (like biologic injection days), working from a comfortable and controlled environment can prevent further pain or exhaustion.
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Split shifts or adjusted hours – working in shorter blocks across the day with longer rest periods in between.
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Meeting flexibility – allowing cameras off during virtual meetings or scheduling shorter, more focused calls.
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Autonomy over workload – empowering employees to manage their own schedules and priorities, focusing on outcomes rather than rigid hours.
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Hybrid models – allowing employees to choose where and how they work best each week, depending on their symptoms.
Flexibility is not about giving people an “easy option.” It’s about creating conditions where they can maintain productivity without sacrificing their health.
Travelling to and From Work
For many people with autoimmune conditions, the commute can be one of the hardest parts of the day. Sitting in traffic, standing on public transport, or driving long distances can trigger fatigue, pain, and inflammation — sometimes before the workday even begins.
Workplaces can help by:
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Allowing off-peak travel so employees can avoid crowds and get a seat.
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Offering remote start options – for example, beginning the day from home and travelling in later when energy levels are higher.
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Providing parking close to the entrance, avoiding long walks across car parks.
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Encouraging virtual meetings to reduce unnecessary travel between sites.
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Reimbursing occasional taxi fares if public transport becomes physically difficult during a flare.
From my own experience, even a 20-minute commute can make a huge difference to how my body feels for the rest of the day. Travelling at quieter times or being able to work remotely after treatment days has been game-changing.
Physical Environment: Think Beyond Desks
Yes, ergonomic chairs and standing desks are important — but so is variety. Being static (even in a “perfect” posture) can be painful.
Workplaces could explore:
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Dedicated wellbeing or “reset” rooms — spaces where staff can stretch, use rollers or mats, or lie flat for a few minutes to ease pressure and stiffness.
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Access to heat therapy tools — such as a plug-in massager, heat pads, or hot water bottles.
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Noise and light control — fatigue worsens in overstimulating environments. Offering quiet zones or dimmer lighting can help.
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Temperature control — extremes of heat or cold can trigger pain or inflammation; personal fans or heaters can make a big difference.
Communication and Understanding
The most powerful “adjustment” is often cultural. People with chronic or autoimmune conditions don’t always need extra equipment — they need permission to be honest.
Encourage open conversations through:
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Regular wellbeing check-ins that focus on energy, not just output.
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Manager training on invisible conditions and empathetic communication.
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Psychological safety so employees can say, “I’m not at 100% today,” without guilt or fear of being judged.
The goal is not to lower standards — it’s to sustain them in a realistic way.
Good Days and Bad Days
Autoimmune conditions are unpredictable. A genuinely inclusive workplace recognises that. The good day/bad day approach helps employees plan their work dynamically:
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On good days → prioritise high-focus or collaborative work.
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On bad days → work from home, rest more between meetings, or focus on admin and lighter tasks.
A simple shared plan can help managers anticipate and support this. Ask:
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What does a bad day look like for you?
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How can we adapt tasks or schedules when that happens?
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What helps you recover faster?
Why It Matters
Inclusion isn’t a legal checkbox — it’s a leadership skill.
Supporting staff with long-term or autoimmune conditions means you’re supporting humans to stay in work, feel valued, and contribute meaningfully. The result? Better wellbeing, lower absence rates, and stronger loyalty.
Workplace Support Plan / Cheat Sheet
Employee name: ___________________________
Condition: ___________________________
Manager: ___________________________
Date: ___________________________
Understanding the Condition
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Typical symptoms: ___________________________
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Flare triggers: ___________________________
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Signs of fatigue or flare-up: ___________________________
Workplace Adjustments
Physical Environment:
☐ Ergonomic desk setup
☐ Standing options
☐ Temperature/light control
☐ Access to rest/stretch area
☐ Quiet zone / sensory reduction space
Working Hours:
☐ Flexible start/finish
☐ Hybrid / remote options
☐ Reduced travel or off-peak commute
☐ Split shifts or variable patterns
☐ Shorter, more frequent breaks
Communication:
☐ Regular wellbeing check-ins
☐ Clear boundaries for updates
☐ Peer or “health buddy” support
Good Day / Bad Day Plan:
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What can you do on good days? ___________________________
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What helps on bad days? ___________________________
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Early warning signs: ___________________________
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Agreed adaptations: ___________________________
Review Frequency: Quarterly / As needed
Final Reflection
Workplaces can’t remove someone’s condition, but they can remove unnecessary barriers.
The most supportive environments aren’t the ones with the most resources — they’re the ones that listen.
If you start with understanding, empathy, and curiosity, you’ll already be doing more than most.
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