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Understanding Ankylosed Wrists, Severe Joint Erosion, and the Real-Life Impact on Work, Mobility, and Human Dignity
Seropositive Rheumatoid Arthritis (RA) is a chronic autoimmune condition that causes the body’s immune system to mistakenly attack its own joints. When this occurs in both wrists—resulting in bilateral ankylosis (a condition where joints become stiff or fused) and severe erosion in the distal radioulnar joint (DRUJ)—the impact can be physically and emotionally devastating.
Despite being largely invisible to the outside world, the pain and limitations caused by RA are anything but invisible to those who live with it. In many cases, individuals cannot carry out basic tasks like lifting objects, typing, or even turning a doorknob. The pain is constant, often described as burning, grinding, or stabbing, and can severely restrict hand function. This drastically reduces a person’s ability to work—especially in roles requiring repetitive wrist movement or manual handling.
Rheumatoid Arthritis (RA) is a progressive autoimmune disorder in which the body’s immune system mistakenly attacks its own healthy joint tissues, particularly the synovium—the lining of the joints. Over time, this abnormal immune response leads to chronic inflammation, causing pain, swelling, stiffness, and eventually erosion of bone and cartilage. As RA progresses, it can result in joint deformities and loss of function, especially in critical areas such as the wrists, knees, and hands. Since it is an autoimmune condition, RA doesn’t just affect the joints—it can also impact other organs and systems, including the lungs, eyes, heart, and blood vessels. Without early diagnosis and proper treatment, the disease can significantly impair daily life, making even simple tasks difficult and painful.
🧬 What Is Seropositive RA and How Does It Affect Daily Life?
Seropositive RA is diagnosed when a person has rheumatoid factor (RF) and/or anti-cyclic citrullinated peptide (anti-CCP) antibodies in their blood—markers that indicate a more aggressive and potentially erosive form of the disease.
With ankylosed wrists and DRUJ erosion, mobility becomes compromised:
- Opening jars, using utensils, or writing can become impossible.
- Even turning a steering wheel or applying makeup becomes painful.
- Many experience chronic fatigue, not just from the disease, but also from the energy it takes to navigate life through persistent pain.
- The disease can also attack internal organs, and because of immunosuppressive medications, sufferers become vulnerable to infections and other serious conditions.
👀 The Stigma of an Invisible Disease
Because RA often presents no external signs to a casual observer, those living with it are frequently misjudged. The ability to walk or drive is sometimes incorrectly assumed to mean the person is “not really disabled.” The reality is, many people with RA push through pain silently, trying to maintain some normality while their joints are being destroyed from the inside out.
This misunderstanding can lead to social stigma and institutional ableism, especially when claimants are assessed for benefits such as Personal Independence Payment (PIP).
⚠️ Why Working Part-Time Doesn’t Mean “Fit for Work”
Some claimants with RA try to retain part-time employment, either out of financial necessity or personal dignity. However, this should never be used to discredit the reality of their condition.
Being able to walk a few steps, drive a car, or work a couple of hours does not negate the fact that:
- They may spend the rest of the day in agony or bed-bound.
- They are at high risk of flare-ups and dangerous joint instability.
- Even light workplace duties could result in accidents, sick leave, or permanent damage—costly for both the employer and the employee.
If a court or assessor dismisses eligibility for disability benefits purely because the person can still perform certain tasks in isolation—without considering pain levels, fatigue, risk, and medical vulnerability—this can be considered a form of discrimination and ableism.
🛡️ Why Personal Independence Payment (PIP) Matters
PIP is not just a financial award—it represents acknowledgment of need. For someone with RA:
- The daily challenges are real and constant.
- Assistive tools, transportation, heating, and care support can be essential.
- Navigating public spaces, employment, and even healthcare appointments can be hazardous without aid.
A claimant with ankylosed wrists and severe DRUJ erosion is clearly living with a long-term, progressive disability. Any suggestion that they are “not disabled enough” because they can smile, sit upright, or hold a steering wheel for short bursts is not just medically inaccurate—it is unjust.
⚖️ Laws That Protect Against Disability Discrimination and Ableism
If a person with a diagnosed disability like Seropositive Rheumatoid Arthritis is denied fair treatment—whether by benefits assessors, employers, or judicial bodies—this may breach the following UK laws:
1. Equality Act 2010
- Section 6 defines disability as a physical or mental impairment that has a substantial and long-term negative effect on one’s ability to do normal daily activities.
- Section 15: Discrimination arising from disability — treating someone unfavourably because of something connected to their disability (like needing time off or assistive support).
- Section 19 & 20: Failure to make reasonable adjustments — if a workplace or public body (such as the DWP or court) fails to consider the barriers a disabled person faces or assumes they don’t need support based on partial functionality (e.g. “can walk or drive”), this can amount to ableism and unlawful discrimination.
2. Human Rights Act 1998
- Article 14 prohibits discrimination in the enjoyment of rights and freedoms outlined in the Act—especially those involving dignity, welfare, and fair treatment.
- When disabled individuals are denied state support due to misunderstanding or bias, there may be a case for a breach of Article 8 (Right to respect for private and family life), particularly when it causes undue suffering or hardship.
💷 Financial Hardship and the Law
Where disability causes a person to experience financial hardship, and their needs are not adequately recognised or supported, this may fall under:
1. The Welfare Reform Act 2012
- This Act governs access to PIP and Universal Credit.
- If decision-makers ignore medical evidence or daily living challenges, or if the assessment method disproportionately disadvantages disabled people, this could constitute systemic discrimination.
2. Public Sector Equality Duty (PSED) – Equality Act 2010
If a disabled person is left in poverty, unable to heat their home, or access essential transport, while the state withholds support due to flawed reasoning, this may breach the PSED.
Public authorities (like the DWP or courts) must have due regard to the need to eliminate discrimination and advance equality of opportunity.
🔚 Conclusion: Recognition, Not Judgment
Seropositive Rheumatoid Arthritis is a debilitating, systemic disease. Its symptoms go far beyond what the eye can see. Judging someone’s capacity based on fleeting abilities rather than lived experience is a disservice—not only to the person, but to the very purpose of disability support systems. Invisible conditions deserve visible recognition. And every person living with them deserves to be heard, supported, and believed.
Resources:
- Seropositive RA: What are the Facts About This Type of RA? – RheumatoidArthritis.org
- Types of Rheumatoid Arthritis
- Types of Rheumatoid Arthritis: Seropositive RA vs. Seronegative RA
- Seropositive and seronegative rheumatoid arthritis (RA) | NRAS
- Bilateral (Both Wrists) Carpal Tunnel Syndrome Surgery: Upper Extremity Specialists: Orthopedic Surgeons
- https://disabledentrepreneur.uk/understanding-rheumatoid-arthritis/
- https://disabledentrepreneur.uk/comprehensive-guide-for-pip-eligibility/
- https://www.nhs.uk/conditions/rheumatoid-arthritis/
Andrew Jones is a seasoned journalist renowned for his expertise in current affairs, politics, economics and health reporting. With a career spanning over two decades, he has established himself as a trusted voice in the field, providing insightful analysis and thought-provoking commentary on some of the most pressing issues of our time.
