Workplace difficulties in early-stage relapsing-remitting multiple sclerosis with low physical disability

This study evaluated perceived workplace difficulties in 128 individuals with early-stage relapsing-remitting multiple sclerosis and low physical disability. Significant workplace challenges were reported by 40.6% of participants. External barriers, including workplace inflexibility and professional-domestic life imbalance (median 23-item multiple sclerosis (MS) Work Difficulties Questionnaire-MSWDQ-23 score: 31.3, interquartile range 6.3-56.3), represented the highest burden. Women reported higher difficulty scores than men (mean MSWDQ-23 total scores: 29.9 vs. 21.2, p = 0.010). Multivariable analysis identified fatigue (OR 1.37, 95% CI 1.17-1.61) and anxiety (OR 1.21, 95% CI 1.05-1.38) as the only independent predictors of significant workplace difficulty (p < 0.001). These findings demonstrate a significant dissociation between physical disability and functional outcomes. Vocational vulnerability is driven by non-motor symptoms rather than overt neurological impairment. Proactive clinical screening for these factors is essential to mitigate work instability and preserve long-term professional trajectories.