Arthritis is one of the most prevalent causes of disability in the United States, affecting 46 million American adults. Most people think of arthritis as limiting leisure activities for seniors such as walking, gardening, or playing with their grandchildren.

But, new research from the United States Centers for Disease Control and Prevention finds that arthritis is also a real problem at work.

Doctors analyzed results from a national survey and found that 1 in 3 people with arthritis had difficulties on the job. Rates of disability varied widely among the states, with 25% of working adults affected in Nevada and as many as 50% in Kentucky.

Workers who have repetitive jobs, such as landscaping, typing, or machine operating are most at risk for developing arthritis because of recurring stress on their joints.

Researchers say flexible work schedules, ergonomic work stations, and efforts to promote exercise can all help workers reduce their pain and disability.