Rheumatic diseases have a substantial impact on the patient but also on the work status and on a social-economical context. In Europe 25% of the cost of disease is related with rheumatic diseases. We are focusing more on disease activity as a clinical challenge but we have to consider that patient occupational activity is a main issue as a strategic gold for patient management. Rheumatologists have to prove on a daily basis their positive impact on the socio-economical impact of these diseases. The search for practical solutions to empower patients in their work status must be based not only on disease activity management but also in facilitating the work station adaptation to the unique characteristics and ability of each patient.