Social support at work is important to individuals’ health, wellbeing and employee retention. Evidence suggests employees may be more willing to offer support to co-workers they already have strong friendships with or if they perceive support-giving will be reciprocated. However, the support relationships of workers with chronic health conditions, who may have variable but long-term need for practical and emotional support, have rarely been studied. We conducted in-depth interviews with workers employed when diagnosed with rheumatoid arthritis (RA), an inflammatory and progressive musculoskeletal disorder, to explore how RA affects work relationships, the willingness of employers and co-workers to offer support, and the importance of support for continued employment after RA onset. Participants’ accounts revealed evidence of receipt of sustained social support, but also its withdrawal. The nature of pre-existing relationships influenced the willingness of others to offer support. Employers demonstrated support and understanding, particularly if they had personal knowledge or experience of disability, and their implementation of workplace modifications helped workers with RA to remain employed. However, modifications could be withdrawn if they disrupted workflow or negatively affected relationships with co-workers. We identify implications for organizational policy and practice.