If you have arthritis or you know someone else with the condition, you’ll know just how difficult joint pain can be. It can be extremely painful and debilitating, and can have a big impact on a person’s quality of life.
Arthritis is a term used by doctors to describe conditions affecting the joints. There are in fact about 200 different musculoskeletal conditions but the two most common types of arthritis are osteoarthritis and rheumatoid arthritis.
Osteoarthritis is a condition in which the joints of the body become damaged and can stop moving as freely as they should and become painful.
Osteoarthritis can affect any joint in the body but the most commonly affected joints are the knee and hip as well as joints within the foot, ankle, hand and wrist. It’s common to have osteoarthritis in more than one region of the body. The risk of developing osteoarthritis increases from the late 40s.
Osteoarthritis is the most common form of arthritis – one third of people aged 45 years and over in the UK have sought treatment for osteoarthritis; across the age groups, a total of 8.75 million people in the UK have sought treatment for it.
Rheumatoid arthritis is an autoimmune disease that causes inflammation in your joints It’s a long-term condition and women are three times more likely than men to be affected by it.
If you have painful, swollen joints and stiffness in the morning that lasts for longer than half an hour, you should see your doctor. Research shows that the sooner you start treatment for rheumatoid arthritis, the more effective it’s likely to be, so early diagnosis is important.
Find out more about arthritis and joint pain at www.arthritisresearchuk.org
There are many reasons why your joints may ache and hurt, including:
- Inflammation inside the joints – This irritates the nerve endings and causes pain
- Worn or damaged cartilage – Cartilage has no nerve endings so you may not know if it’s damaged. But if your cartilage is badly worn, the bone underneath may also begin to wear and change shape. This can be very painful because your bones do contain nerve endings
- Putting extra pressure on your joints – Not surprisingly, carrying heavy items can increase the pain in your hands, arms and shoulders, but you may also feel the effects in other joints. But being overweight will further increase the pressure on these joints
- Extra activity – Pushing yourself to complete a task can cause you more pain the next day. Arthritis can reduce your muscle stamina so you become tired more quickly. Arthritis can also cause your ligaments to become slack, which puts more strain on your muscles and joints
I’ve got arthritis, how can I help myself ?
Arthritis can be extremely painful but simple tips for self-help and daily living can help to ease your symptoms:
Rest and exercise
- Gardening doesn’t have to be a problem if you have arthritis, and it can play an important part in keeping up your physical activity.
- It’s important to keep your joints moving and your muscles strong – whether you have arthritis or not. You should protect inflamed or damaged joints, using them ‘little but often’, though it’s important not to rest the joints too much.
- Make sure you put your joints through a full range of motion at least once a day to prevent them stiffening up. If you have a flare-up of your arthritis, which may occur as a result of overdoing it, applying ice to the painful joints may help to reduce the inflammation (but make sure the ice pack is wrapped in a damp towel to protect your skin). Packs to warm in the microwave are available and may help to ease aching joints.
- A physiotherapist can advise you on helpful exercises, which will vary depending on your type of arthritis.
Anyone who has ever tried to get a referral to see a physiotherapist for exercises for their osteoarthritis will know that they face a long wait. Exercise classes run by NHS physiotherapists in hospitals are thin on the ground. And classes provided by leisure centres and private gyms don’t necessarily cater for people with specific joint problems.
So what’s to be done?
For the past few years these knotty problems have been occupying the minds of Dr Nicki Walsh, associate professor in musculoskeletal rehabilitation at the University of the West of England in Bristol, and Professor Mike Hurley, professor of rehabilitation sciences at St George’s University in London.
Dr Walsh is halfway through an Arthritis Research UK career development fellowship that aims to develop a more effective – and cost-effective – way of making it easier for people with osteoarthritis of the knee, hip and back to get into the habit of exercising regularly in order to keep their pain at bay.
With additional funding from the Chartered Society of Physiotherapy Charitable Trust, she has set up a series of community-based six-week-long exercise classes run by physiotherapists in a number of centres in the South West. The exercises are a combination of generic aerobic exercises such as using a bike and bouncer, plus a series of circuit-based exercises for each of the joints that patients can pick and choose from according to their needs. So far they are proving popular, with many people reporting reduced pain and greater ability to self-manage.
As part of her fellowship Dr Walsh is also interviewing patients and clinicians to find out what patients want and why they’re not currently getting it, and why people don’t continue with community-based exercises once they’ve started.
Lack of motivation is key, and because there are so few exercise classes for osteoarthritis patients, many people will have a short course of exercise with a physiotherapist and then be expected to carry on independently, at which point many of them give up.
These findings have led Dr Walsh to rethink the way that exercise classes are run for people with osteoarthritis, and to consider the possibility of moving classes out of NHS hospital settings into leisure centres and private gyms run by non-healthcare instructors.
- We all need to be sensible about what we eat or drink. If you have arthritis it’s important to avoid being overweight, as this puts extra strain on the joints. If you’re very overweight, losing 2 stone (about 13 kg) can reduce pain in the knee by 50%. A good diet with plenty of fruit and fibre, avoiding too much meat or animal fat, is good for your general health.
- Special diets rarely make a great deal of difference if you have arthritis, although many people feel better when they start eating a healthy diet. You may find that a diet which replaces animal fat with polyunsaturated fats such as fish oils can reduce joint inflammation a little.
- Unless you have gout or osteoporosis, it’s rare for alcohol to affect arthritis but it’s important to remember that some drugs can interact with alcohol. If you’re prescribed drugs for your arthritis you may need to avoid alcohol or limit the amount you drink. If you’re in any doubt, check with your doctor.
Find out more about how your diet at Arthritis Research UK’s diet and arthritis pages.
Chronic arthritis can get you down, and constant pain may lead to anxiety and depression. Counselling from your doctor, or from someone they recommend, may help. You may find that sharing the problem with friends and others who are affected can also be helpful. You may be able to learn useful relaxation techniques with the help of a physiotherapist or occupational therapist. There are often support groups or telephone support lines available where you can talk to others with similar issues.
Complementary therapies such as osteopathy and chiropractic can help some arthritic conditions, especially back pain. There’s a huge range of other therapies, including homoeopathy and herbalism, and a range of food supplements that you may be tempted to try. Most of these are harmless, but if in doubt you should ask your doctor. If you do try these therapies or supplements, be critical of what they’re doing for you, and base your decision to continue on whether you notice any improvement. You may find that changing only one thing at a time helps you to tell which therapies are working.
Arthritis Research UK have developed two authoritative reports into complementary medicines and therapies. These reports assess all the known evidence for these therapies and rate them for effectiveness and safety. You can find these reports at Arthritis Research UK’s complementary and alternative medicines pages.
Will moving to a warmer climate help?
Many people with arthritis feel that changes in the weather affect the level of pain they feel. The weather will probably make a difference to how you feel – warmth and sunshine tend to lift your spirits. However, arthritis and musculoskeletal pain occur in all climates, and although the weather may affect the symptoms of your arthritis or the way you feel, it won’t cause the condition or affect the way it develops.
Tomorrow we’ll be looking at how to make gardening easier if you have arthritis by protecting your joints.