Osteoarthritis

Written by Jan Vickery

A chartered physiotherapist and ergonomist, Jan is head of clinical operations for AXA Health’s specialist Health Services division

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The good news when it comes to osteoarthritis is there's plenty we can do to ensure our quality of life isn't compromised.

The medical profession has changed its thinking in recent years, and now focuses on self-management. This means doing 'what you can to preserve function and mobility of joints, like regular exercise, controlling body weight and treating injuries as and when they occur,' explains our Lead Physiotherapist, Jan Vickery.

Osteoarthritis can occur in the fingers, knees, toes, hips, base of thumb and spine, but as it takes a long time to develop, there is plenty of time to be proactive. It involves the loss of cartilage, the protective surface over the end of the bone, so that joints become swollen and painful.

Rheumatoid arthritis, however, is an auto-immune disease. It also causes swelling, pain and stiffness in the joints, and can be managed well with drugs when caught early. Standard treatment is to manage pain with paracetamol and codeine, and reduce inflammation with NSAIDS (non-steroidal anti-inflammatory drugs).

If this isn't working, doctors have the option to refer patients to a rheumatologist and/or physiotherapist. Usually other drugs for rheumatoid arthritis are then prescribed such low dose steroids, hydroxychloroquine. or disease modifiying drugs such as methotrexate, leflunomide and sulphasalazine.New biologic drugs, such as anti-TNF, are even more potent and precise at targeting the disease.

A controlled exercise programme can help to control symptoms. A physiotherapist may offer manipulation and stretching, and pain relief. 'We want people to be empowered, so they can go away and be able to cope if they have a flare up. For instance, icing the joint, if it flares up helps to bring down swelling.' Osteoarthritis can cause a vicious circle, particularly among the elderly. So, how can we help ourselves?

Rule one: lose weight

“Losing weight is crucial,” says Jan.

“Exercise, weight loss and wearing the right shoes can keep a patient off drugs and injections and prevent surgeryA recent article in Arthritis Today explains, ''Research shows losing as little as 11 pounds may improve joint health and cut the risk of osteoarthritis of the knee by 50 per cent.'

Rule two: exercise

''There's been much more emphasis on movement and muscle building to alleviate the effects ofarthritis in the last 40 years,' says Jan.

“Building up muscle strength improves the function of the joint and retrains it in balance awareness.”

“Exercise slows down the effect of deterioration in joints due to ageing. Try low impact exercises such as cycling or rowing exercises. Exercising in water is an excellent solution as your bouyancy takes stress and weight off your joints.'

In fact, hydrotherapy has become a common form of treatment for arthritis.

'The warm water in a hydrotherapy pool soothes muscles and enables people to do exercise they couldn't do on dry land.'

Rule 3: Get moving

If exercising in a gym isn’t your thing then try dancing (especially if it involves moving your arms and hands) t'ai chi, yoga or even knitting … any activity that helps with dexterity, balance, firms up muscles, eases stress, and keeps the body supple.

To supplement or not to supplement...

Many people with osteoarthritis, or those who have a few early twinges, try supplements, such as glucosamine with chondoitrin, green lipped mussel, fish oils, and rosehip. Evidence is mixed - with glucosamine some trials say it is helpful, and others claim it is not - while people who take them also report different results.

Jan admits, 'There is evidence that such as rosehip and omega-3 fish oils may help pain, and glucosamine might slow down progress of osteoarthritis.'

Replacing joints may be a final option if arthritis is disabling , but according to Jan, 'Alongside someone not being able to function normally, especially in activities of daily living such as washing, dressing and being able to move around, here has to be X-ray evidence of severe joint degenration to justify a joint replacement.. Whenever a joint still has life in it, we try to keep it going.'

Suggestions for easing the pain of arthritis have been passed down from generation to generation.

5 ways to prevent osteoarthritis

1. Posture

Review how you use your body - what position do you spend your day in - are you sitting at a computer? How do you sleep at night? The Alexander Technique or yoga can be great for gaining awareness about where you are putting strain on your body and changing your existing habits.

2. Footwear

Wear shoes that absorb shock, such as trainers or running shoes, to minimise impact on weight bearing joints such as hips, knees and ankles. If you wear high heels you are putting enormous strain on your hips and knees.

4. Core stability

Pilates can help strengthen muscles in the tummy and buttocks which in turn protects the lower body.

5. Weight control

Being overweight puts huge strain on all your joints, but especially your hips, knees, ankles and feet.

6. Exercise regularly

Exercise is essential for overall mental and physical health. It will help strengthen muscles around joints.

Alternative remedies for osteoarthritis pain

Suggestions for easing the pain of arthritis have been passed down from generation to generation. Evidence tends to be anecdotal, but you may want to give some of the following a try:

• Some acidic foods appear to make symptoms worse but this varies according to individuals - red meat, tomatoes, potatoes, citrus fruit, red wine, aubergines and strawberries have been cited.
• Good news foods cited are turmeric, ginger (considered warming in Chinese medicine), olives, green tea and grapes.
• Cider vinegar with (or without) a teaspoonful of honey in warm water each morning is said to be very helpful for easing symptoms.
• Soaking in a hot bath is soothing, but even better with Epsom salts, which may release toxins from the body through the skin.
• Copper or magnet bracelets have a positive effect on some people, but others say they do nothing.

Further reading

How to lose weight well - AXA Health

Fitting change into your lifestyle - AXA Health

Exercises to improve balanceand prevent falls - AXA Health