During National Arthritis Week this week, health professionals will be trying to dispel some common misconceptions about arthritis after a survey revealed the British public have a poor understanding of the disease.
Nearly half of the people polled by Arthritis Research UK believe that arthritis, which is the major cause of pain and disability in the UK, means just “aches and pains when you get old”. And nearly one-third assumes that you can’t do anything about it and just have to live with the pain.
Doctors find the results of the survey troubling and hope the campaign will give people the knowledge to help prevent or ease the symptoms. Dr Anisur Rahman, professor of rheumatology at University College London, says the message this week is about “myth busting”.
Arthritis has many forms affecting the bones, joints, and muscles, causing pain, swelling, and stiffness. Some forms cause the body to attack itself.
“There are 200 different conditions which can cause joint pain, some rare, some common,” says Rahman, who is also spokesperson for the charity Arthritis Research UK..
“It’s important to know what type a person has,” Rahman says. “It can happen to people of all ages, even children. There are people who developed arthritis before they can remember. That’s how young it can start.”
Ten million people suffer from arthritis in the UK according to estimates from the Royal College of General Practitioners. The most common form is osteoarthritis (OA), a loss of the cartilage at the end of the joints, such as knees and hips, mainly affecting older people.
Rheumatoid arthritis (RA), where the body’s immune system attacks itself, is the second most prevalent disease. It can strike at any age.
Yet, Rahman stresses that it is not inevitable that all older people will get symptoms of arthritis; genetic factors play a strong role. No drug currently exists that reverses OA, so many sufferers rely on painkillers or surgery such as knee and hip joint replacements.
“There are lots of things people can do for themselves: being overweight is a risk factor for osteoarthritis particularly in knees and hips, so keeping to a healthy weight is important,” Rahman says. “Keeping active is important, doing gentle exercise like swimming or walking.”
Rahman says people can learn more about causes and treatment from the Arthritis Research UK website.
One back pain sufferer, who was “bent over like an old lady” at only 42 years old, found a new lease of life from participating in a 12-week yoga clinical trial by the University of York specifically aimed at lower back pain.
Although Ruth Perrin had previously done yoga for years she stopped for 12 months after developing excruciating back pain. “I was nervous to move and didn’t want to make it worse,” Ruth says. Ruth tried painkillers and various therapies but to no avail. Doing yoga with instruction and at home had dramatic results.
“At first, one of the simple poses was standing straight and I couldn’t do that without it being very painful. Within three to four weeks I could do that without being in pain.
“Because it was working, the positive emotional effect was amazing: such relief that it was working at last. Without it I’m not sure where I would be now. I’m really grateful I managed to get on that trial,” Ruth says.
Four years on from the trial, Ruth has few problems with her back.
Experts agree that yoga and Tai Chi are beneficial to people with various types of arthritis, giving people a sense of control over their own condition as well as adopting a healthier lifestyle.
Clinical trials on evening primrose oil and cod liver oil taken in high concentrations have shown a pain relieving effect, decreasing the need to use other painkillers.
Complementary therapies such as acupuncture have also had positive results alongside dietary and lifestyle changes.
Sue Kalicinska is a British Acupuncture Council registered acupuncturist in London who has been practising for 25 years. She explains that from the perspective of Chinese medicine, the concept of “damp” can cause OA. Living in the damp British climate and also eating a diet high in “damp” foods, such as mucus-forming dairy, can also make people prone to OA.
“I treat [arthritis] a lot. You can certainly help people get much more mobility. If it’s only just started you can often get it under control; the younger someone is, the more reversal you can get,” Sue says.
Sue has been treating a lady in her 40s who came to her with a swollen foot and had to walk with a stick. “The doctors could not find any cause. They could see the inflammation there, telling her she had to live with it. She’s been having treatment with me for about one year and she’s walking without a stick. The improvement is really remarkable,” Sue says.
“Acupuncture is great because you’re working directly with getting energy flow back through the joint that’s been damaged.”
For people with RA, Sue recommends a low-carbohydrate diet with very lean protein and vegetables. She has also found a cider vinegar and honey drink, recommended by the Margaret Hills Clinic in Warkwickshire, helpful to break down the deposits in the joints.
“I had a client once who had a major traumatic incident to do with her marriage; it left her feeling humiliated. That was when RA started. The body can attack itself if you’re angry with yourself on a profound level. In terms of OA there’s an aspect of rigidity, things becoming blocked; one needs to be more flexible in one’s thinking,” Sue says.
Experts working on RA have also found that a white meat Mediterranean diet and cutting out red meat is helpful to lessen symptoms.
Biological drugs, which are proteins such as antibodies created in biological systems rather than by chemical means, suppress the immune system and reduce attack on joints for RA sufferers.
President of the British Society of Rheumatology Dr Chris Deighton, who is an RA consultant at the Royal Derby Hospital, says for patients who fail to respond to conventional drugs, biological drugs can make a big difference. He has been treating a single mother in her 20s, with three children under the age of 5, who developed very severe RA.
“She had pain and swelling and stiffness all over but particularly in her hands and feet. She could hardly move them, couldn’t stand, couldn’t grip, couldn’t look after her children,” Deighton says. “We treated the disease very intensively with high doses of steroids first and got her onto disease-modifying drugs quickly. She’s now doing much better.”
Deighton recognises the drugs have side effects, for example steroids can cause osteoporosis and biologic drugs can cause a predisposition to infection.
He tries to help patients move on to other forms of treatment as soon as possible, rather than taking steroids long term.
“We’re not complacent about the disease,” Deighton says.
National Arthritis Week runs from October 8 to 14.
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