The hidden condition which affects 10m people causing crippling pain and disability
BY Alison Bellamy
It is often hereditary, can creep up very slowly as a result of wear and tear, or can even strike at a very young age after an infection or injury – all with differing severity.
An estimated 10 million people in the UK live with some form of arthritis.
It is the most common cause of pain and disability in the UK and can affect people of all ages, not just older folk.
Arthritis means ‘inflammation of the joints’. Inflammation is part of the body’s normal healing process after injury, just like the healing of a cut or bruise. If inflammation in the joints becomes extreme, it can cause pain, stiffness and swelling.
People often ignore aches and pains, and as it slowly gets worse, it can often be a long time before people go to their GP for advice.
There is no single cause and it can be linked to genetics, gender, age or an injury to a joint or even an infection can trigger it. Lifestyle also has to be taken into account as obesity and alcohol can trigger gout and smoking may be linked to rheumatoid arthritis.
Simple, regular exercises and stretching can help alleviate pain, especially after you reach the age of 40. Sitting in an office all day, for example, without much movement, could encourage pinched shoulders and stiff joints.
Dr Wendy Holden, who is medical advisor to UK charity Arthritis Action, says the condition can often lead to depression so it is essential to take time for a positive approach and open mind.
“Tai Chi can help with the symptoms of osteoarthritis – at least as much as standard physical therapy and sometimes more,” she said. “It can be safely performed at any age and is a very slow and low impact exercise which won’t put any stress on painful joints. No special equipment is needed and it can be done in a small space indoors or outdoors, alone or in a group. People with arthritis should always seek medical advice before starting a new form of exercise and find an experienced instructor.”
She said Tai Chi had also been shown to improve flexibility and reduce pain in the hips, knees and ankles for those with rheumatoid arthritis. It has also been found to reduce stress if done in a group and can improve confidence and help reduce isolation.
Dr Holden said the most common type of arthritis is osteoarthritis, commonly known as ‘wear and tear’ which often affects people as they get older. This can often lead to hip and knee replacements when the pain becomes impossible to manage and mobility is affected.
The next most common types of arthritis are rheumatoid arthritis where the immune system attacks the joints, and gout which is caused by uric acid crystals in the joints. Rheumatoid arthritis and gout are two types of ‘inflammatory arthritis’ which has a degenerative process that can destroy joints and bones. There are many other forms of inflammatory arthritis including psoriatic arthritis and ankylosing spondylitis.
There is currently no cure, but research is ongoing to find a breakthrough.
Trials are taking place on medication that could provide relief from crippling pain and joint damage on rheumatoid arthritis patients, for up to a year.
Arthritis Action, a UK arthritis charity founded in 1942, believes that self-management techniques help people with arthritis to take control of their lives and therefore improve their symptoms and condition.
The charity advises that people need to help themselves to live well. A spokeswoman said: “Self-management can help decrease pain, reduce mobility, thereby reducing the need for pain medication. There is ample scientific evidence suggesting that changes in diet and lifestyle can really help. We encourage a holistic approach to coping and are encouraged to look at their diet, weight, exercise, well-being and pain management.”
She added that caring for a close family member with arthritis can be demanding. The condition can make a person feel vulnerable and they can become reliant on others, unable to carry out basic tasks, such as washing, dressing and preparing food. Some find their condition hard to accept and it can. At times, dominate their life. There are many types of arthritis but the things they have in common are pain, restricted mobility and fatigue. Experts say it is essential to have coping mechanisms and a positive approach.
More details at www.arthritisaction.org.uk
Most common types of arthritis include:
- Osteoarthritis or ‘wear and tear’ arthritis
- Rheumatoid arthritis
- Ankylosing spondylitis
- Psoriatic arthritis (can affect people who have skin condition psoriasis)
Osteomalacia is a type of arthritis which can affect people of south Asian origin. Anyone who is lacking vitamin D is likely to develop osteomalacia. Although we can get vitamin D from foods, most of our supply of vitamin D is produced by the body itself when cholesterol is converted to vitamin D through sunshine on the skin. Those most at risk are often older people who aren’t able to get outside if they are frail or ill in daylight, or wearing clothing which covers their whole body, stopping any sun getting through, especially in less sunny countries.
It appears that some people from the Indian sub-continent and surrounding region are particularly at risk of osteomalacia. This may be due to women wearing clothes which cover their whole body, such as a burka plus the fact that some foods commonly used in Asian diets are low in vitamin D, for example it is thought that some types of chapatti flour may prevent the normal absorption of calcium from the stomach.
Also many people from the same region are lactose intolerant, or allergic to dairy products, so they may not be absorbing enough calcium.
Mrs Rozina Samarkand, 62, from the East Midlands, enjoyed looking after her two grandchildren and after a busy day would put her feet up and ignore her aching knee and legs, thinking it was caused by running after the children in the garden and lifting them into high chairs.
She left it for many months until the pain became unbearable. She took painkillers and bought anti-inflammatory gels, but suffered sleepless nights and the pain became so bad that she needed to borrow a stick just to hobble around her kitchen.
When she eventually went to see her GP, after much persuasion by her close family members, she could barely walk, but had felt guilty as she was looking after her son’s young children and know he would be stuck if she was not available.
Mrs Samarkand was sent for an x-ray and it was not her knee, but her hip that was the main problem and had been affecting her balance, putting pressure on her knee. Arthritis was diagnosed but then told she needed a hip replacement, not just in one hip, but both, as they were ‘wearing away’.
She was told by doctors if she didn’t have the hip replacement operations, she would be left disabled in a wheelchair, unable to walk.
The operations were done under local anaesthetic and an epidural, meaning she was awake, putting less stress on her body and organs with a general anaesthetic. They were carried out with a six month break in between, giving her time to recover.
She is now back on her feet and regular exercise is vital to keep her moving and in good health.
She says she is delighted to be able to go to the local park with her family once again.
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