Introducing Arthritis
An Information Booklet
Introduction
This booklet is designed to give you some helpful information about arthritis and other joint problems, and how the Arthritis Research Campaign (arc) is fighting them. At the back there is a brief glossary of medical words – we have put these in italics when they are first used in the booklet.
arc produces a wide range of booklets and leaflets on specific conditions and treatments. Details of how to contact arc and other helpful organizations can also be found at the back of the booklet.
Arthritis and rheumatism – is there a difference?
'Arthritis' is a term used by doctors to describe inflammation within a joint – as in rheumatoid arthritis, for example. The term comes from the Greek 'arthros', meaning joint, and 'itis', meaning inflammation. 'Rheumatism' is a more general term which is used to describe aches and pains in or around the joints. Because there are many possible causes of these pains doctors do not often use the term 'rheumatism' and will usually refer to these problems either by a specific diagnosis (e.g. 'rheumatoid arthritis', 'gout') or according to the part of the body affected (e.g. 'low back pain' or 'knee pain'). Doctors sometimes use the terms 'musculoskeletal conditions' or 'the rheumatic diseases' to refer to a whole range of conditions which affect the joints.
What are the main types of musculoskeletal condition?
All in all there are about 200 different musculoskeletal conditions, which fall into five main groups:
Inflammatory arthritis
Inflammation normally occurs as a defence against viruses and bacteria or a reaction to injuries such as a burn, and is part of the healing process. In arthritis, however, inflammation often occurs for no obvious reason. Instead of helping to repair the body, it attacks the tissues in and around the joints, causing pain, stiffness and swelling. Strictly speaking 'arthritis' means inflammation within the joint itself; but inflammation may also affect the tendons and ligaments surrounding the joint (this is known as 'enthesitis'). Inflammation can damage the surface of the joint and sometimes the underlying bone. Inflammatory types of arthritis often affect several joints. Rheumatoid arthritis is an example, but there are many other forms of inflammatory arthritis, including:
- gout and pseudogout
- reactive arthritis
- arthritis associated with colitis or psoriasis
- ankylosing spondylitis.
(See arc booklets 'Ankylosing Spondylitis', 'Gout', 'Pseudogout and Calcium Crystal Diseases', 'Psoriatic Arthritis', 'Reactive Arthritis', 'Rheumatoid Arthritis'.)
Figure 1. Normal and arthritic joints
Degenerative or mechanical arthritis
This is a group of conditions where the main problem is damage to the cartilage which covers the ends of the bones. Normally the smooth, slippery cartilage helps the joint to move smoothly. But in this type of arthritis the cartilage becomes thinner and rougher; the bone underneath tries to repair this damage but sometimes overgrows altering the shape of the joint. This is generally known as osteoarthritis. It becomes more common as people get older and particularly affects the joints that get heavy use (e.g. hips and knees), so it may be that the cartilage is not resilient enough to withstand normal joint use over the years. It can also result from damage to the joint (e.g. a fracture through a joint or previous inflammation in that joint).
(See arc booklets 'Osteoarthritis', 'Osteoarthritis of the Knee'.)
Soft tissue musculoskeletal pain
In this type of musculoskeletal problem, the pain comes from tissues other than the bones and joints. Typically it will come from the muscles or soft tissues supporting the joints including the bursa. Problems may be localized to one particular part of the body following an injury or overuse – e.g. tennis elbow, which can be caused by many different activities besides playing tennis. However the pain may be more widespread and if associated with other symptoms a diagnosis of fibromyalgia may be made. Often the causes of these symptoms are poorly understood.
(See arc booklets 'Fibromyalgia', 'Knee Pain in Young Adults', 'Pain in the Neck',
'The Painful Shoulder', 'Sports and Exercise Injuries', 'Tennis Elbow', 'Work-Related Rheumatic Complaints'.)
Back pain
Back pain is put in a separate category because it is a very common problem which has a number of different causes. Pain can arise from muscles, discs, ligaments, bones and joints. It may even come from other organs inside the body (known as 'referred pain'). Sometimes there is a specific cause such as the inflammatory condition ankylosing spondylitis, or the degenerative condition osteoarthritis, (often referred to as spondylosis when it occurs in the spine). Sometimes the pain may be caused by a 'slipped' disc (the disc itself does not really slip; the central part of the disc bulges through the outer ring) but this more commonly causes pain in a limb. Osteoporosis (thinning of the bones) can cause sudden back pain if one of the bones 'crunches' down. However in the majority of cases it is not possible to identify the exact cause of the pain and doctors often describe this as 'non-specific' or simple back pain.
(See arc booklets 'Ankylosing Spondylitis', 'Back Pain', 'Osteoporosis'.)
Connective tissue disease
Connective tissues are tissues which support, bind together, or separate other body tissues and organs. They include tendons, ligaments and cartilage. The joints are usually involved in this group of diseases, but other tissues such as skin, muscles, lungs and kidneys may also be affected. There may therefore be a range of other symptoms besides painful joints or muscles. Examples of this type of disease include systemic lupus erythematosus (SLE or lupus), scleroderma and dermatomyositis. As these diseases often affect many organs the healthcare team will often include different specialists along with the patient's GP, and nurses, physiotherapists and occupational therapists.
(See arc booklets 'Lupus (SLE)', 'Polymyositis and Dermatomyositis',
'Scleroderma'.)
Who gets arthritis and other types of musculoskeletal pain?
Arthritis and other types of musculoskeletal pain are common, worldwide problems. They affect people regardless of age, sex, race, class or country.
Figure 2. Approximate numbers of people in the UK affected by some of the rheumatic diseases. This is based on those seeking treatment from their doctor.
Millions of people in the UK alone will experience some form of musculoskeletal problem during the course of a year, although many people will not have persistent or severe symptoms. Around 9 million people will seek help from their family doctor each year. Of these, more than 2 million will have osteoarthritis, and more than 350,000 rheumatoid arthritis. Others will have localized musculoskeletal pain, back pain, or osteoporosis. Some people will have one of the less common complaints and about 12,000 children and adolescents will suffer from juvenile forms of arthritis.
(See arc booklets 'Tim Has Arthritis' (for children), 'When a Young Person Has Arthritis' (for teachers), 'When Your Child Has Arthritis' (for parents).)
What causes arthritis and other types of musculoskeletal pain?
There is no single answer to this question, as there are many different forms of arthritis to be considered.
We understand the causes of some diseases, such as gout, and can treat them effectively. Research supported by arc has gone a long way towards unravelling the causes of most of the common forms of arthritis, but there is still much to be done.
Most rheumatic diseases are due to several factors acting together. Firstly, some people are naturally more likely to suffer from certain disorders as a result of their genetic make-up (that is, genetic risk – see 'Genetics and family risks'). Secondly, a variety of 'external' factors may increase the risk in those who are susceptible to the condition in question. These include the factors researchers refer to as 'environmental' – e.g. previous injury, infection, smoking, and occupations which are very demanding physically (see 'Lifestyle and "trigger" factors'). Finally, for many conditions there is a major element of chance.
Genetics and family risks
Most forms of arthritis run in families to a small extent. The way your body is made (based on the genes passed on from your parents) makes you more or less likely to develop the disease in question. arc supports research which is helping us to understand the precise nature of the genetic factors in arthritis. We believe this could lead eventually to our being able to prevent some forms of arthritis.
Lifestyle and 'trigger' factors
Arthritis can start suddenly without any obvious cause, and at any age. In some conditions something in a person's lifestyle or medical history – or a combination of factors – could be responsible. For example, people in physically demanding jobs may be at greater risk of developing osteoarthritis, particularly if the job involves repetitive activity. Professional footballers and farmers are examples of people who are more likely to develop osteoarthritis (of the knee and hip respectively). A previous injury can increase the likelihood of osteoarthritis and a mild infection may trigger some types of arthritis.
Infections or an allergic reaction can cause short-lived arthritis; for example adults who develop rubella (German measles) are quite likely to have an attack of arthritis which clears up by itself. It has also been thought that rheumatoid arthritis may be triggered by infections, but there is no direct evidence for this. Certain foods may appear to make arthritis worse, but diet and food intolerance are unlikely to cause long-term arthritis. Most of the main forms of arthritis occur all over the world, in people with completely different diets and ways of living. However, there is strong evidence that being overweight can be an important factor in the development of osteoarthritis.
(See section on 'Diet' and the separate arc booklet 'Diet and Arthritis'.)
Symptoms and signs
Everyone gets aches and pains in their muscles and joints from time to time, particularly if they take part in unusual or particularly strenuous physical activities. So how can the beginning of arthritis be distinguished from 'normal' pain and stiffness? And how do you know when you should see your doctor about your symptoms?
You should think about the following factors:
- persistence of symptoms
- swelling of joints
- effects on your daily life.
Persistence of symptoms: How and when did the pain start? If you experienced pain associated with a possible injury then you should seek advice quickly. If the pain developed after a spell of unusual exercise or activity then you might just have overdone it a bit, and the pain should ease within a few days. If the pain is not related to an injury and persists for more than a week or 10 days then you should seek advice.
Swelling of joints: If a joint becomes swollen, and especially if it is not related to an injury, then you should seek advice in a few days. This is particularly true if you also feel unwell or have a fever.
Effects on your daily life: If you are unable to do your normal daily tasks because of your joint or muscle pains then again you should seek advice. If you have lifted something heavy and hurt your back, for example, then take some simple painkillers, apply some heat, and try to keep active. If the pain does not begin to ease in a day or so then seek advice.
REMEMBER: If you are worried or in doubt, consult your doctor. |
How is arthritis diagnosed?
Doctors will diagnose your arthritis by asking you about your symptoms and how they have developed (the history); examining you (the examination); and possibly arranging for tests to be done (investigations).
Symptoms
The site of the pain, whether in the joint or between the joints, and which joints are involved are important pieces of information which help to categorize arthritis. Rheumatoid arthritis affects a particular pattern of joints, and osteoarthritis affects joints that get a lot of use, e.g. hips and knees. Separating inflammatory arthritis from degenerative is important: in inflammatory arthritis the stiffness in the morning tends to last longer than that for osteoarthritis. There is likely to be more swelling of the joints in inflammatory arthritis and more variation in the pain (which cannot be explained simply by the level of physical activity). Other symptoms of a rheumatic disease can include tiredness, a general feeling of being unwell, loss of weight, mild fevers or night sweats, and skin rashes. But these symptoms are not specific to arthritis and can be caused by other illnesses. Similarly arthritic conditions can cause symptoms in many other organs in your body, so your doctor will ask about other aspects of your health.
Examination
An inflammatory arthritis is likely to cause swelling of the affected joints. Other signs of arthritis are restricted joint movement, pain on movement, and tenderness of the joints. Degenerative arthritis will tend to give pain and restricted movement but with less swelling and often a grating feeling (called 'crepitus'). Soft tissue problems will usually give tenderness at the site and pain when the muscle, tendon or bursa is used. Back problems may be related to restriction of movement. If there is pressure on a nerve this can usually be detected by examination. Because some forms of arthritis can have other signs and symptoms (e.g. a rash or mouth ulcers) the doctor will need to examine other parts of your body besides your joints.
Tests
Tests may be carried out to help confirm the diagnosis, to rule out other possible causes, or to assess the severity of the condition. Blood tests may show evidence of inflammation or more specific results such as rheumatoid factor in rheumatoid arthritis. However, none of these tests are infallible and the results must be interpreted in the context of your other signs and symptoms. Rheumatoid factor is found in many people who do not have, and never will have rheumatoid arthritis. Also it is possible to have rheumatoid arthritis without there being detectable rheumatoid factor in the blood.
Your doctor may arrange for images of your joints to be taken. This could be by x-rays (also known as radiographs), an ultrasound or an MRI scan. Once the history and examination have been carried out, and the results of any blood tests and imaging are available, the pieces of a jigsaw puzzle begin to come together and a diagnosis is made. Your doctor will then discuss with you a treatment plan for you to follow.
How is my condition likely to progress?
The symptoms of musculoskeletal problems tend to be very variable from day to day and from week to week. Many problems will get better by themselves including such things as reactive arthritis and sprains. Similarly episodes of backache or painful 'flare-ups' of osteoarthritis are often short-lived even though the underlying wear has not changed. Other conditions, including gout, can often be controlled by treatment.
However, many types of arthritis, including rheumatoid arthritis and osteoarthritis, are persistent (chronic) disorders, where the disease cannot be cured. The symptoms of these conditions tend to vary over time. Often the symptoms may go into remission for quite some time but then there will be a 'flare-up' (where the symptoms become worse) for a while. Although these flare-ups may be related to particular events such as viral infections, they will often occur for no apparent reason. The aim of treatment is to keep you in remission for as much of the time as possible, so that you can get on with your life as normally as possible, while minimizing any progression of the disease.
Arthritis can affect different people in different ways and this makes it difficult for doctors to predict a clear outcome for any one patient. However, most people with arthritis do not have major mobility problems, and effective treatment will help reduce the risk of disability, even in more severe cases.
How are musculoskeletal conditions treated?
Just as there is no simple answer to the cause of most forms of arthritis, there is – as yet – no single cure for most rheumatic diseases. For some diseases, such as gout, where there is a build-up of uric acid especially in the blood and joints, there are satisfactory drugs that will correct the problem. However, for most rheumatic diseases this is not the case; yet with modern treatment the diseases can be effectively controlled. Research has led to great improvements in this area.
Because the severity and impact, as well as the type of arthritis, varies greatly in different people, and at different stages of the disease, treatment has to be tailored to the needs of each individual. You and your healthcare professionals will need to balance the risks and benefits of each treatment taking into account your personal needs and circumstances.
With treatment, many people with arthritis will be able to live full lives with relatively little pain or disability. For some, the condition may cause major problems or difficulties, although the effects of these can often be minimized with treatment. Alternatively, the problem may resolve itself in the course of time. A few people still develop very serious problems due to arthritis, in spite of modern treatment. For example, some forms of arthritis can also cause problems with the heart, lungs and kidneys. More research is needed to help develop other ways of treating people in this situation and to reduce the number suffering in the future.
Who will be involved in my treatment?
Go to your own doctor first. S/he can often provide all the help you will need. If necessary you may be referred to hospital to see a specialist such as a rheumatologist or an orthopaedic surgeon. Your doctor or specialist may suggest you see other professionals such as specialist nurses, physiotherapists, occupational therapists, or podiatrists.
Doctors have an important role to play in diagnosing the different forms of arthritis, providing advice about the likely effects of a disease and prescribing therapy – including drugs, injections and surgery. Hospital specialists are often part of a team of people which includes nurses, counsellors, therapists, podiatrists, social workers and others who have a special understanding of and expertise in helping people with arthritis. The team works closely alongside orthopaedic surgeons who specialize in operations on bones and joints – including joint replacements.
(See arc leaflets 'A Mind Map on the Rheumatology Department', 'Drugs and Arthritis' and booklets 'Feet, Footwear and Arthritis', 'Hand and Wrist Surgery for Arthritis', 'A New Hip Joint', 'A New Knee Joint', 'Shoulder and Elbow Joint Replacement'.)
Specialist nurses have special training and experience in different aspects of arthritis. They can provide a great deal of help and advice about lifestyle and adjustments at work and at home. They will help with monitoring of your drugs and often are available for you to contact by telephone when you need to.
Physiotherapists can teach you exercises to help improve movement and reduce pain. They can advise on what activities you should do and how much exercise to take, and how to use your joints with as little strain as possible. They can also help you to choose the right walking aids for you.
Occupational therapists can advise on how to protect and reduce the strain on painful joints. They can provide splints and a variety of aids or appliances to help maintain a large measure of independence, even if arthritis has caused severe joint damage. They may also be able to advise on personal matters like sex or going to the toilet if your arthritis is causing problems with these.
Podiatrists are experts on feet and will help with your footwear, and any special insoles you may need, and can help with your foot and nail care if your arthritis makes this difficult.
Help is also available from a variety of other sources, for example, pain clinics, social services and voluntary sector organizations such as Arthritis Care. If you are in employment but having difficulty at your work, help will be available from the Employment Medical Advisory Service and the local Disability Employment Adviser. (See 'Useful addresses'.)
(See arc leaflets 'Keep Moving', 'Occupational Therapy and Arthritis', 'Physiotherapy and Arthritis', 'Work and Arthritis' and booklets 'Caring for a Person with Arthritis',
'Sexuality and Arthritis', 'Looking After Your Joints When You Have Arthritis', 'Feet, Footwear and Arthritis'.)
REMEMBER: There are many treatments and therapies available which can help with your arthritis. Try to make sure that you are getting the best professional advice – and follow it! |
Drug treatments
Drug therapies are designed to help the arthritis, and in the case of inflammatory arthritis it is important to start them quickly because the sooner treatment is commenced the more effective it is likely to be. Drug therapy can be divided into two main groups:
- drugs that treat the symptoms of arthritis (e.g. pain and stiffness)
- treatments that suppress the disease process and may improve the outcome
Drugs may be available under different names. Each drug will have an approved (generic) name – these are the names used in this booklet. But different manufacturers may give their own brand name to a drug – for example, Voltarol and Diclomax are both brand names for diclofenac.
It is important to understand that there is no effective treatment that does not occasionally cause side-effects. Minor side-effects are not uncommon; fortunately, serious side-effects are rare. These problems can be minimized by following your doctor's advice.
Table 1. Some drugs are used in all types of arthritis, others only in certain types of disease. Many people benefit from a combination of drug treatments. |
||
|---|---|---|
Drugs that treat the symptoms |
||
Type |
Examples |
Used for |
Analgesics |
paracetamol |
all types of arthritis |
Non-steroidal anti-inflammatory drugs (NSAIDs) |
Standard NSAIDs:
COX-2 NSAIDs:
|
all types of arthritis (including osteoarthritis if there is inflammation) |
Steroids |
prednisolone – tablets or injections |
given as tablets in inflammatory arthritis or connective tissue disease; may be given as an injection into any swollen, painful joint |
Drugs that suppress the disease |
||
Disease-modifying anti-rheumatic drugs (DMARDs) |
methotrexate |
inflammatory arthritis, some connective tissue diseases |
Biologics |
anti-TNF:
B-cell depletion:
|
rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis
severe rheumatoid arthritis |
Drugs that treat the symptoms
Analgesics (painkillers) such as paracetamol, which reduce pain. These can be used for all types of arthritis. It is best to take them before an activity which is likely to aggravate the pain rather than wait until your pain is very bad. This is similar to the way people use their inhalers for asthma before exercising to stop them getting too wheezy while active.
Anti-inflammatory drugs (NSAIDs), which reduce stiffness and swelling, as well as relieving pain. As the name suggests they reduce inflammation; however they can also be helpful in types of arthritis where inflammation is not the main problem (e.g. osteoarthritis). They can be used for short spells when your symptoms flare up, and in combination with analgesics when additional pain relief is required. The most common problems with the older NSAIDs (e.g. ibuprofen, diclofenac, naproxen, indometacin) are indigestion and bleeding from the stomach. The newer anti-inflammatory drugs, known as COX-2-specific NSAIDs or 'coxibs', are less likely to cause stomach problems, but they still have some of the other side-effects of the older drugs, such as aggravating asthma, or affecting the kidneys. All anti-inflammatories have been linked with a slightly increased risk of heart attack and stroke, but this risk is small provided the dose is low. You should take the lowest dose of anti-inflammatory that controls your symptoms, and for the shortest possible time, so your doctor may advise you to use them for short spells, rather than taking them all the time. Sometimes an NSAID cream may be given to rub on the affected joint – this reduces the risk of side-effects.
Steroids are powerful, natural anti-inflammatory agents, which can be injected into painful joints or the muscles, as well as being used in tablet form. They may also have some effect on the way the disease progresses. Although they are most commonly used to treat inflammatory arthritis and connective tissue diseases they can be used in osteoarthritis usually as a joint injection to ease a flare-up in a single joint. They too can have side-effects – especially if used for a long time – as well as great benefits. One of the possible side-effects of steroid treatment is osteoporosis. Because of this steroids are commonly used only for short periods. If you do need steroid treatment on a long-term basis you may be given other tablets with them to protect against osteoporosis. Steroids must not be stopped without discussion with your doctor.
Drugs that suppress the disease
Disease-modifying anti-rheumatic drugs (DMARDs) (e.g. sulfasalazine, methotrexate, leflunomide and gold) suppress inflammation. They are used in inflammatory types of arthritis and occasionally in some types of connective tissue disease. They work in a different way to the anti-inflammatory drugs, and it may be several weeks before they have any effect, so anti-inflammatory drugs are often used alongside them. It is usual to have regular blood tests while you are on disease-modifying drugs, and your blood pressure and urine may also be checked regularly. These drugs can be stopped for short periods without harm, for example if you are on a course of antibiotics for an infection.
Biologic drugs, e.g. infliximab, etanercept, adalimumab and rituximab, are a new class of drug. They are used in rheumatoid arthritis and in some other types of inflammatory arthritis when other types of disease-modifying drugs have not been effective. They are unique in their design and action in that they were made specifically to counteract messages between the white blood cells that cause inflammation.
(See arc leaflet 'Drugs and Arthritis' and other leaflets on individual drugs.)
REMEMBER: Drugs are often beneficial, but need to be used carefully, according to your doctor's instructions. If you are worried, or think that they may be causing side-effects, consult your doctor. |
Surgery
Surgery may be necessary and advisable if the damage to a joint is severe enough to cause difficulties with everyday life, and when other treatment is not reducing the pain. Joint replacements are now very sophisticated and successful. Many different joints, including hips, knees, shoulder and elbow joints, are routinely replaced in people with advanced arthritis. There are also a number of other pain-relieving or reconstructive operations which are sometimes helpful.
(See arc booklets 'Hand and Wrist Surgery for Arthritis', 'A New Hip Joint', 'A New Knee Joint', 'Shoulder and Elbow Joint Replacement'.)
Figure 3. Joint replacement surgery is now very successful. This x-ray shows an artificial knee joint in place.
What about complementary therapies?
Complementary therapies such as osteopathy and chiropractic can have benefit in some arthritic conditions especially back pain. There are a huge range of other therapies, e.g. 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. When trying such therapies or supplements do be critical for yourself of what they are doing for you, and base your decision to continue on whether you notice any improvement. Try to change only one thing at a time so that you can tell which therapies are having an effect.
Glucosamine and chondroitin are food supplements that do have some evidence of effectiveness for osteoarthritis, although there has not been enough research to date for them to be licensed for use as drugs in the UK. They are available from health food shops and chemists. Many brands of glucosamine and chondroitin are made from shellfish, but vegetarian or shellfish-free types are available – so look for these if you have an allergy to shellfish.
(See arc booklets 'Diet and Arthritis' and 'Complementary and Alternative Medicine for Arthritis'.)
Helping yourself
There are many ways in which you can help yourself if you have arthritis – some of these are described below, and further information can be found in the arc booklets and leaflets referred to.
Rest and exercise
It is important to keep your joints moving and your muscles strong – whether you have arthritis or not. It is usually better to keep active. It is generally true that the stronger the muscles which support a joint, the less pain you will experience in that joint.
If a joint is very inflamed, a short period of rest may help the inflammation to settle down. You should also protect inflamed or damaged joints. It is better to use them little but often rather than persisting with activities that afterwards cause lasting pain. However, it is also important not to rest the joints too much. All joints should be put through a full range of motion at least once a day, to prevent them stiffening up. In every case, keeping active is good for your general health. 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.
In addition, specific exercises may be helpful, but these will depend on the type of arthritis and the joints affected. A physiotherapist will be able to provide advice on this.
(See arc leaflets 'Keep Moving', 'Physiotherapy and Arthritis'.)
REMEMBER: Keep your joints moving and your muscles strong. Get as much exercise as you can but don't overdo the activities which cause pain. |
Diet
All of us need to be sensible about what we eat or drink. It is important to avoid being overweight (as this puts extra strain on the joints). If you are very overweight, losing 2 stone can reduce pain in the knee by 50 per cent. A good diet with plenty of fruit and fibre, avoiding too much meat or animal fat, is good for general health.
Special diets rarely make a great deal of difference to arthritis, although many people feel better when they start eating a healthy diet. A diet that replaces animal fat with vegetable or fish oils may reduce joint inflammation a little, and be of benefit to some people.
Occasionally someone with arthritis finds that a specific type of food upsets them, but this is quite unusual. If you think you may have an 'intolerance' to a particular food try removing it from your diet for about 3–4 weeks and then reintroducing it. If you do have an intolerance you will notice a flare-up in your arthritis within a few days. See arc booklet 'Diet and Arthritis' for more information about 'elimination' or 'exclusion' diets.
It is rare for alcohol to affect arthritis or other types of musculoskeletal pain. Please note, though, that certain drugs can interact with alcohol. If you are prescribed drugs for your arthritis you may need to avoid alcohol or limit the amount you drink; if you are in any doubt, check with your doctor.
Beware of the many books, articles and advice about diets that claim to cure arthritis. Many of them recommend quite different things, and most people do not benefit from them. In fact, an unusual diet may do you more harm than good.
(See arc booklet 'Diet and Arthritis'.)
REMEMBER: It is unlikely that a 'special' diet will significantly affect your arthritis but eating sensibly is good for general health. |
Stress
Chronic arthritis can get you down and constant pain may lead to anxiety and depression. Counselling from your doctor, or from someone s/he recommends, may help. Sharing the problem with friends and others who are affected can also be helpful. Relaxation techniques, which you may be able to learn with the help of a physio-therapist, occupational therapist, or from other sources, can also be beneficial. Some of the organizations listed under 'Useful addresses' can also offer help.
REMEMBER: Stress does not cause arthritis, but it can make it feel worse. So try to find ways of dealing with any anxiety that your condition causes. |
Will moving to a warmer climate help?
Many people with arthritis feel that changes in the weather affect the level of pain they feel. Most people prefer hot, dry climates, but some people feel better in the cold and damp. 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 will not cause the condition or affect the way it develops.
FINALLY: Even though there is not yet a cure for arthritis, there is still a great deal that can be done to relieve the symptoms and help you to get on with your life. In most cases the sooner the treatment begins the more effective it will be, so don't hesitate to consult your doctor if your symptoms persist for more than a few days. |
Glossary
Bursa – a small pouch of fibrous tissue lined (like a joint) with a synovial membrane. Bursae help to reduce friction; they occur where parts move over one another, e.g. where tendons or ligaments pass over bones. Others, however, form in response to unusual pressure or friction.
Cartilage – a tough, slippery tissue which covers the bone ends. It acts as a shock absorber and allows smooth movement between bones.
Ligaments – tough, fibrous bands which hold two bones together in a joint.
MRI (Magnetic Resonance Imaging) – a type of scan which uses radio waves in a strong magnetic field to build up pictures of the inside of the body. It works by detecting water molecules in the body tissues which give out a particular signal in the magnetic field.
Spondylosis – the term used to describe the x-ray appearance of mechanical or degenerative changes of the small joints in the neck and back. Commonly present in all of us, often without causing any symptoms.
Tendons – strong fibrous cords that connect muscles to bones.
Ultrasound – a type of scan which uses high-frequency sound waves to build up pictures of the inside of the body.
Useful addresses
The Arthritis Research Campaign (arc)
PO Box 177, Chesterfield
Derbyshire S41 7TQ
Phone: 0870 850 5000
www.arc.org.uk
As well as funding research, we produce a range of free information booklets and leaflets. Please contact the address above for a list of titles or, on this website, see Publications for People with Arthritis.
Arthritis Care
18 Stephenson Way
London NW1 2HD
Phone: 020 7380 6500
Helpline: 0808 800 4050
www.arthritiscare.org.uk
Offers self-help support, a helpline service, and a range of leaflets on arthritis.
Dial UK (Disability Information & Advice Line)
St Catherine's
Tickhill Road
Doncaster
South Yorkshire DN4 8QN
Phone: 01302 310123
www.dialuk.info/
Disabled Living Foundation (DLF)
380–384 Harrow Road
London W9 2HU
Phone: 020 7289 6111
Helpline: 0845 130 9177
www.dlf.org.uk
Employment/benefits
Your Jobcentre Plus office can put you in touch with your local Disability Employment Adviser. For information on benefits you can contact the Benefit Enquiry Line on 0800 882200.
Employment Medical Advisory Service (EMAS)
To find your local office, see the telephone directory under 'Health & Safety Executive'. The address and phone number should also be available in all workplaces. Alternatively, you can get this information from:
HSE Infoline: 0845 345 0055
www.hse.gov.uk/contact/index.htm
nras (National Rheumatoid Arthritis Society)
Unit B4 Westacott Business Centre
Westacott Way, Littlewick Green
Maidenhead SL6 3RT
Phone: 0845 458 3969
Helpline: 0800 298 7650
www.rheumatoid.org
A national charity which focuses specifically on rheumatoid arthritis.
RADAR (Royal Association for Disability & Rehabilitation)
12 City Forum
250 City Road
London EC1V 8AF
Phone: 020 7250 3222
www.radar.org.uk
Relate
See the telephone directory under 'Relate' or the Yellow Pages under 'Counselling and Advice' for your local Relate centre. Or Relate Head Office can be contacted at:
Premier House
Carolina Court
Lakeside
Doncaster DN4 5RA
Phone: 0300 100 1234
www.relate.org.uk
Information on drugs
Separate arc leaflets are available on many of the drugs used for arthritis and related conditions. We would recommend that you read the relevant leaflets for more detailed information about your medication.
