JOINT VENTURE
Knee, hip, wrist, elbow, feet and spine pain affects 22 per cent of people in the UK. TOM ROWLEY asks the experts the best ways to keep your joints on point
NEARLY 19 million people in Britain have a musculoskeletal condition including arthritis, according to the charity Versus Arthritis, the main campaigner for people with arthritis in the UK. Arthritis can affect any age group – even children and teenagers – but it’s most often associated with midlife and older people. There’s no cure but treatments have improved greatly, and for many types, particularly inflammatory arthritis, there’s a clear benefit in starting treatment early.
A recap: arthritis is all about your joints, especially those in your hips, knees, elbows, hands, wrists, feet and spine. This is where different bones meet, normally separated by cartilage and lubricating fluid. Arthritis is the word used to describe the pain, swelling and stiffness in these joints.The most common types are osteoarthritis, rheumatoid arthritis and gout. But there are other musculoskeletal problems that affect millions of us, too – back pain being a major culprit.
Osteoarthritis has been linked to obesity and trauma in the joints. It’s also hereditary, so if your parents or grandparents have it, you’re more likely to develop it. But it might not be inevitable, and there are ways to help prevent it.
A study from the American Academy of Orthopaedic Surgeons found weight loss may slow down the onset of osteoarthritis, and that obesity may trigger the inflammatory changes that cause osteoarthritis.
KEEP MOVING
Surprisingly, exercise can have a positive effect on joint pain. A study from Queen Mary University of London found exercise can help to prevent the damage to cartilage caused by osteoarthritis. This is because when we exercise, we compress the cartilage in our joints; our cells detect this, then work to stop inflammation. Other research has found that running reduces inflammation in knee joints, and a 2007 study found most cardiovascular exercise helps keep knee cartilage healthy – though Versus Arthritis suggests low-impact is best to avoid added strain.
If you’re looking to be extra safe, swap your weekly 10k run for a 5k, and add in some low-impact exercise such as Pilates.The Arthritis Foundation recommends yoga, as it builds strength and improves balance.
However, according to Philip Conaghan, professor of musculoskeletal medicine at the University of Leeds, and spokesperson for Versus Arthritis, joint pain is a wider problem than simply arthritis. “The most common by far is back pain, and most of us experience an episode during our lifetime.”
In fact, back pain is the largest cause of disability in the UK. For many, it can feel like something they’re stuck with. But research suggests several solutions can help reduce and prevent pain.The NHS recommends staying active as a way to prevent back pain and a review of medical literature in the Jama Network of journals found that exercise alone can help the symptoms of back injury.
“When you are younger, it’s more likely joint problems are due to tendonitis
– inflammation where the ends of muscles attach to bones. As you age, the chances of osteoarthritis increase, so you might have both arthritis and tendonitis.”
KILLING THE PAIN
Conaghan points to two types of treatments: pharmacological ones such as painkillers,
non-steroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen), opioids, steroid injections and disease-modifying antirheumatic drugs (DMARDs). And nonpharmacological ones such as weight loss, muscle strengthening and exercise.
“Society tends to like pharmacological treatments as they are quick,” he says. “But non-pharmacological treatments, especially for mechanical joint problems, are probably the most effective therapy there is.”
Conaghan steers clear of recommending dietary supplements but others swear by them. Nutritionist Mays Al-Ali (healthymays.com) suggests methylsulfonylmethane, chondroitin, glucosamine, turmeric and fish oil can all help improve joint health. Plantbased health practitioner Dr Gemma Newman (plantpowerdoctor.com) says osteoarthritis sufferers may benefit from supplements with extracts of sigesbeckia, boswellia serrata, pycnogenol and curcumin.
Of course, there is no silver bullet. Many patients benefit from a combination of diet, exercise and pain control. Alex Beechey is a musculoskeletal physio for Connect Health, and an academy physio for Tottenham Hotspur Football Club. “Arthritis is best managed like a jigsaw puzzle,” he says. “No one piece will significantly affect the overall picture, but the right combination will see the best management.
“The body is complicated and differs from person to person. It may require lots of patience, and trial and error.”