Dr Sarah Jarvis
My Weekly’s favourite GP from TV and radio writes for you
At least half of us will develop osteoarthritis if we live to receive a pension – that’s 9 million people in the UK. For most, it’s an inconvenience, but for some, it can be life-changing, and not in a good way.
Arthritis is just the medical term for inflammation of the joints, and there are several other types, all less common than osteoarthritis.
First signs of osteoarthritis are usually in hips, knees, fingers, neck or lower back. Pain and stiffness when sitting or lying for long periods is often the earliest symptom, wearing off once you’re up and about. With time, it may take longer for the pain to wear off and movement in affected joints becomes limited. Although it’s not an “inflammatory” form of arthritis (more about those
later) the slightly called Osteoarthritis joint some “wear swollen, can inflammation occur, and warm used tear” with to arthritis joints. be of because that covers the and tough protects cartilage the joint becomes worn down, leading to pain and sometimes a grinding sound on bending. Bony outgrowths, called osteophytes, can develop around the edge of the joint, further limiting movement. Your GP can make a diagnosis of osteoarthritis based on your symptoms. There are no blood tests for osteoarthritis, although X-rays can be useful. Other scans like MRI or CT scans may be recommended if there’s a suspicion that nerves are being pressed or the diagnosis isn’t clear. For some, osteoarthritis doesn’t keep getting worse – in fact, symptoms often wax
ANTI-INFLAMMATORY GELS CONTAINING DICLOFENAC OR IBUPROFEN CAN RELIEVE PAIN WITHOUT THE SIDE EFFECTS OF ANTI-INFLAMMATORY TABLETS
and wane and improvements can last months or years. You can stack the odds in your favour with regular exercise: non-weight bearing exercise like swimming is ideal, but ask your GP about physiotherapy referral for advice on exercises to do. Keeping your weight down and wearing well cushioned shoes as shock absorbers for joints also help.
Guidelines from NICE no longer routinely recommend “washing out” an arthritic joint using a telescopic procedure under anaesthetic. However, if pain is severe and is affecting you even at rest, joint replacement has a high success rate.
Rheumatoid arthritis is the second most common form and is an inflammatory arthritis – your immune system, which usually helps you to fight off infection, sees your joints as enemies and attacks them. It tends to affect smaller joints than osteoarthritis – wrists, feet and ankles as well as hands, although any joint can be affected. Along with pain and stiffness (like with osteoarthritis, often worse in the mornings) you can develop redness, swelling and tenderness round the joints. In time the joints can become significantly damaged, leading to deformity. Another kind of inflammatory arthritis is linked to the skin condition psoriasis. Several new medicines to damp down the immune system have revolutionised treatment for these kinds of arthritis, but exercise and physiotherapy are important here, too.
Gout causes joint inflammation, but it’s due to deposits of crystals inside the joint (usually the base of your big toe) and the joint often goes back to normal after a brief painful attack. Antiinflammatories control the pain while you have a flare-up, but if you have frequent attacks, regular tablets can cut the chance of further episodes. Next week: Are your breasts normal?
INFECTION OF A SINGLE JOINT IS RARE, BUT LEADS TO SEVERE PAIN, REDNESS AND SWELLING, OFTEN WITH FEVER. IF IN DOUBT, SEE A DOCTOR URGENTLY!