Live well: Avoiding arthritis
It affects more than 10 million people in the UK, but can we prevent this painful condition?
When we hear the word ‘arthritis’, most of us think of someone much older and frailer than us. But arthritis can affect people of all ages, including children. This common condition causes joint pain, inflammation, stiffness and limited movement, and can significantly impact quality of life. We speak to Dr Fiona Watt, associate professor and consultant rheumatologist at the University of Oxford and spokesperson for Versus Arthritis, who reveals which groups are at risk and why, describes preventative measures and discusses exciting medical developments that, incredibly, could reverse joint damage…
What is arthritis?
Arthritis isn’t a single condition. There are several different types, but the main ones are osteoarthritis, which affects almost nine million people in the UK, and rheumatoid arthritis, which affects around 400,000. They may sound the same, but they are actually very different conditions.
When osteoarthritis occurs, cartilage covering the surface of a joint – usually in the knee, hip or hands and sometimes in the foot or spine – becomes damaged. Bone around the joint thickens in response, forming bony growths. This process causes pain, inflammation and problems using the joint. ‘It’s more common in women in their 40s and 50s, but can occur in younger people, especially if they’ve had a significant injury,’ explains Dr Watt. A family history of the disease, being overweight, smoking and consistently overloading your joints, such as repetitively kneeling or carrying heavy objects, can increase your risk, too.
Rheumatoid arthritis typically affects more than one joint simultaneously, often the same joint on both sides of the body. It can also cause inflammation in other areas, including the heart, lung, skin or even the eyes, especially if it goes unchecked. ‘People may also feel unwell and lose weight,’ explains Dr Watt.
Although the risk factors for both conditions are similar – such as being a woman (we’re twice as likely to get this as men), being overweight, smoking or having a family history – rheumatoid arthritis is an autoimmune condition. This is when the immune system mistakenly attacks the body’s healthy tissue, such as the joints, causing inflammation.
Can surgery help?
Going under the knife may be key to getting moving again after an injury, but the scalpel is not a magic wand. ‘Removal of the meniscus (the cartilage that acts like a shock absorber between your shin and thigh bone) after an injury, like a meniscal tear, may reduce pain and make your knee feel more stable, but it doesn’t reduce the risk of osteoarthritis later on,’ explains Dr Watt. In fact, the jury’s out on whether it could make things worse. ‘Taking away bits of the meniscus can become an additional injury,’ she adds. Doctors are now using physiotherapy and steroid injections (in the short-term) as a first line of treatment, unless your knee is ‘locked’ and unable to move.
What’s that pain?
So how do you know if it’s arthritis or just a temporary niggle? ‘If you’re experiencing pain and discomfort in a particular joint on most days for two to three months, then it’s time to talk to your GP. This most commonly could be osteoarthritis and there are things you can do to help,’ says Dr Watt.
However, if you’re concerned you may have rheumatoid arthritis – think pain in more than one joint, swelling and marked stiffness, plus do you have a family history – then don’t hang around. Dr Watt suggests booking a doctor’s appointment within two to three weeks. ‘We have pathways in rheumatology to see people quickly – even at the moment with COVID-19,’ she explains. ‘It’s important to get patients onto the right drugs and bring the condition under control as soon as possible.’
Can you fix it?
Well, yes, it seems you can. Arthritis is debilitating – inhibiting your ability to exercise, pick up your grandchildren and work (even typing on a keyboard may be impossible). So, apart from raiding your medicine cabinet for another pack of paracetamol, what other treatment is available?
Like the conditions themselves, the treatments for osteoarthritis and rheumatoid arthritis are very different. ‘Rheumatoid arthritis is driven by inflammation,’ explains Dr Watt. ‘Some of our treatments include biologic therapies that target chemicals in the joints that we know are driving the inflammation.’ These can help reduce pain, get your joints functioning normally again and protect joints from future damage.
Unfortunately, these same drugs don’t work for osteoarthritis. But simple lifestyle changes do. Not smoking, losing weight and exercising are the most effective forms of treatment for osteoarthritis and preventing its progression, particularly if diagnosed early. ‘Exercise not only keeps you fit and helps shed those pounds, but specific workouts, such as yoga and Pilates, which take your joints through a range of motion increase flexibility and muscle strength around joints and reduce load through the joints.’
Joint replacement – especially for those in the latter stages of the condition – has also proved successful. But the hope is that doctors can do more to prevent patients getting to that place.
Versus Arthritis is the UK’S leading charity supporting people with arthritis. For more information, advice and support on these conditions and anything related to arthritis, please visit versusarthritis.org, or call their free helpline for access to condition-specific leaflets (0800 520 0520).