How I Manage My Mental Health as Someone With Chronic Illnesses

From yahoo.com/lifestyle

In 2013 I was diagnosed with psoriatic arthritis, fibromyalgia and chronic fatigue. Along with that, my anxiety and depression have appeared more than they used to; they come and go. My anxiety was the worst and it still creeps up on me from time to time. I sometimes have panic attacks from heartburn / indigestion / arthritis in the sternum.

These conditions have made me depressed, angry and frustrated, especially when my body won’t allow me to do something or won’t stop hurting even when I have done everything to try and stop it — pain killers, heat packs, massages. Sometimes while I am out, I will pick up a virus or a bug due to my low immune system.

I am only 33 and these conditions have really taken over my life. I worry that when I am out and about my hip will go out or I will fall over and seriously hurt my back. That gives me anxiety sometimes, so I normally grab a trolley when I can, even though I might be getting a few things it still helps me feel a little more stable and in control.

When I was dealing with everything at the start, a few of my GPs suggested I go see a counsellor. They did actually help by letting me get my frustrations out and talk about what is going on inside my head and my body without the judgment or the “I feel sorry for you” face.

I have found a few things that work for me, like laying down and listening to music, and going out for a walk (I usually try to do 5,000-10,000 steps a day depending on what my body allows). That has been helping to clear the hornets in my head, as well as doing Warm Water Movement Therapy class, which has definitely made a great change in not only my mental state but also my flexibility and weight loss. I have lost around 30 kgs since I started going to the pool at the end of January this year. My trainer Martin has helped me; I have put in the work, but he really has changed me in so many ways.

I also like to write down things or write blog posts. I will post most of them on my blog but there are some things I just write down and just to get things off my chest. I will also try doing some adult colouring books or a jigsaw puzzle (depending on if my hands allow me to do so).

The best thing I have found for me is to have rest days, as stress makes my condition worse, so I get rid of as much stress as possible from my life.

If I am having a moment of sadness or anger, I usually allow myself to feel it for a little while and then do something about it. I try to remember there are people in this world worse off than I am, and my condition is what it is. Nothing is going to change that and there is no cure. So I pick myself up, dust myself off and keep going to the next hurdle. I believe the key is to get yourself back up no matter what, because you always have a choice in life. You can wallow in self-pity or keep fighting and keep going. I believe no matter how hard things seem at that moment in time, it will get better.

https://www.yahoo.com/lifestyle/manage-mental-health-someone-chronic-060015331.html?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAAD3fTa84uN5WCf0qZ2KnfASsMlcb5PM3i-W8XdRUdyDjuYwNX-E6hADrUeQ-wMXdcjwl5FSdlLpAApfoa5XOIp3NrvdiSQS9pXFzjWRtllssQLc0XtNWnRLQRwRULP_J4x2JNc73e_4rhtEwFhbDDLPhmNmu4z6ZU9-3gp7i5mnq

Lifestyle Tips for Those Suffering From Rheumatoid Arthritis

From docwirenews.com

For patients living with rheumatoid arthritis (RA), every day can sometimes feel like a challenge. In some cases, it starts before the morning comes, as pain and stiffness associated with the disease could make sleeping difficult or near impossible. While there is currently no cure for RA, a combination of the right medication regimen and lifestyle modifications can help make the symptoms more manageable.

Turn Up the Heat

Heat may help relief joint pain and stiffness, especially first thing in the morning after a long night of inactivity.
“Heat helps improve your pain tolerance and relaxes muscles, both of which can reduce the pain of rheumatoid arthritis,” according to Harvard Health. “Heat treatment remains a standard part of the physical therapist’s practice.”

There are also ways to warm up right at home. Starting the day with a long, hot shower may be helpful, as could a heating pad. Harvard Health notes that moist heat may be more effective than dry heat, so using a microwave to heat a damp towel could be especially effective. On the more difficult days, one patient suggests breaking out the heavy artillery: heated blankets.
“I actually have two and I make myself into a kind of hot sandwich between them,” Angela K. shared with CreakyJoints. “I turn them on high and just soak in the warmth for 15 or so minutes before I get out of bed.”

Another patient speaking with CreakyJoints, Stephanie M., said she sleeps with a heated mattress cover to make the mornings easier.

Get Moving

While the pain and stiffness that come with RA could make stretching and physical activity sound like a bad idea, patients and experts agree that the opposite is in fact true. The Rheumatoid Arthritis Support Network (RASN) recommends light activities such as walking and yoga in order to fix range of motion issues and increase flexibility. Other low-impact activities include swimming and the use of the treadmill or elliptical. RA patients can also practice strength training to help increase muscle strength.

As is the case with any patient, physical activity prevents RA patients from engaging in a sedentary lifestyle, which could exacerbate stiffness as well as lead to weight gain. Weight management is important for RA, too, as being overweight puts additional pressure on the joints, the RASN notes. The Arthritis Foundation suggests additional arthritis-friendly exercises, including golf, Pilates, and tai chi.

To approach an exercise regimen in the presence of arthritis pain, the Centres for Disease Control and Prevention (CDC) recommends following “S.M.A.R.T.” tips: Start low, go slow; Modify activity when arthritis symptoms increase, try to stay active; Activities should be “joint friendly”; Recognize safe places and ways to be active; and Talk to a health professional or certified exercise specialist.

The CDC also gives several recommendations for pain management during and after exercise:

• Make modifications in the beginning, such as exercising fewer days per week or fewer minutes per session
• Switch to exercises that put less pressure on the joints (e.g., from walking to water aerobics)
• Be sure to include a proper warm-up and cool-down routine in your exercise plan
• Keep your pace comfortable while exercising
• Wear comfortable shoes

Follow These Diet Dos and Don’ts

Although no magic food will cure RA, eating certain foods while eliminating or minimizing others may help ease its symptoms. Experts recommend sticking to an anti-inflammatory diet and avoiding foods that cause inflammation.

Inflammation is the body’s response to foreign objects that may cause it harm. On the outside, inflammation often manifests through redness and swelling, but inflammation can happen inside the body, too. Diet may contribute to inflammation.

Some foods have anti-inflammatory properties and can be helpful to reduce inflammation. Some of these foods include:

• Leafy greens like spinach and kale
• Fruits including strawberries and blueberries
• Foods with healthy fats, such as salmon
• Nuts like walnuts
• Olive oil
• Tomatoes

On the other hand, certain foods may trigger an inflammatory response in the body. The bottom line? Use common sense. Generally speaking, “junk food” items should only be consumed infrequently if avoiding or limiting inflammation is the goal. Unsurprisingly, it’s a lot of the “fun” stuff. Here are some foods to limit or avoid to reduce inflammation:

• Soda, “fruit” juices with added sugar, and other sugar-sweetened beverages
• Pastries
• Desserts
• Fast food/fried foods
• Sugary breakfast cereals
• Candy
• Red meat
• Processed meats

Get Enough Shut-eye

Sleep is crucial for a variety of health reasons—two of which include diet and exercise. Catching those zzz’s every night increases the chances of sticking to a healthy diet and exercise plan.

According to the National Sleep Foundation, “Research shows that all mammals need sleep, and that sleep regulates mood and is related to learning and memory functions. Not only will getting your zzzs help you perform on a test, learn a new skill or help you stay on task, but it may also be a critical factor in your health, weight and energy level.”

Sleep may also affect diet. Maintaining a proper sleep schedule will lead to less daytime sleepiness—and lessen the chance of reaching for an unhealthy, sugar-bomb option for that afternoon pick-me-up.

https://www.docwirenews.com/blog/blog-lifestyle-tips-for-those-suffering-from-rheumatoid-arthritis/

General Arthritis vs. Lupus Arthritis

From health.usnews.com

For anyone with creaky joints or painful, swollen fingers, you likely know the pain of arthritis. This very common condition typically afflicts older adults, but there are actually many different types of arthritis that can impact people at various stages of life.

In total, the Arthritis Foundation reports there are more than 100 distinct types of arthritis, and the Centres for Disease Control and Prevention reports that more than 54 million U.S. adults – that's about 1 in 4 – have some type of arthritis.

                                                                       (Getty Images)

General Arthritis

Generally speaking, "arthritis is inflammation of a joint," says Dr. Travis Scudday, an orthopaedic surgeon with Hoag Orthopaedic Institute in Irvine, California. The most common type of arthritis is a condition called osteoarthritis. This is the form of arthritis that's associated with aging.

Dr. David Pugliese, a rheumatologist at Geisinger in Danville, Pennsylvania, says that "osteoarthritis is essentially a wear-and-tear phenomenon" that gets worse over time. As you age, the cartilage that sits between the bones that meet in the joints and acts as a cushion to those bones starts to wear thin.

Eventually, this cartilage becomes so thin that the bones rub against each other. This can create pain from the direct contact of bone on bone, and the more you use the joint, the more painful it becomes.

Virtually everyone will eventually develop osteoarthritis if you live long enough, it's just a simple matter of the body's protection systems breaking down with use. Osteoarthritis is "a disease of old age, basically," says Dr. Esther Lipstein-Kresch, chief of rheumatology at ProHEALTH Care in New York. "Unless you've had some kind of trauma to a joint," or there's another abnormality in the structure of the joint, "you wouldn't expect someone who is 30 or 40 to develop osteoarthritis," she says.

Osteoarthritis affects "nearly half of all people over age 65," Scudday adds. It's typically diagnosed with a clinical exam, and "there is often radiographic evidence in simple X-rays" of damage to the cartilage.

Osteoarthritis can usually be treated non-operatively with physical therapy and anti-inflammatory medications, such as over-the-counter pain killers. Some people may find relief with steroid injections into the painful joint to ease the inflammation there. "If all non-operative treatments have failed, often a joint replacement is necessary," Scudday says.

Lupus Arthritis

By comparison, another type of arthritis is related to an autoimmune disease called lupus. About 1.5 million Americans are estimated to have lupus, according to the CDC, and the disease causes a variety of symptoms including:

• Chronic pain.
• A signature, red butterfly rash across the face and the bridge of the nose.
• Other rashes and skin problems.
• Joint pain and swelling.
• Chest pain.
• An overall feeling of malaise.
• Mouth sores.
• Inflammation of blood vessels.
• Fever.
• Strokes.
• Cardiovascular disease.
• Extreme fatigue.
• Hair loss.
• Weight loss.
• Arthritis.

Although there are a few different types of lupus, systemic lupus is the most common, accounting for about 70% of all cases of lupus, the Lupus Foundation of America reports. When someone says "lupus," they're usually referring to this systemic type, which is also called lupus erythematosus.

Why exactly lupus happens to some people and not others isn't entirely clear, but may be related to:

• Genetics. The LFA reports that about 20% of people with lupus have a close relative (parent or sibling) who has or will develop lupus.
• Hormones. About 90% of people with lupus are women, but men and children can develop it too.
• Environmental triggers. Infection with certain viruses, such as the Epstein-Barr virus, or exposure to chemicals, such as silica dust, could play a role in the development of lupus by some individuals. Other stressors on the body are also believed to be potential triggers for the disease.
• Medications. Certain medications, including some antibiotics or sulfa drugs that increase sun sensitivity, are thought to be potential triggers of lupus.

Lupus occurs when the immune system goes haywire and begins attacking your own cells erroneously. This causes widespread inflammation, and when this occurs in the joints, it causes a type of arthritis called lupus arthritis.

Lupus arthritis is caused by inflammation in the joints that develops because of the immune system processes that cause the disease. People with lupus may experience "flares" or periods when their joints are more inflamed, followed by periods where there's less pain, swelling and redness.

Lupus can be very challenging to diagnose, but joint pain is often one of the first signs of the disease. "We usually see swelling of the hands and wrists but can also see knee and hip involvement," Scudday says. Unlike with osteoarthritis, lupus arthritis doesn't usually show obvious signs on X-rays.

Because it might not be clear straight away what's causing the problem, lupus is sometimes missed or misdiagnosed as a different disorder. Scudday says a blood test looking for certain blood markers associated with the autoimmune condition can help make the diagnosis, "but not all lupus patients have positive blood markers."

If you have been diagnosed with lupus, you'll likely need medication to keep your immune system in check. This can help relieve symptoms of the disease, including arthritis.

"Lupus can be treated with medication that alters the immune system to decrease the amount of inflammation," Scudday says. "Injections can be effective in the large joints such as the knee or hip." In the most advanced cases where there's irreparable damage to the joint, a total replacement might become necessary – partial joint replacement isn't an option because of the extensive, system-wide inflammation associated with lupus.

It's important to note that while lupus is not curable, it is a disease that can be effectively managed and treated. Early detection of lupus or any other inflammatory or autoimmune disease is critical to starting treatment before the damage progresses. "Treating with medication will often stop the progression of any lupus-related arthritis," Scudday says.

Stopping or slowing progression is the name of the game in treating rheumatological consequences of autoimmune disease because once the damage occurs, it can't be reversed. "It's important to diagnose and treat lupus as early as possible," Scudday says, because in such cases, "the joint issues may be completely avoided."

Similar Pain From Different Diseases

Though the pain you feel in the joints caused by either osteoarthritis or lupus-related arthritis might feel similar, the two diseases are quite different. And lupus isn't the only autoimmune disease that can cause arthritis; if you have any kind of autoimmune disease, you may well have rheumatological involvement because of the extensive inflammation caused by these conditions.

But, if your autoimmune disease is well-managed, then you may be able to avoid some of the worst arthritis symptoms. In such cases, it's possible that you may "develop age-related osteoarthritis, just like the rest of the population," rather than lupus arthritis, Scudday says.

Regardless of whether your joint pain is caused by osteoarthritis or another form of arthritis, it's important to get it checked out. Arthritis symptoms can be vastly improved with careful management of lifestyle factors and the addition of medication or physical therapy. The key is to not suffer in silence.

https://health.usnews.com/health-care/patient-advice/articles/general-arthritis-vs-lupus-arthritis

Food and ingredients to cure arthritis!

From ehealth.eletsonline.com

Arthritis is caused by inflammation of the joints. There are many foods and ingredients that can ease inflammation and may help relieve some of the joint pain associated with arthritis. Adding these foods to a healthy diet can help alleviate our arthritis symptoms. Let’s have a look on list of food and ingredients that we can try using at our homes in order to get some relief from the arthritis-related pain.

Grains

While considering our options in the bread, cereal, and pasta, we should avoid refined grains. Not only are they highly processed grains but limited in nutrition, can lead to inflammation throughout the body. For Example, switching from refined flour to whole-wheat flour in our recipes can increase the intake of nutrients and potentially lower inflammation. Likewise, barley is filled with 6 grams of fibre per cup, a perfect addition to soups, stews and risotto dishes.

Nut and seeds

Nuts and seeds are a useful component in our diet. Most importantly it offers a variety of health benefits to people with arthritis. With their high ALA content, nuts like walnuts are omega-3-containing and researchers studying their effects have found that they lower C-reactive protein (CRP), an inflammation marker linked to an increased risk of cardiovascular disease and arthritis. Likewise, chia seeds are also an excellent source of anti-inflammatory ALA, but their greatest benefit is likely their high fibre content.

Fruit and vegetables

Fruits are naturally sweet and have a substantial amount of antioxidants, protein, vitamins, minerals, and other nutrients, just like red raspberries, tart cherries and strawberries are filled with antioxidants that help to get rid of radicals that encourage inflammation whereas Vegetables are rich in antioxidants and other nutrients that protect against cell damage and lower inflammation throughout the body, including in the joints. For example, fresh, leafy vegetables such as broccoli, spinach, brussels sprouts, kale, swiss chard, and bok choy are loaded with antioxidants such as vitamins A, C, and K which protect cells from free radical harm.

Spices

According to traditional Eastern medicine, ginger and turmeric are two spices that have anti-inflammatory properties. Along with its anti-inflammatory properties, some studies have shown ginger can also reduce osteoarthritis symptoms, if not in food one can also opt-in the form of a herbal supplement -like IMOVE containing popular, active and trusted pain management ingredients such as ginger and turmeric. It also includes Glucosamine & Chondroitin for joint repair and lubrication, thereby offering full joint treatment.

Fish

Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are called marine fatty acids as they are derived from fish, adding omega-3 sources to our diets inflammation could be reduced. Fatty fish such as salmon, tuna, sardines, and mackerel are the best sources of marine omega-3s. Anti-inflammatory effects of omega-3s are helpful not only for the relief of arthritis but also for the prevention of other inflammatory diseases, such as heart disease. It is usually suggested to eat 3 to 6ounce serving of these fish two to four times a week to reduce inflammation and protect the heart Omega-3-rich fishes are also high in mercury, which causes brain and nervous system can harm if consumed in large quantities. It’s important to choose smaller fish that have less mercury.

(Disclaimer: Writer is Sargam Dhawan, Director, Planet Herbs Lifesciences Pvt Ltd. Views expressed are a personal opinion.)

https://ehealth.eletsonline.com/2019/12/food-and-ingredients-to-cure-arthritis/

How to manage arthritis flare-ups during the holidays

From startsat60.com/health

Arthritis is one of the most common conditions that develops through ageing and is known to not only impact mobility but also the overall quality of life.

Christmas can be particularly challenging if you or a loved one has arthritis. The change in diet, often humid weather and increase in parties, gatherings and functions can make the condition a lot worse.

“Christmas traditions in Australia generally aren’t well suited to the requirements of the average sufferer of arthritis,” Brendan Howell, director of Arborvitae Health and Wellbeing, tells Starts at 60.

“Whether it’s Christmas lunch, going to the beach, eating pavlova, having a beer or backyard cricket, Aussie Christmas traditions often force arthritis sufferers to sit on the sidelines.”

With the help of Howell, we’ve put together some tips to help you deal with the holiday season.

Eat right

There’s something about the holidays that makes us want to indulge a little, and rightly so. It’s a time for fun, frivolity and enjoying quality time with good friends and good food. But, as tempting as it is, snacking on fruit mince pies or digging into a festive pudding is a big no-no.

Howell says arthritis sufferers should be really careful about what they eat during the festive period, adding that the types of food traditionally eaten at or associated with Christmas aggravate arthritis symptoms.

“Every Christmas meal I’ve ever had has been packed with ham, sausages, alcohol, chocolate, soft drink and bread,” he says. “Christmas lunches around Australia are full of sugar, saturated fats, refined carbohydrates, gluten and alcohol – all of which are an arthritis sufferer’s worst nightmare.”

Howell adds poor food choices can cause painful arthritis flare-ups, and even more serious health issues in the long-term.

Plan ahead if you’re travelling abroad

If you’re visiting family or friends overseas during the Christmas break and take arthritis medication, make sure you have a doctor’s certificate with you, Howell advises. You don’t want to be caught in a situation where you can’t take your meds with you.

A change in weather or humidity can also affect arthritis. Plan ahead and ensure you dress appropriately for the trip.

Stay positive

Howell’s biggest piece of advice for arthritis sufferers is to stay positive during the Christmas period.

“Arthritis may stop you from doing a lot of things at Christmas,” he says. “You may not be able to eat exactly what you want or be able to participate in the family backyard cricket tournament. But it’s important to stay positive, especially during Christmas!”

Howell recommends talking with your loved ones and suggesting activities that everyone can join in on, such as board games or cards.

Important information: The information provided on this website is of a general nature and information purposes only. It does not take into account your personal health requirements or existing medical conditions. It is not personalised health advice and must not be relied upon as such. Before making any decisions about your health or changes to medication, diet and exercise routines you should determine whether the information is appropriate in terms of your particular circumstances and seek advice from a medical professional.

https://startsat60.com/health/health-issues/arthritis/arthritis-how-to-cope-at-christmas-tips

Arthritis: Best Christmas treat to relieve joint pain

From express.co.uk

ARTHRITIS is a widespread condition in the UK, with more than 10 million people living with arthritis or other, similar conditions that affect the joints. While the condition cannot be cured, certain lifestyle interventions have been shown to alleviate symptoms, including a popular Christmas treat.

Arthritis is an umbrella term for a number of conditions that cause swelling and tenderness of one or more of your joints. Osteoarthritis and rheumatoid arthritis are the two most common types of arthritis.
Osteoarthritis mainly affects the hands, spine, knees and hips, whereas rheumatoid arthritis usually affects the hands, feet and wrists.

There's no cure for arthritis, but there are many treatments that can help slow it down and maintain quality of life, including the key ingredient found in gingerbread men.

A number of studies suggest ginger extract can help to alleviate the joint pain associated with arthritis.
One notable study found that ginger extract was as effective as ibuprofen in the first treatment period of a cross-over study.
Researchers in another study also found that ginger and echinacea supplements effectively reduced inflammation and pain after knee surgery.
Echinacea is a very popular herb, and it is commonly taken to help combat flu and colds.

  Arthritis: Ginger has been shown alleviate joint pain in a number of studies (Image: Getty Images )

Additionally, researchers found that highly concentrated doses of ginger extract were effective in treating people with osteoarthritis of the knee.
Before beginning the study, the participants experienced moderate-to-severe knee pain but after taking ginger extract the participants reported a reduction in knee pain upon standing and after walking.

Furthermore, an animal study revealed that ginger can help to relieve joint pain from rheumatoid arthritis.
Bolstering the findings, one study found that ginger was an effective pain reliever for human muscle pain resulting from an exercise-induced injury.

Participants who ingested two grams of either raw ginger or heated ginger experienced reduced pain and inflammation.
Heat-treated ginger was thought to have a stronger effect, but both types of ginger were found to be equally helpful.

Findings also suggest applying a cream or gel containing ginger directly onto the affected area may also provide respite.
According to research, ginger extract is able to improve osteoarthritis in knees when applied topically.

Participants applied ginger extract three times per day for 12 weeks, and, during this time, they experienced reduced levels of pain and other symptoms.

Other ways treat arthritis

As Mayo Clinic explains, you may need to try several different treatments, or combinations of treatments, before you determine what works best for you.
Some people find exercise can help to alleviate symptoms associated with certain types of arthritis.
“Exercises can improve range of motion and strengthen the muscles surrounding joints. In some cases, splints or braces may be warranted,” explained Mayo Clinic.

    Arthritis : Evidence suggests applying a cream or gel containing ginger may help alleviate pain                                                                   (Image: Getty Images )

A course of medication may be recommended depending on the type of arthritis.
A class of drugs called corticosteroids, for example, are an anti-inflammatory medicine reduces inflammation and suppresses the immune system.
According to Mayo Clinic, if milder measures do not relieve symptoms, your doctor may also suggest surgery, such as:

• Joint repair. In some instances, joint surfaces can be smoothed or realigned to reduce pain and improve function. These types of procedures can often be performed arthroscopically — through small incisions over the joint.
• Joint replacement. This procedure removes your damaged joint and replaces it with an artificial one. Joints most commonly replaced are hips and knees.
• Joint fusion. This procedure is more often used for smaller joints, such as those in the wrist, ankle and fingers. It removes the ends of the two bones in the joint and then locks those ends together until they heal into one rigid unit.

https://www.express.co.uk/life-style/health/1219857/arthritis-pain-symptoms-treatment-ginger

Skiing with arthritis

From timesofindia.indiatimes.com

Arthritis used to end people’s skiing lives. No longer. Current non-operative therapies, as well as operative repairs, now have people on the slopes into their 90s. Here are the reasons why:

Arthritis of the knee and hip are the most common aches and pains that discourage people in their middle and older ages from skiing. Yet today, these men and women visit our offices for “lube jobs,” as many call them, in order to enjoy winter sports. What has changed?

Joint lubrication used to be a simple injection of hyaluronic acid (HA). It worked but often didn’t last long enough. This was in part because inflammation is the most common cause of joint pain, and HA alone is not potent enough to combat the inflammation generators. Today, HA is combined with growth factors from a variety of sources. These include your own blood (called PRP), amniotic fluid and membranes, fat, and bone marrow. These growth factors stimulate the joint lining to produce more HA, decrease the degradative enzymes in the joint associated with arthritis, and increase the anabolic factors that promote healing.

The current thinking is that specific growth factors recruit the body’s own stem cells to the joint. These further decrease inflammation and promote whatever healing can occur. Last year’s thinking—that we should inject stem cells directly—has been replaced, as it is now believed that the directly injected stem cells probably die off too quickly. But since all people have billions of stem cells, recruiting them to the site of injury makes the most sense. Our research today focuses on which injected bioactive factors are most effective at recruiting stem cells: producing natural HA as a lubricant and decreasing inflammation. Our “lube job” of today is a potent cocktail of these factors. Many patients report six months to a year of joint pain relief—usually enough to get through the ski season.

Physical therapy, Pilates, yoga, and workouts with stretching, guided by great trainers and therapists, definitely helps keep arthritic joints moving. Stiffness and loss of motion are what people notice the most when returning to skiing, and those activities help tremendously. Getting in a hot tub before skiing, and doing a stretching fitness class early in the morning before hitting the slopes, are also great ways to get more enjoyment out of your day. Even a pre-ski 20-minute stationary bike spin can do the trick. Most of my 70-90-year-olds ski the sweet spot of the day (10 am -2 pm), avoid low visibility or icy days, and smile all the way down the slopes. I often write prescriptions that state, “must ski powder.”

NSAIDS such as Ibuprofen and Celebrex still have their place and can be used for a few days before and during skiing. We prefer not to keep people on them, as they have deleterious side effects. We avoid cortisone, preferring to use bioactive factors.

If the tissue is damaged enough, it’s best to repair it rather than masking the injuries. Surgical repairs, both biologic and bionic, have improved so much that skiing after either meniscus replacement and articular cartilage repair, or after robotic partial and total knee replacements, is now prescribed as a therapy rather than abandoned. In general, it takes three to six months to return to skiing after complex knee joint repairs—so many patients opt for surgery in the late spring or summer. By the time early winter comes, they prefer joint lubes. This allows them to delay their joint repairs until after the snow has melted.

So buy your lift tickets. Tune your skis. Buckle the new lightweight soft-flex, high-reactive ski boots and head for the hills. If your joints talk to you, quiet them with targeted care that keeps you moving, sliding, turning, and gliding.

DISCLAIMER : Views expressed above are the author's own.

https://timesofindia.indiatimes.com/blogs/siliconvalley/skiing-with-arthritis/

Hope for millions of arthritis patients after scientists develop a vaccine that blocks pain

From stockdailydish.com

Hope is on the horizon for millions of arthritis patients after scientists have found a vaccine could treat their daily agony.  

Osteoarthritis sufferers currently have to rely on painkillers to combat their excruciating pain.

But Oxford University researchers have developed a vaccine which blocks the cause of the agony – nerve growth factor (NGF).

The vaccine triggered the immune system to work against the naturally occurring NGF in mice, numbing their pain. 

Figures estimate nearly nine million people suffer with osteoarthritis in the UK and 30million in the US. 

There is currently no cure for the condition but the latest findings could pave the way for more effective treatment. 

Professor Tonia Vincent, co-author of the study published in Annals of Rheumatic Disease, said: ‘This is the first successful vaccination to target pain in osteoarthritis, one of the biggest healthcare challenges of our generation.‘ 

The vaccine triggers the immune system to produce antibodies that would work against the NGF.

It was tested in mice that had uneven distribution of weight across the hind legs – which the scientists said was a sign of painful osteoarthritis.

The vaccine, which has been described as ‘very promising‘ by a charity, was shown to visibly reverse their pain.  

Instead of leaning to one side due to the pain in their leg, the mice stood with their weight more evenly distributed.  

The mice who had been given the vaccine also had higher levels of antibodies, which was ‘appeared to be associated with an analgesic response‘. 

And the vaccine, named CuMVttNGF, helped relieve pain in the mice when it was given both before and after pain had taken hold.

WHAT IS OSTEOARTHRITIS?

Osteoarthritis – sometimes called ‘wear and tear‘ – is a condition that occurs when the surfaces within joints become damaged.

Cartilage covering the ends of bones gradually thin over time, and the bone thickens, according to .    

Around a third of people aged 45 years and over in the UK suffer from the condition. This equates to roughly 8.75 million people. At least 20 million are known to suffer in the US.

It is different to rheumatoid arthritis, a long-term illness in which the immune system causes the body to attack itself, causing painful, swollen and stiff joints.  

Replacement joints are often necessary for osteoarthritis patients, because the joint has been worn down and causes agonising pain.

The authors said the total cost of osteoarthritis, the most common joint disease, to the economy of developed countries is estimated between 1-2.5 per cent of the GDP. 

Arthritis UK predicts that working days lost due to arthritis will reach 25.9million by 2030, equating to an annual £3.43billion productivity hit to the economy. By 2050 these figures will increase to 27.2million working days and an annual cost of £4.74billion.

X-ray studies show at least 50 per cent of people older than 65 have evidence of osteoarthritis, according to NICE – a UK health watchdog, but there are limited treatment options.   

Fewer than 25 per cent of patients currently have adequate pain control for their condition, and long-term use of painkillers are well known to pose significant risks.

The team at Oxford believe a vaccine could be more effective for pain and cost of treatment.  

Professor Vincent said: ‘Whilst there are still safety issues that need to be considered before these types of approaches can be used in patients, we are reassured that this vaccine design allows us to control antibody levels and thus tailor treatment to individual cases according to need‘. 

Dr Stephen Simpson, from charity Versus Arthritis, which funded the research said: ‘We know that for the ten million people with arthritis, persistent pain is life changing. 

‘Too many people living with pain do not get effective relief from the treatments that are currently available.

‘And that is why the development of more effective pain killers, with fewer side-effects, is vital for people living with arthritis.

‘Although at an early stage, this is highly innovative research and these results are very promising. 

‘We are proud to support research such as this, which aims to tackle this urgent problem and discover new ways to help people overcome pain.‘ 

https://stockdailydish.com/hope-for-millions-of-arthritis-patients-after-scientists-develop-a-vaccine-that-blocks-pain/

What Type of Doctor Treats Arthritis?

From health.clevelandclinic.org

While most primary care doctors can treat osteoarthritis, there are times a specialist is needed

If you have joint pain and think it might be arthritis, you may wonder what type of doctor you should see. Should you go to an orthopaedist or a rheumatologist or some other specialist?

The most common type of arthritis is osteoarthritis, and for that the place to start is with your primary care doctor. “If you have aching joints with activity or walking and it’s persisting, it’s probably osteoarthritis, says orthopaedist Michael Star, MD.
Here Dr. Star explains what various types of doctors can do to treat arthritis:

Primary care doctor – A primary care doctor can manage osteoarthritis with standard treatments, like anti-inflammatory pain medications and referral to a physical therapist. The doctor will probably order X-rays. “That’s usually all that is needed,” Dr. Star says. An MRI isn’t necessary.
If the doctor suspects there might be some other cause of joint problems besides osteoarthritis, a rheumatologist will be consulted. If your symptoms don’t improve or get worse, your doctor may send you to an orthopaedist or a rheumatologist for more intense medical management or an orthopaedic surgeon for surgery.

Orthopaedists – Orthopaedists are doctors who treat injuries and diseases of the musculoskeletal system, including osteoarthritis. For arthritis that gets worse despite treatment, they can perform injections of corticosteroids (powerful anti-inflammatory drugs) or hyaluronic acid (a substance that lubricates joints).
For severe arthritis that causes significant pain and seriously limits daily life, an orthopaedic surgeon can perform surgery, such as joint replacement.

Rheumatologists – Rheumatologists specialize in musculoskeletal diseases and autoimmune conditions. They treat all types of arthritis, including osteoarthritis, rheumatoid arthritis and psoriatic arthritis.

If there’s a chance you have something other than osteoarthritis, you will be sent to a rheumatologist. They provide treatment for joint diseases, including prescribing medications and giving injections. They do not perform surgery.

Other specialists – Sometimes the specialist you see will be dictated by the location of the problem. Some medical centres have specialized spine centres. This may be the place to go to be treated for osteoarthritis of the spine.

Most doctors, regardless of their specialty, will probably send people with osteoarthritis to a physical therapist. “That is the treatment that’s shown to have the greatest benefit,” Dr. Star says.
This article first appeared in Cleveland Clinic Arthritis Advisor.

https://health.clevelandclinic.org/what-type-of-doctor-treats-arthritis/

Q&A: What can I do to limit joint pain from arthritis?

From inquirer.com/health

Q: I was diagnosed with arthritis. What can I do to limit joint pain?

A: Arthritis occurs when the cartilage on the ends of bones that make up our joints becomes damaged and worn down. This happens when the cells in your cartilage release enzymes and free radicals, which lead to inflammation and degradation.

There are more than 100 types of arthritis affecting more than 50 million American adults, according to the Arthritis Foundation. Osteoarthritis, in which the cartilage wears down over time, is one of the most common forms of arthritis. Rheumatoid arthritis (RA), another common form of arthritis, is an autoimmune disease that causes the immune system to attack healthy cartilage tissue. Other common causes of arthritis include injury, gout, infection and aging.

Symptoms of arthritis include pain, swelling and stiffness, which may range from mild to severe.

Although people may think that exercising with arthritis leads to joint pain, exercise done in the right manner may actually help reduce arthritis symptoms. Low-impact exercise conditions muscles and increases joint mobility, which may help control pain and stiffness. Examples of low-impact exercise for those living with arthritis include bicycling, swimming, walking, and using an elliptical machine or rowing machine.

However, certain exercises may damage the joints and increase pain and swelling. High-impact exercises, such as running and squatting, are not recommended for those with lower extremity arthritis because they put excessive stress on the joints. Limiting participation in high-intensity sports may help relieve arthritis symptoms.

The most immediate arthritis treatment options involve lifestyle changes to reduce stress on affected joints. Those with occupations involving frequent or repetitive movements, kneeling, squatting and heavy lifting are encouraged to modify their work style to limit their arthritis symptoms.

Weight loss is another lifestyle change that may help reduce joint pain caused by arthritis. Excess weight places additional stress on the joints, potentially making symptoms worse. Losing weight may relieve stress on the joints, which may lessen pain and inflammatory flare-ups.

Additional at-home treatment options include:

• Hot and cold therapy. For acute, arthritic flare-ups, ice may provide pain relief and control swelling. For baseline pain and stiffness, heat therapy may relax the surrounding tendons and muscles.
• Walking aids. Canes, walkers and other mobility aids may offload painful, swollen arthritic joints.
• Braces. Knee braces may offload knee joint stress.
• Medication: Acetaminophen (Tylenol), anti-inflammatories (Advil, Aleve, ibuprofen, aspirin) and topical capsaicin may be effective for arthritic pain relief.

Other treatment options include physical therapy, acupuncture, injections (including steroids or platelet rich plasma) and joint replacement surgery.

If you are experiencing joint swelling, stiffness or pain, talk to your doctor immediately to find the best treatment option. Always consult with a physician before initiating any weight loss or exercise program.

https://www.inquirer.com/health/expert-opinions/joint-pain-arthritis-treatments-20191116.html

Curcumin for arthritis: Does it really work?

From health.harvard.edu/blog

Robert H. Shmerling, MD
Faculty Editor, Harvard Health Publishing

Osteoarthritis is a degenerative joint disease that is the most common type of arthritis. Usually, it occurs among people of advanced age. But it can begin in middle age or even sooner, especially if there’s been an injury to the joint.

While there are treatments available — exercise, braces or canes, loss of excess weight, various pain relievers and anti-inflammatory medicines — these are no cures, and none of the treatments are predictably effective. In fact, often they don’t work at all, or help only a little. Injected steroids or synthetic lubricants can be tried as well. When all else fails, joint replacement surgery can be highly effective. In fact, about a million joint replacements (mostly knees and hips) are performed each year in the US.

So, it’s no surprise that people with osteoarthritis will try just about anything that seems reasonably safe if it might provide relief. My patients often ask about diet, including anti-inflammatory foods, antioxidants, low-gluten diets, and many others. There’s little evidence that most of these dietary approaches work. When there is evidence, it usually demonstrates no consistent or clear benefit.
That’s why a new study is noteworthy: it suggests that curcumin, a naturally occurring substance found in a common spice, might work for osteoarthritis.

A new study of curcumin for osteoarthritis of the knee

In the study, researchers enrolled 139 people with symptoms of knee osteoarthritis. Their symptoms were at least moderately severe and required treatment with a nonsteroidal anti-inflammatory drug (NSAID). For one month, they were given the NSAID diclofenac (50 mg, twice daily) or curcumin (500 mg, three times daily).
Why curcumin? It’s a naturally occurring substance, found in the spice turmeric, that has anti-inflammatory effects. Its use has been advocated for cardiovascular health, arthritis, and a host of other conditions. However, well-designed studies of its health benefits are limited.
Here’s what this study found:

• Both treatments relieved arthritis symptoms and helped to a similar degree: 94% of those taking curcumin and 97% of those taking diclofenac reported at least 50% improvement.
• People reported fewer side effects with curcumin. For example, none of the study subjects taking curcumin needed treatment for stomach trouble, but 28% of those taking diclofenac needed treatment.
• Those taking curcumin lost, on average, nearly 2% of their body weight in just four weeks — that’s 3.5 pounds for a 175-pound person.

Ready to start taking curcumin?

Not so fast. It’s rare that a single study can change practice overnight, and this one is no exception. A number of factors give me pause:

     The study was small and only lasted a month.

Only osteoarthritis of the knee was studied. We should not assume that other types of arthritis or that osteoarthritis of other joints would respond similarly.

Curcumin was compared with only one possible dosage level of diclofenac (not the highest advisable dose). In addition, the diclofenac used in this study was uncoated (even though there is a coated formulation designed to be easier on the stomach). The results of this study might have been different if another NSAID or a different dose or formulation of diclofenac had been compared with curcumin.

The study was unblinded — that is, study participants and researchers knew who was getting curcumin and who was getting the NSAID. This can sometimes bias the results by changing expectations of side effects or benefit.

We don’t know how well curcumin would work, or if it would be safe, for the types of people excluded from this study. For example, this study enrolled adults ages 38 to 65 and excluded those with significant kidney or stomach disease. For younger or older people, those with other medical problems, or those taking multiple medications, the results might have been different.

Over-the-counter dietary supplements (“nutriceuticals”) are not tested or regulated the way prescription drugs are. So, information regarding purity, strength, and potential interaction with other medications or diseases is typically limited for treatments like curcumin. It’s worth noting that reports of lead contamination in turmeric have been recently published.

Weight loss as a side effect of taking curcumin might be a problem for those who are already lean.

The bottom line

Studies of this sort are vitally important in trying to understand whether dietary changes can be helpful for arthritis. While this new study provides support for curcumin as a treatment for osteoarthritis of the knee, I’d like to see more and longer-term studies in osteoarthritis and other types of joint disease, as well as more extensive testing of its safety, before recommending it to my patients.

https://www.health.harvard.edu/blog/could-a-naturally-occurring-substance-derived-from-a-common-spice-provide-relief-from-osteoarthritis-of-the-knee-a-new-study-suggests-curcumin-might-help-but-the-research-has-some-important-limitati-2019111218290

From stigma to addressing invisible illnesses: Young people share what it’s like living with arthritis

From metro.co.uk

Arthritis can affect anyone, at any age. So why is it that adverts and leaflets frequently show images of greying, elderly people with the condition? The NHS states that around 15,000 children and young people in the UK are affected every year by arthritis. But that figure doesn’t take into account people in their 20s and 30s who are diagnosed, too. The winter months can be particularly difficult for those living with arthritis, as the cold weather can often cause ‘flare ups’ – particularly bad, painful episodes.

We spoke to three young people living with arthritis, who shared their experiences of coping day-to-day, as well as their thoughts on the stigma around invisible illnesses.

Hayley Woodland, a 27-year-old teacher, was diagnosed with juvenile idiopathic arthritis at the age of three. Doctors originally dismissed her swollen knee thinking it was just a bump – but when she returned to the hospital a year later, the arthritis had spread.

           Arthritis doesn’t just affect the elderly (Picture: Phébe Lou Morson for Metro.co.uk)

Hayley tells Metro.co.uk: ‘In 1994 there was still a bit thing around the fact that it wasn’t a “young person’s disease” and it wasn’t very likely to be that. We were lucky that we found someone a bit more specialised and I started getting treatment from about the age of three – but by that point it had spread from a knee to literally everywhere.

‘Luckily, that isn’t the case now for children being diagnosed, as they are spotting it so much earlier. But back then it was ignored, which was frustrating. I have swan neck in my fingers. It’s a condition where the tendons in the fingers couldn’t develop properly because of the arthritis, so they are in the wrong place. So I can’t bend my fingers pretty much at all and that happened from very young age.

‘It’s now proven that no child being in that situation will get swan neck. There is no reason for that to happen anymore because they know how to stop it.

‘I do sometimes reflect back and think “Oh I’m angry that wasn’t the case at the time”, but that’s how medical research goes. You can’t always be lucky enough to be born at the time when things can be stopped. But I am lucky enough to still be young enough that we are able to find treatments.’

Growing up Hayley says she was only in school around ‘30-40% of the year’, due to her arthritis. The rest of the time she was either in hospital or at home with her mum. Reflecting on her experience now, she says her school showed a lack of understanding towards her condition. She says: ‘I used to think it was the older teachers and older generation at the time who didn’t understand it – who saw it as “not a thing children get” and that my mum was exaggerating.

‘I think it was my Year 4 teacher – quite a young girl, probably a few years into teaching – she was atrocious to me. One day I had to go in in my wheelchair – I used it sometimes but that often – but I had to go in my wheelchair that day because I wasn’t feeling well. Then the next day it wasn’t so bad, so I didn’t need it and I went in as normal and she had a massive go at me. She was adamant that it was proof that we were lying about everything.

‘It’s that attitude that we face quite a lot – this idea of either you have it or you haven’t. There’s no awareness of the fact that that’s not how arthritis works. I think that’s something everyone with arthritis faces, people seem to find it hard to get their heads around the fact that it isn’t a consistent disease.’

Hayley says advances in medicine – compared to when she was diagnosed in the 90s – make things a little more promising for those living with arthritis. She recently underwent a hip replacement – which was something she was told 10 years ago would never really be an option. Her new ceramic hip will last her around 30 years.

Chloe Elliott was diagnosed with arthritis in 2013 – at the age of 23. She visited the doctor after suffering with severe body pain, leaving her unable to walk, lift her head or use her hands. Following a blood test and a session with rheumatologist, she was diagnosed with psoriatic arthritis – which develops from skin psoriasis. Chloe says: ‘I had to leave my job in fashion buying and move back home as I was completely unable to do anything for myself.

‘Now, I still have daily pain, some days are better than others. I take an anti-TNF injection once a month to help with my symptoms which include joint pain, extreme fatigue, and nausea. I try to keep as comfortable as possible, sleep as much as I can and as often as I need to. I’m lucky to be self-employed so I sleep when I can.

‘I have no idea how people in full time work – in an office for example – cope with having arthritis and not being able to rest when they need to. I also take pain relief which helps. ‘Keeping warm is absolutely vital too, as my body is definitely more likely to flare in cold weather.’

In terms of day-to-day activities, Chloe says living with arthritis has changed aspects of her life, such as socialising with friends and exercising. She says: ‘It takes a lot of my social life away. I am forever having to cancel plans or rearrange because I never know how I’m going to feel on the day. ‘I’m unable to exercise like I used to – I still try but it’s really painful for the entire week after I do any exercise. ‘I think many people with arthritis will agree with me when I say that you can go out and do one nice thing you’ve really been looking forward to, and you then pay for it for a solid week because it has taken everything out of your body.’

Chloe agrees with Hayley that more needs to done in terms of education around invisible disabilities, such as arthritis. She believes this is the best way to tackle the stigma and attitudes that the condition only affects ‘older people’.

She says: ‘I have been challenged whilst sitting in the accessible seats on a train and I have a disabled person’s railcard. I have also been challenged when parking in a disabled bay and I have a blue badge. ‘Unless I use my crutch – which I have to use a lot of the time – people don’t see the illness so they automatically assume that one isn’t there. Being challenged on your illness is absolutely humiliating and a complete violation. You can not determine someone’s health at face value. ‘I think it’s about more education, more people talking about it and more people purposefully educating themselves about invisible illnesses. It’s not my job as a disabled person to educate you – you should be doing it yourself. ‘I must admit that I myself thought that arthritis was for the elderly before I was diagnosed with it.

‘I remember phoning my mum after I’d seen the rheumatologist and telling her I thought we needed a second opinion and it couldn’t be arthritis. Thankfully, marketing is finally changing to show a range of people with the condition thanks to charity Versus Arthritis. This isn’t a condition purely reserved for the elderly. ‘

Paige Calvert’s arthritis derives from Crohn’s Disease – an auto-immune condition. At the age of 27, she was diagnosed with enteropathic arthritis – which causes inflammation surrounding the tendons and soft tissues around the joints. She has this in her wrists, knees, shoulders, elbow and lower back. The winter months can be particularly challenging for Paige, as her arthritis tends to flare up when the temperature drops.

                                    Paige was diagnosed at the age of 27 (Credit: Paige Joanna)

She says: ‘Coping day-to-day depends on the pain level, as some days I can feel achy and it’s bearable and other days it can really affect my mobility and the pain can be disabling. ‘On a fairly good day, I just try to keep warm, rest when I feel fatigued and stay as active as possible. ‘On a bad day, it can be mentally challenging but I manage it the best I can. I use joint pain relief gels, hot baths, hot water bottles and pain relief, as well as lots of rest. It’s about knowing your body is responding in the right way so that you don’t injure yourself or make the pain worse. ‘It can mean making sacrifices on bad days and cancelling plans but it’s important to put your body first.’

She adds: ‘In winter, I find my arthritis really flares up and I have learned to invest in good thermals when going out and keeping warm wherever possible. The change in temperature from cold to hot can also make inflammation and pain worse for me so it is challenging most days. ‘It doesn’t stop me on good days, but on bad days it definitely has a huge impact on my activity level. ‘Having it in my knees is the most disabling because I struggle to walk without it being painful, so when that flares I have to have help getting up and down the stairs.’

Paige says arthritis is a misunderstood condition and that people with invisible disabilities (such as arthritis) often struggle day to day, due to a lack of awareness. She says: ‘Since being diagnosed I have had many reactions where people assume I am too young to have arthritis. I have to explain that anyone at any age can develop it as it’s a form of autoimmune disease.

‘It’s getting better with the help of charities like Versus Arthritis but there is still a way to go. I also carry around a “please offer me a seat” disability badge from TfL and I wear it on bad days. I’ve been glared at and even had negative comments made when people see me with it on, waiting for someone to kindly offer their seat. People can assume you are putting it on because it’s invisible.

‘I’d love to see people understanding invisible illness and invisible disabilities because it would make our lives a little bit easier to not have to explain our struggles constantly.’ Charities such as Versus Arthritis are working to tackle this stigma around arthritis. They also offer advice for anyone living with the condition, such as how to cope with seasonal flare ups.

https://metro.co.uk/2019/11/09/from-stigma-to-addressing-invisible-illnesses-young-people-share-what-its-like-living-with-arthritis-11040563/

Rheumatoid arthritis: 5 Beverages that can help relieve the pain

From thehealthsite.com

Rheumatic pain is at times unbearable and doesn't get better even with pain killers. However, few daily hacks may help in better pain management. Here's a list of 5 beverages that can be beneficial in relieving arthritis pain.

Rheumatoid arthritis is a severe inflammation of joint and tissues in which even a slight pressing may trigger pain. It’s an uncomfortable and painful condition in which even sleeping or sitting in one position may hurt as the joints and tissues get pressed. Usually, strong medicines are given to relieve the pain, but experts believe that lifestyle changes are important to lead a healthy life with rheumatoid arthritis. Apart from food, there are several drinks that have proven benefits against rheumatic pain. Regular consumption of these may give some relief from pain.

1  Turmeric milk: If you are not lactose intolerant, milk can be beneficial to relieve your arthritis pain. Dairy does have some anti-inflammatory properties. When mixed with turmeric, which is known for its healing and therapeutic effects, the impact of milk on joint pains is positive. So, unless you are not allergic to dairy, you may like to take a glass of turmeric milk at the bedtime.

2  Green tea: Green tea has anti-oxidants that helps attacking inflammation in body. It’s known to ‘target pro-inflammation protein’ says a study published in the journal Arthritis and Rheumatology. However, if you are taking blood thinner then you must consult with your doctor before having green tea. Vitamin K present in it may counterattack blood thinner’s effects.

3  Red Wine: Alcohol may not sound like a nice idea when suffering from rheumatic condition, but this drink prove otherwise. Resveratrol present in red wine has anti-inflammatory properties. Studies show that it may help in cutting risk factors contributing to the development of rheumatoid arthritis. However, if consumed in excess may aggravate the condition; make sure to have it in moderation.

4  Fruit and vegetable mix smoothie: Experts believe in the goodness of whole fruits and vegetables mixed together to make a smoothie over squeezing the fresh juice. The nutrients and anti-oxidants from both are better consumed in the form of a smoothie. So, if you have more patience and time, you may replace simple fresh juice with a smoothie.

5  Vitamin C-rich fresh juices: Vitamin C has helps in building better immunity and therefore, orange, pineapple, tomato juices can give relief from pain. These fruits have anti-oxidants to fight free radicals in body. So, if you are a slacker to cut and eat fruits, just juice these for your benefit.

https://www.thehealthsite.com/photo-gallery/rheumatoid-arthritis-5-beverages-that-can-help-relieve-the-pain-698169/healthy-drinks--698173

Q: Do I need surgery for my ankle arthritis?

From northerndailyleader.com.au

                   When you have had to give up activities because of your pain, that's when                                                                            it's worth doing something about it

A: The decision to have an operation for arthritis is related to how much a person's quality of life is affected by the condition. When you have had to give up activities because of your pain, that's when it's worth doing something about.

In order to justify going through an operation and recovery, there has to be a significant amount of improvement in the patient. So someone who's bothered a little bit by their arthritis is probably not going to be that happy after a big operation. They might say 'Well, I'm only a little bit better'.

But someone who says 'I've had to give up walking, I've had to give up playing bowls, I've had to give up exercising and now I can do those things after my joint replacement' - they've gained a lot, even though it's been quite inconvenient to have the surgery. They're so much better than they were, it was worth doing.

Up until recently, surgical treatment for arthritis in the foot has meant fusing the joint together. The outcome of that is you often go from what is a stiff and painful joint to a stiff and painless joint. So you lose what movement you have, but you also lose the pain.

However newer treatments are able to preserve the joint and its movement so that we hopefully get a joint that moves but doesn't hurt. The first one is ankle replacement. By using a CAT scan we create a 3D printed version of the ankle which allows us to analyse exactly where the custom-made instrumentation will fit onto the existing limb.

The big toe is also susceptible to arthritis. That joint is about the size of a 10 cent piece, and you put all of your body weight through that one little joint as you're pushing off on it. If you do a lot of walking or running or if you do things in the gym like squats or lunges, or you wear high heels, it can obviously be quite painful.

A new thing that we use in the foot and ankle is a thing called Cartiva, a small implant made from the same material as contact lenses. It's currently used in big toes as well as the smaller toes, and I'm sure they will look at using it in other joints.

What is arthritis?

Arthritis is a disease of the joints. There are two types of arthritis: the most common is osteoarthritis (OA) which is due to the wear and tear of the joint surface, and inflammatory arthritis (IA), where the body has a reaction against itself which damages the joints. IA can occur in younger people as opposed to OA which affects more older people.

The signs of arthritis are pain, swelling and stiffness. All of us are experiencing these symptoms to some degree. Sometimes people who have had damage to the cartilage in their joints can develop OA, or are likely to develop it in the future. Some people have a genetic predisposition, and for others it just happens.

Treatment for arthritis consists of simple things like pain relief using anti-inflammatories, wearing comfortable and supportive shoes.

https://www.northerndailyleader.com.au/story/6468465/q-do-i-need-surgery-for-my-ankle-arthritis/

When Is Wrist Surgery Needed for Arthritis?

From health.clevelandclinic.org

When arthritis becomes severe enough, surgical options can fuse, remove or replace

If wrist pain and stiffness from arthritis can no longer be managed with conservative treatment, surgery may be an option. Just like for hips and knees, there’s joint replacement for the wrist. But other surgeries are actually more common.

The wrist is made up of eight small bones (carpal bones) arranged in two rows. “It’s like a pyramid of ball bearings, lined up perfectly,” explains orthopaedic surgeon David Shapiro, MD.
“If you injure the ball bearings or change their alignment, the rest of the pile will shift, and then they start to rub against each other in ways that cause them to wear down — that’s arthritis.

Arthritis in the wrist can have different causes:

• Osteoarthritis is degeneration of the impact-absorbing cartilage at the ends of the bone.
• Inflammatory arthritis, including rheumatoid arthritis, psoriatic arthritis and others, are systemic diseases that can damage cartilage.
• Pseudogout is a type of arthritis that can lead to wrist arthritis.
• Trauma, infection and congenital abnormalities are some other causes.

Partial procedures

There are several surgical options to stop arthritic bones from rubbing together.
“One is to remove the arthritic bones and another is to fuse them together so they don’t move and don’t hurt,” Dr. Shaprio says.
Which operation is better depends on which bones are involved. “You can remove the whole bottom row and the rest of the stack of bones will stay up,” he says. But if you take out just one bone from the middle, the whole pile of bones will collapse.

A partial fusion stabilizes the wrist and removes the arthritic joint. Both of these options provide good pain relief, although patients typically lose some portion of their wrist motion.

Whole-wrist procedures

Some people have arthritis in most or all of the joints in the wrist. This can occur in advanced osteoarthritis or rheumatoid arthritis. In these cases, the choice is between fusing all of the bones (total fusion) and joint replacement.
With total fusion, the wrist will no longer bend, but you can still rotate it, turning palm up and palm down since this motion comes from the elbow joint. Fusion sounds debilitating, but it does give great pain relief.

“Patients almost always find they can do more things more comfortably after surgery than before,” Dr. Shapiro says.
Joint replacement seems appealing because it retains, and may even improve, range of motion in the wrist. “The problem is durability of the implant,” Dr. Shapiro says. With wrist replacement, bones are removed and an implant made up of metal parts and a plastic spacer is inserted. These implants aren’t as predictably long-lasting as implants for other joints, such as hips and knees. And complications can be particularly challenging to treat.
Joint replacement generally is reserved for older adults who don’t put too much stress on the wrist. Surgeons may also consider replacement for people who have had one wrist fusion and need surgery on the other side, so they retain movement in one of their wrists.

What to expect from surgery

The surgeries usually are done as same-day procedures under regional anaesthesia (which blocks sensation to the arm) and sedation. With fusion and joint replacement, the wrist will be in a cast for three to eight weeks. Most people require physical therapy to work on regaining strength and motion. Complete recovery takes a few months.
Like all surgeries, there are potential complications, including bleeding and infection. “Fusions do not heal as well in smokers, so I try to get people to stop smoking well before the surgery,” Dr. Shapiro says.
“Future developments will hopefully lead to ways to longer-lasting and more durable implants to increase the indication for and success of wrist replacement.”
This article originally appeared in Cleveland Clinic Arthritis Advisor.

https://health.clevelandclinic.org/when-is-wrist-surgery-needed-for-arthritis/