Britons with arthritis told to exercise more and use painkillers less

From theguardian.com

Britons with arthritis are being urged to lose weight and exercise more rather than rely on painkillers as the main therapies for their condition.

NHS guidance from the National Institute for Health and Care Excellence (Nice) says people who are overweight should be told their pain can be reduced if they shed the pounds.

Aerobic exercise such as walking, as well as strength training, can ease symptoms and improve quality of life. Exercise programmes may initially make the pain worse, but this should settle down, the guidance suggests.

The guidelines also give recommendations on the use of medicines, such as offering non-steroidal anti-inflammatory drugs (NSAIDs) but not offering paracetamol, glucosamine or strong opioids.

Nice said there was a risk of addiction with strong opioids, while evidence suggests little or no benefit for some medicines when it comes to quality of life and pain levels.

In the guidance, doctors are told to diagnose osteoarthritis – the most common form of arthritis – without further investigation in people aged 45 or over who have activity-related joint pain.

Patients should have no morning joint-related stiffness, or morning stiffness that lasts longer than 30 minutes, to be diagnosed this way.

The draft guidelines say people can be offered tailored exercise programmes, with the explanation “doing regular and consistent exercise, even though this may initially cause discomfort, will be beneficial for their joints”.

The guidelines say doing regular and consistent exercise will be beneficial for joints. Photograph: Yuri_Arcurs/Getty

Exercising in the long-term also increases health benefits, the guideline adds.

When it comes to weight loss, people will be told “any amount of weight loss is likely to be beneficial, but losing 10% of their body weight is likely to be better than 5%”.

People can also be referred for hip or knee replacement if their condition cannot be managed in other ways, and referrals should not be held off due to age, sex or obesity.

Dr Paul Chrisp, director for the centre for guidelines at Nice, said: “Osteoarthritis can cause discomfort and prevent people from undertaking some of their normal daily activities.

“However, there is evidence which shows muscle-strengthening and aerobic exercise can have an impact on not just managing the condition, but also providing people with an improved quality of life.

“Beginning that journey can be uncomfortable for some people at first, and they should be supported and provided with enough information to help them to manage their condition over a long period of time.

“While topical and sometimes oral NSAIDs remain an important treatment option for osteoarthritis, we have taken the decision not to recommend some painkillers, such as paracetamol and some opioids for osteoarthritis.

“This is because new evidence has shown there was little or no benefit to people’s quality of life, pain or psychological distress, and particularly in the case of strong opioids there was evidence that they can cause harm in the longer term, including possible addiction.”

In the UK, more than 10 million people have arthritis or other, similar conditions that affect the joints. The most affected areas are the knees, hips and small hand joints.

Tracey Loftis, head of policy and public affairs at the charity Versus Arthritis, said: “We’ve seen first-hand the benefits that people with osteoarthritis can get in being able to access appropriate physical activity, especially when in a group setting. Something like exercise can improve a person’s mobility, help manage their pain and reduce feelings of isolation.

“But our own research into the support given to people with osteoarthritis showed that far too many do not have their conditions regularly reviewed by healthcare professionals, and even fewer had the opportunity to access physical activity support.

“The lack of alternatives means that, in many cases, many people are stuck on painkillers that are not helping them to live a life free from pain.

“While we welcome the draft Nice guidelines, healthcare professionals need further resources and support to better understand their role in promoting treatment like physical activity for people with osteoarthritis.

“There is clearly a need for people with arthritis to be given a bigger voice so that their health needs are not ignored.”

https://www.theguardian.com/society/2022/apr/29/lose-weight-and-exercise-for-arthritis-pain-says-nice 

Arthritis: Green leafy vegetables are rich in vitamin C, E and K to reduce painful symptoms

From express.co.uk

ARTHRITIS is a painful condition which can steadily get worse over time unless certain changes are not adhered to. Green leafy vegetables have been shown to be one of the healthiest food types to help

Some people find that making changes to their diet improves their arthritis symptoms. This may involve avoiding inflammatory foods, such as saturated fat and sugar. On the flip side there are many other foods which have been shown to help reduce symptoms.

“When you have arthritis, the produce section is one of the most important stops you can make in the grocery store,” said the Arthritis Foundation. “Vegetables are rich in antioxidants and other nutrients that protect against cell damage and lower inflammation throughout the body, including in your joints.”

Green, leafy vegetables such as broccoli, spinach, Brussels sprouts and kale are rich in vitamins A, C, and K - antioxidants which protect against cell damage. They are also high in calcium, which helps keep bones strong, while some contain a compound called sulforaphane, which blocks inflammation.

Arthritis: One of the healthiest food types to help reduce symptoms (Image: Getty Images)

Eating plenty of vegetables is key to an arthritis-friendly diet. Vegetables are full of antioxidants, nutrients and vitamins - all of which can help to lower inflammation in the body, including your joints.

Losing weight can also help you to manage arthritis better, so piling your plate with low-calorie vegetables will help you to maintain a healthy weight too.

In addition to eating the right vegetables, the way you cook them can have an impact on how many nutrients the vegetables retain.

Try steaming vegetables rather than boiling them, as boiling vegetables can lead to nutrients and antioxidants leaking out into the water. Avoid frying your vegetables for long periods of time too.

Foods which are notorious for inflammation build up increasing painful arthritis symptoms include:

• Sweets
• Dairy
• Fatty foods
• Carbohydrates
• Tobacco and alcohol
• Advanced glycation end (AGE) products
• Gluten
• Additives.

https://www.express.co.uk/life-style/health/1602154/arthritis-symptoms-food-green-leafy-vegetables-broccoli-spinach

 

Two telling signs you have osteoarthritis in the knee - 'things you can do'

From express.co.uk

ARE YOU concerned that you might be developing arthritis? How can you tell if a niggling pain is a minor injury or an indication that cartilage is thinning?

Osteoarthritis roughly affects more than eight million people in the UK, most commonly affecting the knee joint. What are the telling signs of the condition? According to leading charity Versus Arthritis, osteoarthritis will cause the knee to feel "painful and stiff at times". The charity explained that osteoarthritis occurs when the joint changes shape or structure.

In healthy joints, the end of bones are covered in cartilage – a smooth and slippery surface. This supple cartilage enables the bones to move against each other without friction. However, osteoarthritis develops when the cartilage begins to thin and roughen, causing friction in between two sets of bones.

People who have osteoarthritis may find that only one knee is affected, which may feel worse at the end of the day, or when you move your knee.

Osteoarthritis typically develops over a couple of years "that only causes fairly small changes in just part of the knee".

"The pain can be felt all around your knee, or just in a certain place such as the front and sides," Versus Arthritis noted.

There may be a creaking or crunching noise as you move, and the pain may ease with rest. However, even though it may be tempting not to move the knee (in order to avoid pain), this would be one of the worst things you could do for the condition in the long-term.

"Joints need to be exercised regularly to keep them healthy," assured Versus Arthritis. "It’s very important to keep moving if you have osteoarthritis of the knee." Finding the "right" balance between exercise and rest is key, as too much movement increases how much pain one feels whereas too much rest causes stiffness.

Movement is key if you have arthritis (Image: Getty)

In order to find the right fit for you, seek the advice of a physiotherapist.

When it comes to osteoarthritis of the knee, regular movement helps to strengthen the muscle around the knee. Moreover, exercise helps to improve your posture and to lose weight, thereby putting less pressure on the joints.

One activity to consider is hydrotherapy, otherwise known as aquatic therapy, which is where you get the muscles and joints working in a heated pool. The pool is warmer than a regular swimming pool, so it can be "soothing and relaxing".

Do you do stretches on a daily basis? (Image: Getty)

Weight-bearing exercises are also important, such as walking, to help strengthen bones; in order to promote joint flexibility, stretching is ideal.

Aerobic exercise can also be useful as it releases pain-relieving hormones called endorphins. Examples of aerobic exercises include cycling, swimming, walking, which should be done for nearly three hours each week.

"You can spread this out over the week and don’t need to do it all in one go," added Versus Arthritis.

https://www.express.co.uk/life-style/health/1599828/arthritis-osteoarthritis-in-knee-symptoms-signs-treatment-exercise

 

Osteoarthritis: Bumps in the middle of your fingers or at the ends could be early symptoms

From express.co.uk

OSTEOARTHRITIS is the most common form of arthritis and is known to cause unusual bumps and nodes on the fingers. What do they look like?

Osteoarthritis most often affects the joints of the hands, knees, hips, lower back, and neck. When this happens, the tissues that normally cushion the joint space are worn away. Over time, a person will start to experience joint pain, stiffness, and even the visible enlargement of the joint.

Symptoms of osteoarthritis include joint tenderness, increased pain and stiffness when the joint has not been moved for a while, and joints appearing slightly larger than usual.

A grating or cracking sensation or sound in the joints, weakness, and muscle wasting are also symptoms of osteoarthritis. Symptoms of arthritis can also appear on the fingers.

                       Osteoarthritis: Early symptoms to spot on your fingers (Image: Getty Images)

Bouchard’s nodes form in the middle of the fingers, while Heberden’s nodes form at the ends of the fingers. Bouchard's nodes are bony enlargements of the middle joints of the fingers, also known as proximal interphalangeal (PIP) joints. These are the first joints immediately above the knuckles.

Heberden's nodes are small bony growths that appear on the joint closest to the tip of your finger.

Bouchard's nodes are less common than Heberden's nodes, which are bony enlargements of the distal interphalangeal (DIP) joints closest to the fingertips. They can cause pain and limited motion in your hands.

 Osteoarthritis: Unusual bumps and nodes could indicate early symptoms (Image: Getty Images)

There are a number of treatments for osteoarthritis including lifestyle measures, medication, and supportive therapies. Experts recommend exercise is one of the key treatments for patients with osteoarthritis as it builds muscle and helps the joints to strengthen. Furthermore, exercise can help a person to lose weight and therefore take weight off the joints so there’s less pressure exacted upon them.

A GP or doctor may prescribe a tailored exercise regime that will best help treat their patient's arthritis.

There are no blood tests to help diagnose a person with osteoarthritis.

Your healthcare professional will perform other tests to rule out rheumatoid arthritis and gout as possible causes to your unusual finger symptoms. These tests may include blood tests to check for rheumatoid factor (RF) and anti-cyclic citrullinated peptide (CCP) antibodies seen in people with rheumatoid arthritis.

Blood tests can also check for elevated uric acid levels if gout is suspected.

Joint fluid may also be obtained to check for uric acid crystals associated with gout.

https://www.express.co.uk/life-style/health/1597103/osteoarthritis-arthritis-symptoms-fingers-hands-bumps-nodes-bouchards-heberden

 

Pain in the knees? Know the reason and its cure

From thestatesman.com

One might think that the pain is the result of Arthritis but it may not always be the case. It is just the inflammation of joints that is temporary

The pandemic did not just negatively impact our work lives but also our physical health. Reduced mobility, changed job habits and lifestyle as a result of working from home have adversely affected people’s physical health. Being static in one position for long hours with access to every kind of food item and still not exercising enough to neutralize its effect have all led to bone and joint problems for many people. 

One of the most prominent effects is on the knees causing agonising pain at times. One might think that the pain is the result of Arthritis but it may not always be the case. It is just the inflammation of joints that is temporary.

            Oh my Knee! Is the pain age related or something else?.(Photo:IANSLIFE)

Let’s get some insight into Arthritis!

Understanding the structure of bones can help us arrive at the cause of pain. Bones as thick and robust as it is supports our weight and provide functional structure. They contain nerves that would get irritated by any kind of movement if there was nothing in between the connecting bones. Therefore, the ends of our bones have a cap.

These caps are nothing but cartilage that functions to absorb shocks and bearing load. They are better known as Articular cartilage. Healthy cartilage is bathed by joint fluid, a thick engine oil acting as a cushion at moderate speeds. Fluid’s function is to distribute the strain over the joint and protect it when doing heavy tasks. High-speed runs can make it thinner providing less resistance and allowing the joint to move very swiftly.

Sr. Consultant Orthopedic and Joint Replacement Surgeon at Sitaram Bhartia Institute and Holy Family Hospital in New Delhi, Dr. Biren Nadkarni described the relation between the pandemic and changed lifestyles, said that “people became inactive as a result of the pandemic and have been away from their fitness regimen and activities for the past two years. Now that the pandemic limitations have been lifted, individuals should be cautious when returning to their pre-Covid lifestyle and exercise regimen”. He further added that “people should test themselves for any bone-related issues that may have gone unnoticed because of the lockdown”.

He also mentioned that “as we age, the cartilage in our joints can break down into little fragments, resulting in arthritis. These particles may float to the surface of the joint and become trapped there. This creates inflammation, which leads to the production of additional fluid. This causes swelling, irritation, and discomfort in the joints.”

As the day starts, everyone has more pain and stiffness compared to later in the day when the fluid offers joints a more frictionless glide as the body moves. The pain might reappear with pressure and stress. Moreover, the pain becomes much more severe as the cartilage wears down.

How to cure Arthritis if you have it?

The first step in this direction is getting an X-ray done. It is an essential step but not adequate as it indicates the presence of arthritis, but not the severity of joint discomfort.

About medication, Dr. Biren Nadkarni says, “Because arthritis is caused by inflammation, anti-inflammatory drugs that are available over-the-counter can help. When anti-inflammatory medication fails to relieve pain, an injection into the painful location is usually the next step”.

Consulting an orthopaedic can be a good place to start. Otherwise, there are excellent conservative-approach alternatives one of which is bracing to help support the joint and improve mobility. Physical treatment can also be helpful. When all these methods fail, joint replacement may be the best option. 

https://www.thestatesman.com/lifestyle/health/pain-knees-know-reason-cure-1503061104.html 

The #1 Best Juice To Drink Every Day, Says Science

From eatthis.com

This healthy drink will make you pucker, which should keep you from drinking too much 

While we'd much prefer you ate a whole fruit —it gives you a solid dose of fibre, which slows the absorption of the sugar and reduces its impact on your blood sugar level—there are some benefits to drinking juice. (Just avoid those unhealthy pseudo juice drinks that are sweetened with added sugars; some of those pack upwards of 60 grams of sugar.)

Just like how different fruits have different benefits, different juices provide unique benefits, and there is one type of juice, in particular, that has such a wide variety of benefits, we'd argue it's the #1 best juice to drink every day: tart cherry juice. Scientific research suggests that tart cherry juice offers specific perks that may benefit you. 

IMPROVE YOUR SPORTS PERFORMANCE

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A meta-analysis of 10 studies in the Journal of the American College of Nutrition found that athletes who drank tart cherry juice (or took powdered cherry extract) 7 days to 1.5 hours before swimming races, high-intensity cycling, and full and half marathons improved their endurance performance. The researchers attribute the result to the juice's high concentration of anthocyanins, powerful antioxidants that reduce inflammation and enhance blood flow to muscles.

Previous studies have also shown that tart cherries reduce strength loss and improve muscle recovery after intense exercise.

PROTECT YOUR HEART

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Bananas, leafy greens, beans, and nuts are rich sources of potassium, which helps regulate blood pressure. You can add tart cherry juice to that list, too. Studies show that tart cherries can help lower blood pressure and reduce the risk of cardiovascular disease and stroke thanks to their abundance of nutrients like polyphenols and potassium.

HELP YOU FALL ASLEEP

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If you suffer from insomnia, a swig of tart cherry juice concentrate may send the sandman your way. Several studies involving the elderly who tend to have difficulty with insomnia have shown the potential benefit of tart cherries as a natural sleep aid. One of the abundant phytochemicals found in tart cherry juice is melatonin, a hormone in humans that regulates our sleep-wake cycle.

A randomised controlled trial published in the European Journal of Nutrition involved two groups of volunteers, one that was given tart cherry juice concentrate, and another given a placebo drink. After seven days of this regimen, researchers reviewed participants' sleep questionnaires and analysed their urine samples, and found that the people with more melatonin in their urine reported improved sleep quality and duration.

EASE YOUR ARTHRITIS PAIN

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Researchers had 66 adults suffering from knee arthritis drink either 16 ounces of tart cherry juice or a placebo drink every day for four months and then evaluated their pain, stiffness, and plasma biomarkers of cartilage. The study published in Current Developments in Nutrition found that the daily consumption of tart cherry juice significantly improved all those symptoms of arthritis as well as participants' self-evaluation of quality of life. Other studies have shown that drinking 16 ounces of tart cherry juice for six weeks resulted in a marked decrease in C-reactive protein (CRP), a marker of inflammation.

PROTECT YOU FROM GOUT

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The anti-inflammatory benefits of drinking cherry juice or eating cherries may be helpful to people who suffer from recurrent flareups of a particularly painful form of arthritis called gout, which is characterized by joint swelling, most often in the big toe joint. Gout is caused when too much uric acid in the body crystallizes and deposits in the joints, causing inflammation and pain.

Several studies have shown that cherry juice, cherries, or cherry extract may be helpful in preventing those flareups. One large survey of 633 gout sufferers found eating cherries or taking cherry extract for two days was associated with a 35% or more reduction in risk of gout attacks compared with when no cherries were consumed.

https://www.eatthis.com/best-juice-drink-every-day/ 

Passive smoking linked to increased risk of rheumatoid arthritis

From medicalxpress.com

Passive smoking during childhood and/or adulthood is associated with increased risk of rheumatoid arthritis (RA), according to a study recently published in RMD Open.

Yann Nguyen, M.D., M.P.H., from the Université Paris-Saclay in Villejuif, France, and colleagues examined the association between exposure to passive smoking and the risk of incident RA in a French prospective cohort of healthy women. Self-reported questionnaires were used to assess exposures to passive smoking.

The researchers identified 698 incident cases of RA among 79,806 women. Overall, 13.5 and 53.6 percent of women were exposed to passive smoking in childhood and adulthood, respectively. In all models, passive smoking in childhood and in adulthood was associated with RA risk (hazard ratios, 1.24 and 1.19, respectively). Never-smokers with exposure to passive smoking in childhood and/or adulthood had similar absolute risk of RA as that of ever-smokers with no passive smoking exposure (47.6 and 47.2/100,000 person-years, respectively); the highest absolute risk was seen for ever-smokers also exposed to passive smoking (53.7/100,000 person-years).

"Passive smoking during childhood and/or adulthood was associated with an increased risk of RA, especially among never-smoking women. Such exposure should be limited as much as possible to prevent the onset of the disease," the authors write. "Even if our study was not designed to investigate this point, this message could especially apply to individuals at risk of RA, for example, relatives of patients with RA."

https://medicalxpress.com/news/2022-04-passive-linked-rheumatoid-arthritis.html 

Life with Psoriasis: 7 Signs of Psoriatic Arthritis You Should Know

From healthline.com 

Up to 30 percentTrusted Source of people who have psoriasis will also develop a related joint condition called psoriatic arthritis (PsA), suggests a 2013 study including 949 people with plaque psoriasis. This is likely related to the inflammatory response in the body that contributes to both conditions.

Your immune system’s job is to protect your body from harmful invaders. In inflammatory conditions like psoriasis and PsA, your immune system gets mixed up and targets otherwise healthy parts of the body. This can cause damage if inflammation persists.

With psoriasis, this atypical immune response targets skin cells. With PsA, it targets the joints.

When you’re living with psoriasis, it’s important to watch for changes in your joints. Early diagnosis and treatment of PsA can help you better manage symptoms and prevent joint damage.

Here’s what to look out for.

Joint pain and swelling

PsA can affect one or more of your joints and lead to symptoms like pain and swelling. You may also notice redness or warmth in the joints.

It can affect any joint in the body, but commonly affects smaller joints in the:

• fingers
• hands
• wrists
• toes
• feet
• knees

These symptoms are caused by the overactive immune response that targets otherwise healthy joints.

When the immune system responds, it increases blood flow to the area to help battle what’s perceived as an invader. But when the “invader” is actually your own body, it can lead to damage.

Morning stiffness

Another sign of PsA is joint stiffness. You may feel like you don’t have as much movement or mobility in certain joints. This makes it harder to move around.

You may feel especially stiff first thing in the morning or after sitting for long periods. This feeling is often referred to as morning stiffness.

Dactylitis

PsA can also cause a whole finger or toe to swell up. This is known as dactylitis. People with this condition describe their fingers or toes as looking like little sausages.

Dactylitis can affect one or more fingers or toes. It can be painful and may interfere with your use of your hands and feet.

Enthesitis

In the body, connective tissue called enthesis joins ligaments to bone. Sites of enthesis in the body include the:

• heel
• elbow
• bottom of the foot

PsA can lead to inflammation in the enthesis. When the enthesis becomes inflamed, it’s called enthesitis.

Enthesitis can cause swelling and pain in these areas that gets worse with movement.

Lower back pain

PsA can lead to inflammation and pain in the joints that make up your spine. Any part of your back can be affected, but it’s most often the lower part of the back, called the lumbar spine.

When PsA targets the spine, it’s called spondylitis.

Symptoms of spondylitis are often worse when you first get up in the morning or if you spend a lot of time in the same position during the day. Some people also experience decreased flexibility and mobility.

Nail changes

PsA is known to affect the nails. Around 80 percentTrusted Source of people living with PsA experience changes to their nails, known as nail involvement.

You may notice nail symptoms like:

• pitting
• grooves
• thickening
• separation from the nail bed

These symptoms can affect both the fingernails and toenails.

Eye changes

PsA can also affect your eyes.

This happens when it triggers the immune system to attack the uvea. The uvea is the part of the eye between the white of the eye and the retina.

Inflammation in the uvea is called uveitis. Symptoms of uveitis include:

• blurry vision
• redness
• pain
• light sensitivity

If you notice any changes to your eyes or vision, get them checked out right away. Left unmanaged, uveitis can cause permanent vision loss.

The takeaway

People living with psoriasis have an increased risk of developing PsA. Be on the lookout for symptoms like joint pain, stiffness, and swelling, as well as changes that affect your eyes and nails.

Left untreated, PsA can lead to permanent joint damage. It’s important to get treatment early to preserve joint structure and function.

Last medically reviewed on March 31, 2022

https://www.healthline.com/health/psoriasis/psoriatic-arthritis-signs?slot_pos=article_1&utm_source=Sailthru%20Email&utm_medium=Email&utm_campaign=psoriasis&utm_content=2022-04-12&apid=39239719&rvid=058431b717dcfa59c0cdd27cd0a9313769e8b3dd4ad59d88efd0ded7ddb4774e