As it is Arthritis Awareness Week and I am obsessed with getting old, I thought I’d share some of the advice of Dr Alexander Brand – Consultant Rheumatologist at The Lister Hospital, London who is an expert and will help uncover some of the myths about the condition. Because Arthritis is an umbrella term, used to describe a complex family of musculoskeletal disorders consisting of more than 100 different diseases or conditions that can affect people of all ages, races and genders it can be difficult to understand and diagnose.
It is the main cause of disability in the UK, with over 10 million people suffering, so we should know all there is to know….
How prevalent is arthritis? Are men or women more at risk?
“Arthritis is a descriptive term, meaning ‘inflammation of the joints’ and there are many different types. Osteoarthritis- OA (a degenerative process)is more common in older people, but the peak age of onset of inflammatory arthritis such as Rheumatoid Arthritis (RA) and Ankylosing Spondylitis (AS) is in the 20-40 age bracket, although there is a second peak for RA in older people. RA and AS may affect as many as 1 in 200 people. RA is more common in women than men and AS is more common in men than women.”
What forms can arthritis take? Are some more common than others?
“Arthritis can affect pretty much any joint in the body, but different types have different patterns of joint involvement. RA tends to involve the knuckles and wrists, toes and ankles; whereas AS always causes low back pain and stiffness. OA is clearly the most common form of arthritis as it is a degenerative process.”
What are the symptoms?
“All arthritis presents with joint pain. The key way to work out if you may have RA or AS or one of the other forms of joint inflammation is if you have stiffness in the morning or after sitting for a while. Many people have bad backs, but if it is inflamed then it may be stiff in the morning for an hour or more, or experience interrupted sleep.”
Do you agree that it is a relatively misunderstood disease, with many believing it is just an old-age disease?
“I think awareness of arthritis is improving, especially with much press reporting of new ‘miracle drugs’ for the treatment, I agree that the main misconception is that arthritis is a condition affecting older people.”
What are the other key myths of arthritis?
“The main myth is that nothing can be done. There have been huge advances in treatment over the last 20 years and we now have the ability to stop these diseases in its tracks, with drugs that are safe and that we know are effective. I would aim to have my patient symptom free within weeks fo coming to see me and leading a normal life. This often comes as a huge surprise to my patients who have often been led to believe that a diagnosis of arthritis automatically condemns them to a life of pain and disability. This is not the case now.”
How is arthritis treated?
“The main treatment of inflammatory arthritis is with drugs, but we should never forget the importance of self help and staying fit . Rheumatologists use a multidisciplinary team, involving Physios, osteopaths, podiatrists and of course, the patient’s own GP to help patients manage their arthritis. Over the last 20 years there has been an explosion of research into arthritis, meaning that we now know exactly who to treat, with what drugs and for how long. We also know that the sooner arthritis is treated, the better the condition responds, so if you suspect you may have arthritis it is best to seek medical advice sooner, rather than later.”
What is the impact of exercise on arthritis? Do other lifestyle factors also play a part in the severity of the condition?
“Exercise is essential in the management of arthritis. When a joint is inflamed or damaged, the muscles around the joint can shrink and become weak. Even when the arthritis is treated, a patient may continue to get pain unless those muscles are exercise back to normal strength and fitness. This is where physiotherapy is indispensable and I have access to a large network of physios in many areas. My patients often ask me if diet plays a role in management of arthritis. The simple answer is, ‘no’ although it is rather more complicated than that! Some foods such as oily fish have natural anti inflammatory properties, but dietary modifications should only be used as complementary treatments in addition to the medication prescribed by a Rheumatologist.”
