Osteoarthritis

Osteoarthritis

Osteoarthritis

The word arthritis is used to describe pain, swelling and stiffness in a joint or joints. Arthritis isn’t a single condition and there are several different types. You can read about the main types of arthritis here. This blog is just about osteoarthritis. We used to think of this as a problem just in a joint (often referred to as “wear and tear”) but now we know it is a mild, whole body inflammatory process, which can show up in any joint.

We frequently see patients with osteoarthritis in clinic and they are nearly always worried about their arthritis and pain getting worse. I can see why; who doesn’t know someone who has had a joint replacement? Well-meaning friends and family often tell you to “be careful” and to “take it easy” and, unconsciously, use language that plays into your fears. These beliefs are often deep-rooted and, as a clinician, it can be really hard to counter them.

The diagnosis of osteoarthritis can be done via a thorough case history. Often you will feel more stiff in the morning or after inactivity and you feel better once you are up and about. Scans or X-rays are often not very helpful; they usually show findings that are normal for age and they do not correlate well with pain levels. Someone else’s X-ray may look “worse” than yours, but they may have less pain and manage daily activities better. Scans do not determine what you are capable of.

We need to be kind to ourselves and each other when talking about weight. People with osteoarthritis are often told to lose weight, but with limited guidance on how to do so. Weight does matter, but perhaps not how you think. To cut a long story short, obesity increases the inflammatory processes in your body and this is what causes the problem, rather than increased load on the joints. In fact, cartilage loves loading and adapts in response to it – marathon runners have increased thickness of the cartilage in their knees, whereas astronauts have decreased thickness.

It’s helpful to understand how we perceive pain and there’s more on this in the podcast given below. Pain does not equal tissue damage (repeat that several times, out loud, it’s a tough one to get your head around). Our pain system is basically a danger detection system. It’s complex and it can be very sensitive. We know that people with arthritis have increased sensitivity in their pain system and this plays a significant role in the pain that they experience. The good news is that this can be changed.

The research shows that exercise/activity is the best treatment for arthritic pain. However, you will remain fearful of movement unless you understand that arthritis does not equal wear and tear; think of it more as wear and repair.

Activity has the following benefits, all of which promote repair (not tear!):
– it is anti-inflammatory
– it helps to reduce pain sensitivity
– it improves cartilage health and nutrition
– it improves mood
– it improves confidence
– it is something you can do for yourself

People with arthritis often find that low-impact activities, such as swimming, cycling, brisk walking and yoga, suit them. It’s important to find something you enjoy so that you keep doing it. Many people enjoy meeting up with friends or a group to keep them active.

You may feel some discomfort or pain when you exercise. This feeling is normal and should calm down soon after you finish. It is really important to know that, even if an activity causes some pain or discomfort, it can still be safe.

So where do we come in? We take the time to hear your story, examine you throughly and discuss your diagnosis with you. We can offer treatments for the symptomatic relief of your pain, as well as advice and reassurance to get you moving to help repair your joints and decrease inflammation.

Our role is to work with you to help you to manage and gradually increase your activity levels to find the “sweet spot” where you can load your joints to improve their health without provoking your pain system. We can also offer advice on simple dietary changes (blog to follow…) to help reduce inflammation and maintain a healthy weight.

Below I am sharing some of my favourite resources if you would like to delve deeper.

Flippin Pain provide fantastic resources. If you want more information on what we currently know about osteoarthritis, watch Tash Stanton’s talk.

It is always helpful to know you are not alone. In this article, several people share their experiences of living with arthritis. 

To learn more about chronic pain in arthritis and how to manage it, tune in to this short (25min) podcast.

Connect

A safe space to chat about arthritis and how it affects you hosted by Versus Arthritis.

Follow

Arthritis Action is a UK charity working with people living with all forms of arthritis to help them live a fuller, more active life with less pain.

Email Me

If you would like any further information or resources, or have any suggestions on how I could improve this blog, please let me know.

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All content and information on this website is for for informational and educational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your GP or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before making any decisions in respect of your healthcare.

Menopause

Menopause

Menopause

This is a subject very close to my heart. I started getting menopausal symptoms at the age of 40 and, nearly 10 years later, I am still getting them and I am not even officially menopausal yet. For many people, it’s a long road and one that still isn’t talked about very much, although there has been much more media coverage recently with high profile celebrities sharing their stories and parliamentary campaigns to reduce the cost of medication.

I talk about people, not women, as people of all genders can experience menopause and I want to include everyone in the conversation.

As people near the end of the reproductive stage of their lives, the levels of reproductive hormones such as oestrogen, progesterone and testosterone decline. There are hormone receptors in cells throughout the body which is why symptoms are so widespread and so variable. Every person’s experience will be different.

Menopause is not a medical condition; it’s a natural transitional phase. The menopause itself only lasts for a day – the day12 months after your last period. After that, you are post-menopausal.

The average age of natural menopause is 51, but this varies considerably. The perimenopause occurs during the years running up to the menopause. During this time, a person will still be having periods alongside menopausal symptoms. For most people, this happens from their mid 40s onwards. However, it can happen much earlier and many people do not realise their symptoms are due to the perimenopause.

Some of the most common symptoms are mood swings, anxiety, disturbed sleep, bladder issues (eg increased frequency), vaginal dryness and, of course, hot flushes and night sweats. For a full list of menopausal symptoms click here.

The saying goes “a problem shared is a problem halved” and so, inspired by a BBC documentary on the menopause, I set up a local Menopause Cafe so people can share their experiences. Due to Covid, we haven’t been able to meet up yet but we have a Facebook page and private group (see below). All are welcome – you don’t have to be menopausal to join us.

Below I am sharing some of my favourite resources if you would like to delve deeper.

A fantastic summary of menopause, including the benefits and risks of HRT and alternatives by Dr Louise Newson, a GP with a special interest in menopause.
Check out Jackie Lynch’s book for easy to implement nutritional advice, including lots of guidance for specific symptoms.
Great discussions around menopause and midlife with Liz Earle. This episode busts some menopause myths and looks at the role of diet and HRT in managing symptoms.

Connect

If you are looking for local support, why not join our private Facebook group? When restrictions ease, the plan is for regular meet ups in Wimborne.

Follow

For a bit of light relief and menopause related humour (warning – it’s a bit sweary!).

Email Me

If you would like any further information or resources, or have any suggestions on how I could improve this blog, please let me know.

Share Blog

If you think someone you know would benefit from this blog, please share it.

All content and information on this website is for for informational and educational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your GP or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before making any decisions in respect of your healthcare.

We Remain Open Through Lockdown #3

We Remain Open Through Lockdown #3

 

I am pleased to confirm that, as essential healthcare workers, we remain open through the current lockdown.

We are following all guidance from Public Health England and our professional association to ensure your safety and we continue to offer  online appointments for any patients for whom a face to face appointment is either not appropriate (eg self isolating) or who would prefer not to attend clinic. The evidence shows the remote appointments can be just as effective as face to face. Chris agrees (full Google review here).

“Rona’s service was clear, efficient and tailored to my needs. The follow up care has been equally impressive. I can confidently recommend her online service without reservation.”


New procedures

Whilst infection rates remain high locally, we will be asking all patients to swap their mask for a single use surgical mask on arrival at clinic and osteopaths will be wearing visors as well as masks, gloves and an apron.

Pre-Appointment Screening

We will email you the day before your appointment with a short form for you to complete in advance of your appointment to assess your suitability for a face to face appointment and to run through some Covid-19 screening questions. If we do not complete the screening form, we will not be able to see you in clinic. Your cooperation is very much appreciated.

Hygiene Measures

We continue to implement our stringent hygiene measures and wear personal protective equipment (PPE) – a mask, apron and gloves and we will provide you with a mask to wear whilst you are in clinic. We are allowing additional time between appointments for cleaning and ventilation and have staggered appointment times with Carole the podiatrist who also works in the clinic to ensure social distancing.

There are more detailed instructions in the booking confirmation and reminder emails. Please take the time to read and follow these instructions. Your cooperation is very much appreciated.

If you have any queries or concerns, then please call us so that we can talk you through our procedures in more detail. You can click on the link to read our full C-19 Risk assessment WOC January 2021 PDF

A huge thank you to all our patients for their support during these times.

Pilates face to face classes

I am delighted to announce that I will once again be offering face to face Pilates classes at the Community Learning and Resource Centre from 7th June. Classes will be in the Walford room which has a hard floor for ease of cleaning.

Class participants should note the following information:

  • DO NOT ATTEND CLASS IF YOU HAVE ANY C-19 SYMPTOMS OR HAVE BEEN TOLD TO SELF ISOLATE OR QUARANTINE (https://www.gov.uk/coronavirus)
  • arrive on time (not early to avoid congregating and aid social distancing in the centre)
  • sanitise your hands on arrival
  • wear a face covering (unless exempt) whilst in communal areas of the centre (you are welcome to wear a mask during class if you choose, but there is no requirement to do so)
  • bring your own clean mat or a clean bath towel to cover your mat and a small towel to use as head support
  • I will place mats in the room for you to place your own mat/towel on top of – please do not move the mats 😀
  • bring a water bottle if you like to drink during class as there will be no water fountains
  • windows and doors will be open, so please dress for a cooler temperature
  • only bring essential items with you
  • only the accessible toilet will be available for centre users so please use the loo before you leave home and come changed
  • observe social distancing measures through the centre and when entering the room

You can read our full risk assessment here: C-19 RA Group Exercise June 2021

I will also continue to offer online classes – for more details, click here

Re-opening: Keeping You Safe

Re-opening: Keeping You Safe

 

I am delighted to announce that we are now able to see patients for face to face appointments. Everything is in place to ensure your safety and we have reopened online bookings.

In line with our professional guidance, we can only see patients for whom an online appointment would not be sufficient. The evidence shows the remote appointments can be just as effective as face to face. Chris agrees (full Google review here).

“Rona’s service was clear, efficient and tailored to my needs. The follow up care has been equally impressive. I can confidently recommend her online service without reservation.”


New procedures

We cannot see patients who:

  • are experiencing symptoms of Covid-19
  • have tested positive for Covid-19 and are still undergoing isolation
  • or have been instructed to isolate due to contact with someone with Covid-19.

If you are at higher risk or are shielding, we can still see you, but we want to make it as safe as possible for you, so please call us and we will discuss your circumstances and arrange the most suitable appointment for you (typically first thing when the treatment room hasn’t been used for a while).

Screening Call

We will call you the day before you appointment to assess your suitability for a face to face appointment and to run through some Covid-19 screening questions. If we are not able to complete the screening process, we will not be able to see you in clinic. Please note you may be called from a withheld number.

Hygiene Measures and PPE

As I am sure you can imagine, we have strict hygiene measures in place and we will be wearing personal protective equipment (PPE) – a mask, apron and gloves and we will provide you with a mask to wear whilst you are in clinic. We are allowing additional time between appointments for cleaning and ventilation and have staggered appointment times with Carole the podiatrist who also works in the clinic to ensure social distancing.

There are more detailed instructions in the booking confirmation and reminder emails. Please take the time to read and follow these instructions. Your cooperation is very much appreciated.

Hours

Initially, I will be working 8am-3pm on Tuesdays and Thursdays and Katherine will be working 8am-3pm on Fridays. We hope to return to our normal hours soon, subject to demand. As always, if you need an appointment at a different time, please get in touch.

Fees

We have increased our fee for returning patients to £45 to help cover our increased costs.

If you have any queries or concerns, then please call us so that we can talk you through our procedures in more detail. For any of you with lockdown insomnia, you can click on the links to read our full reopening policies and risk assessment.

A huge thank you to all our patients for their support during these times. We can’t wait to see you.