a guide

INTRODUCTION INTRODUCING OSTEOARTHRITIS About the disease GETTING A DIAGNOSIS The process of getting diagnosed COMMUNICATING WITH HEALTH PROFESSIONALS Who you will see, what you will do LOOKING AFTER YOUR JOINTS Useful ways of living with arthritis PRACTICALITIES Sources of help USEFUL ADDRESSES 3 4 10

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Osteoarthritis is a disease of the joints affecting almost everyone as they get older. Around eight out of 10 people over the age of 50 are affected. In its early stages, it can be very difficult to detect. Some people who have arthritis are not even aware that they have the disease, or only become aware of the problem when symptoms develop. Osteoarthritis also varies tremendously from person to person. Pain might be a problem for some, while others may find it difficult to move and use the joint. Osteoarthritis can begin at a young age, so it does not mean that you are over the hill – teenagers have sometimes been known to develop it. Osteoarthritis cannot be cured, but an early diagnosis can help slow its progression and a lot can be done to ease the symptoms. It is not a good idea to ignore sore joints, inflammation and other warning signs. Some people delay seeking treatment because they believe chronic aches and pains are simply signals that they are getting old, and that nothing can be done about them. In fact, there is a wide range of treatments to try once a diagnosis has been made and a lot that you can do to make day-to-day living easier for yourself.


What is OA?
Osteoarthritis is a condition that usually develops gradually, over several years. It affects a number of different joints, but is most commonly found in the fingers, knees, hips and spine. The precise cause of osteoarthritis is unknown, but it does appear more in females than males and often starts after the menopause, which can lead to it being seen as part of the ageing process. For some people, the changes are so subtle and develop over such a long period of time that they are hardly noticeable. But others may experience gradually worsening problems, with pain and restricted movement, particularly in large joints such as the hip or knee, being involved. You may still have to see the doctor from time to time to have your condition reassessed and your treatment plan discussed. We do not yet know the causes or the cure for osteoarthritis, but recent research is uncovering the mechanisms which lead to joint damage as well as factors that control the healing response. For example, we now know some of the chemicals which thin out the cartilage in osteoarthritis. Drugs are being tested that inhibit the actions of these chemicals. Doctors and research workers have changed their attitude a great deal in recent years. They now see real possibilities of understanding and controlling osteoarthritis in the future. They no longer see osteoarthritis as an inevitable part of ageing or a wear and tear disease, but more as a major challenge and an important problem which they can one day solve.

What happens?
Healthy cartilage – the protective layer that covers the bone end in the joint – is very smooth, strong and flexible. It absorbs the stresses put on a joint, and protects the bones from damage. In osteoarthritis, this becomes pitted, brittle and thin, and, over time, can wear out completely. When the cartilage deteriorates, the bone underneath thickens and broadens out, spreading the weight that the cartilage has to support. As the cartilage becomes thinner, the bones of the joint rub 4

inflammation and the gradual build-up of bony outgrowths (osteophytes). causing pain. At the same time.CAPSULE AND LIGAMENTS BONE SYNOVIAL FLUID SYNOVIAL MEMBRANE BONE CARTILAGE A normal joint THINNING CARTILAGE The early stages of osteoarthritis CARTILAGE THINS FURTHER THICKENED JOINT CAPSULE BONE THICKENS AND SPREADS OUT (OSTEOPHYTES) More advanced osteoarthritis together. the joint capsule becomes thicker and 5 . which make it look knobbly.

very hard repetitive activity may injure joints. However. it does not generally make you feel unwell. like most conditions. especially the hips. Causes Specific causes of osteoarthritis are hard to pin down and. Carrying extra weight puts pressure on weight-bearing joints. Obesity The effects of obesity on osteoarthritis are well documented.the amount of synovial (lubricating) fluid can increase. such as the muscles becoming weaker. Joint injury A major injury or operation on a joint may lead to osteoarthritis at that site later in life. Osteoarthritis is common in people with certain occupations such as physiotherapists (osteoarthritis of the thumbs). Exercising too soon after an injury has had time to heal properly may also 6 . Usually. putting on weight and the body becoming less able to heal itself. and in professional footballers (osteoarthritis of the knee) if they have had cartilage surgery. Although it is uncommon before the age of 40. Age People usually develop osteoarthritis from their late 40s through to old age and it is often undiagnosed. Gender Osteoarthritis is more common and often more severe in women. there are many factors that can increase the risk of developing it. It also increases the chances of osteoarthritis worsening once it has developed. but it is probably due to bodily changes which come with old age. It may also become stiff and painful to move. especially in the knees and hands. it is not unheard of. several factors need to be present before osteoarthritis develops including the following. Normal activity and exercise are good for the joints and do not cause osteoarthritis. Whilst the pain itself can be very unpleasant. It is not known for sure why older people tend to develop it. often causing the joint to swell. knees and spine.

ageing and joint injury. There are some very rare forms of osteoarthritis that start at a young age and run in families and these are linked with single genes that affect collagen – an essential component of cartilage. This particularly affects the hands of middle-aged women. rather it is a term that doctors use to describe the type of damage that osteoarthritis causes in a joint. osteoarthritis. Heredity There is one common form of osteoarthritis (nodal osteoarthritis) that runs strongly in families.lead to osteoarthritis in that joint later on. In other common forms of osteoarthritis. Therefore. one of whom will have virtually perfect joints. or protection against. but it is believed that many genes are involved. This does not necessarily mean that you have done something to cause it. physiotherapist or nurse when it is safe to exercise after you have sustained an injury. There are many people who have had very similar lives. 7 . For example. It is always best to check with your doctor. The standard explanation for osteoarthritis is that it is a result of wear and tear. while the other has quite severe osteoarthritis. heredity plays a small part compared to obesity. It is not known which inherited genes lead to nodal osteoarthritis. but the following factors are associated with an increased risk of developing the condition: ● obesity – being overweight for several years can put strain on the joints ● stress on joints caused by occupation ● stress on joints caused by activity or ageing ● injury to the joint lining caused by a past fracture. ■ Who gets it? Osteoarthritis is usually not hereditary. people with rheumatoid arthritis can develop osteoarthritis in the joints that were most affected by rheumatoid inflammation. Other types of joint disease Osteoarthritis is sometimes caused by injury and damage from a different kind of joint disease years before. there must be an inbuilt susceptibility to.

For example. in all types of climate. Diet can cure arthritis Many people who have arthritis spend a lot of their time searching hopefully for a special arthritis diet. even young people can develop arthritis.’ Meriel Blake Although there is no evidence to support this claim. it is very important to keep your weight as close as possible to the ideal for your height and age. While some types of arthritis – gout for example – are directly affected by diet. Only older people get it It is true that the majority of people who have osteoarthritis are over 45. However. but not the actual arthritis itself. Genetic disorders. But we do know enough to correct some myths. This will reduce the risk of osteoarthritis. While researchers continue to investigate the link between arthritis and diet. which are more painful when the weather turns bad. many people find that their joints are often sensitive to the weather and tend to feel worse when the atmospheric pressure is falling. However. This helps to explain how some people with osteoarthritis can predict rain and why joint pain seems to be linked with the damp. sports injuries and other trauma can cause osteoarthritis at any age.Challenging the myths Osteoarthritis does have other causes – we just don’t know what they are yet. However.’ Mrs Lipman ‘The warm weather is definitely better for my joints. they generally agree that excess weight compounds the problem. It is also important to eat a balanced diet to nourish muscles. Which joints? Osteoarthritis is very variable and can affect different joints in different ways. Osteoarthritis occurs all over the world. cartilage and bone. but is most 8 . The weather makes arthritis worse ‘I find that the climate affects my knee and spine. auto-immune diseases. We know this is true because warmer regions in the world do not have lower incidences of arthritis than colder regions. the weather may temporarily affect symptoms. there is no evidence that a particular arthritis diet will eliminate either the disease or the symptoms. just before it rains.

in fact. The weight-bearing joints such as the knees. with the pain tending to be worse while exercising the joint and at the end of the day. Early signs and symptoms Osteoarthritis tends to creep up on you and the early signs are so mild that they are often easy to miss. walking a long way or getting in or out of the car. rising from a reclining or sitting position and walking difficult. picking small things up. but I didn’t see a doctor about them. ankles and hips are most frequently affected by osteoarthritis.commonly found in the knees. Shoulder and elbow joints are also susceptible to arthritis although this is much rarer. but the joint may not move as freely or as far as normal and may ‘creak’ or ‘crack’ when moved. writing and doing up buttons. You can prevent this by doing muscle-strengthening exercises. making sitting down. Elbows are very sensitive to injury so very mild arthritis here can lead to quite a significant loss of mobility. Stiffness after resting usually wears off after a minute or two. In more advanced cases. You may find that the weather affects your joints.’ Jan Slaney ‘As a child. Symptoms can vary and you may have bad patches of a few weeks or months followed by better periods.’ Veronica Jones ‘I had a car crash before I was diagnosed and they attributed the neck pain to whiplash when it was.’ Joyce Cox ‘I slipped a disc in 1966 and I’m wondering whether this signalled the beginning of my OA. hands and spine. I was diagnosed with OA at about the age of 45. Osteoarthritis of the knee or hip may cause difficulties in going up and down the stairs. The main symptoms are stiff and painful joints. Pain can vary in severity and can be so mild that many people don’t even notice it. Osteoarthritis in the fingers. and grinding and swelling can often occur. as mentioned earlier. Sometimes you may feel the joint giving way because of weak muscles. there may be constant pain and everyday tasks may become difficult. Some people may experience a grinding feeling in the shoulder and a reduced range of movement. thumbs and wrists affects grip strength and the ability to perform everyday tasks such as opening jars. You may find that the joints appear swollen due to the bony osteophytes or extra synovial fluid. arthritis.’ Joyce Cox 9 . ‘In my 30s I started getting vague pains in my legs and neck. Pain from arthritis in the shoulder may also make it difficult to sleep. I had various rheumatic illnesses and OA is on both sides of my family too. hips. Arthritis in the elbow joint can make the elbow very difficult to straighten and bend. or so severe that mobility and quality of life is affected. or that it depends on how much physical activity you do.

He or she will feel for any bony swellings and creaking joints. Testing for osteoarthritis There is no blood test for osteoarthritis although you may be given one to rule out other types of arthritis. Make sure you tell your doctor exactly how you feel. you will be asked about any other medical conditions you may have and whether you are taking any medicines. bone damage and osteophytes. Physical examination Your doctor will examine your joints and may check muscles. If your arthritis is severe. giving a good description of pain. It is more difficult to tell if the disease is causing the person's symptoms because pain in an area may not be due to osteoarthritis. how to avoid joint strain and how to cope with pain. Your history To diagnose osteoarthritis. you may be referred to a hospital specialist such as a rheumatologist or an orthopaedic surgeon. Your GP will be able to assess whether you have osteoarthritis or whether your symptoms are due to another illness.GETTING A DIAGNOSIS It is usually not difficult to tell if somebody has osteoarthritis. X-rays are the most useful test to confirm osteoarthritis and to see how much damage has occured. to a physiotherapist or occupational therapist who can give you special exercises to do and advice on how to relax. and how they have changed over time. stiffness and joint function. X-rays do not determine how much your arthritis will trouble 10 . and when and how the condition started. You may be referred. your GP will begin by asking you to describe the symptoms. These will show such things as cartilage loss. excess fluid or instability in the joints. nerves and aspects of your general health. after a time. It is also important for the doctor to know how osteoarthritis affects your work and daily life. how to overcome mobility problems. They will also see any restricted movement and will look for joint tenderness and any thinning muscle. Finally.

some questions have no answer. Ultimately. new developments or drug side effects.’ Jan Slaney ‘I did a lot of research before I went to my GP and found that it really helped me. nobody will think you are stupid. but many people feel that it trivialises the condition. I have a general interest in that sort of thing anyway. This will help you understand and feel confident about any treatment you are given. Not all are sympathetic or easy to talk to. You have got the job of taking charge of your arthritis. Going away with unanswered questions or worries may cause you greater concern. Of course. giving the impression 11 . He knows I hate having to take drugs and so I always check with him when I want to try taking a supplement. COMMUNICATION WITH HEALTH PROFESSIONALS Your GP will be your main contact to do with matters concerning your treatment.’ Anne Howard ‘I was lucky – I had a good GP when my hip got really bad. Don't be afraid of asking questions if something is not clear. but if that is the case. It may help you to write things down or to take a friend or relative with you. Doctors are often rushed. only you know how you feel.’ Mr Viv Williams Wear and tear The phrase ‘wear and tear’ is often used by GPs to describe osteoarthritis. it is important to develop a good relationship. before much cartilage loss has taken place. Also. the difficulties you face and the sort of help you need most. they may not show early osteoarthritis damage. you need to know this. Talking to him or her openly will ensure that you are given the correct treatment and one that is most effective for you. but it is important that you make the most of your consultations. ‘Luckily my GP is very flexible and he keeps an eye on me. As a result. I also took a friend to the surgery with me. Between us we sort it out. to prompt me in case I forgot to ask anything. Very little of any information you give your doctor will be unhelpful. learning how to manage it and adjusting to how it affects your life. Most doctors and health professionals are happy for you to do this if you explain that you feel it will help you. You and your GP must work together to help you manage your arthritis by relieving your symptoms and helping you live as normal a life as possible. The part you play in this is vital.you – an X-ray that shows severe changes does not necessarily mean that you will have a lot of pain or disability. It might be about the treatment options available.

Treatment versus prevention While it can be difficult to avoid. don't be afraid to use your joints. Your local surgery will be able to tell you of its rules. However. This usually occurs many years after the injury and it is not usually possible to prevent the condition occurring. you can always ask for another appointment. Appropriate exercise is actually very beneficial for osteoarthritis because it helps to strengthen the muscles that surround the joint. maintaining a normal weight for height and body structure. keeping physically active and avoiding excessive stress on the joints as you get older. Some argue that wear and tear is actually inaccurate since younger people can get osteoarthritis too and their bones are not old at all. However. It will give you confidence too. making the joint more stable and less painful. Ways to reduce stress on the joints include: ● sticking to your ideal weight. injuries to a joint increase the risk of developing osteoarthritis in that joint. This may be easier said than done. can reduce the severity and impact of osteoarthritis. ● Don't be afraid to discuss the treatment options available or to take on more responsibility for your own needs. ● It is worth reminding your GP of any other conditions you have or medications and supplements you are taking. ■ Tips on getting the most out of your GP appointment ● It is a good idea to make a list of about four questions to ask your GP before your appointment in case you become flustered or your mind goes blank. If you hear the phrase wear and tear to describe your osteoarthritis. but losing excess weight 12 . You may even be able to book a double appointment. for example. arthritis. ● If you feel that you need more time with your doctor to bring up the points that are worrying you. ● When you join a practice you can ask at reception if a GP is interested in a particular condition. the same disease factors are involved.that they have been put on the scrap heap and that nothing can be done to help.

● Swimming in a heated pool can help. damaging the tissues in the joint. can ease pain. Make sure you follow the dosage instructions on the packet. ● Should your condition deteriorate to the point where your mobility is severely affected.and rheumatoid arthritis? Osteoarthritis and rheumatoid arthritis are two very different diseases. ● A GP may prescribe a different non-steroidal antiinflammatory drug (if this is appropriate for you) or a stronger codeine-based painkiller. spread them throughout the day or week ● wearing shoes with thick. ■ Tips for managing your arthritis ● General exercise – keep moving. It also helps to reduce pain. The 13 . ● Mild to moderate disease can usually be managed successfully with simple over-the-counter painkillers. or an orthopaedic surgeon to discuss the possibility of joint replacement surgery. ● Sleeping on a good mattress. knees and hips. such as housework or mowing the lawn. Rheumatoid arthritis can occur at any age from childhood onwards. ● Massaging the muscles around the joints will help ease pain and help keep you supple. you may be advised by your GP to see a rheumatologist for specialist advice on medical management.may be the most effective method of arthritis prevention. such as paracetamol or ibuprofen (a non-steroidal anti-inflammatory drug). such as a pocket- sprung mattress. and reduce jarring ● using a walking stick can reduce the weight and stress on a painful hip or knee joint. although the average age is the late 40s. Instead of attending to the jobs that need doing all at once. Many joints are involved and the synovium becomes inflamed. A therapist can advise you on the most appropriate one for you and how to use it properly. What's the difference between osteo. Combining regular exercise with healthy eating is often better than dieting alone ● pacing yourself. soft soles can act as shock absorbers for your feet.

Just because you do not have to see a rheumatologist. and the best one to try first. Treatment with drugs ‘When I had my knee replacement. They come in varying strengths and the stronger ones are only available on prescription. the painkillers I was on made me physically sick. Treatment of osteoarthritis depends very much on GPs who are more than capable of treating your disease. although taking too great a dosage can cause liver damage. The medication each person is prescribed and how often they take them differs depending on their disease type and on how they react to the drugs. They will see a range of health professionals such as rheumatologists and orthopaedic surgeons who will keep an eye on the progression of their disease and help them to find the right treatment for them.affected joints are painful. X-rays show that the bones can become thin and eroded. but don't assume that. Blood tests show widespread inflammation which affects the body generally. but help relieve the pain and stiffness. is the simplest and safest painkiller. People with rheumatoid arthritis will need to take a mixture of drugs to help control their disease and reduce inflammation. which is available over the counter. rather than the bony spurs and calcification which indicate osteoarthritis. Side effects are unusual. often very stiff and are warm.’ Joyce Cox ‘My tablets keep the pain under control. such as paracetamol. Paracetamol. it does not mean that you are not being as well looked after. that do not affect the arthritis itself. just because they are easy to obtain. There is a difference in the pattern of stiffness – people with rheumatoid arthritis tend to be worse in the morning while people with osteoarthritis tend to be worse in the evening. Some of the most commonly used drugs for osteoarthritis are listed below. but they can make me feel funny – not quite myself. For a while. I felt as though I had to make a choice between sickness and pain.’ Veronica Jones There is a vast range of drugs to treat arthritis. weight loss and tiredness. often causing anaemia. Analgesics These are pain-relieving drugs. Many pain relieving drugs. tender and swollen with fluid (not with bone). including pain relief gels. they are 14 . can be bought over the counter without a prescription. Treatment is also different.

Capsaicin cream (made from capsicum. people using other medicines known to increase the risk of gastrointestinal problems or those reqiuiring longterm use of NSAIDs at the maximum dose. rofecoxib (Vioxx) and valdecoxib (Bextra). and the correct dose. parecoxib (Dynastat). but are more likely to cause side effects – especially indigestion and diarrhoea. these drugs may have no advantage over painkillers. especially for knee and hand osteoarthritis.’ Anne Howard ‘You have to watch out if you have other conditions too. They tackle inflammation in a similar way. Your doctor will advise you which is the appropriate one to take. Ask your doctor if you are eligible. However. Non steroidal anti-inflammatory drugs (NSAIDs) If you have mild inflammation in your joints. such as constipation or dizziness. if there is no inflammation. Never take more than the recommended dose and. NSAID creams and gels can often help. ‘I find with painkillers that they don’t actually remove the pain completely. Some anti-inflammatory drugs such as ibuprofen can be used as painkillers in low doses. the pepper plant) if used regularly. Combined painkillers such as coproxamol. NSAIDs can help some people more than paracetamol. Cox-2 inhibitors are a new type of NSAID. Guidance from the National Institute for Clinical Excellence states that Cox-2s can only be prescribed to people who may be at a high risk of developing serious gastrointestinal problems. They include celecoxib (Celebrex).harmless. Ibuprofen and diclofenac are commonly used NSAIDs but there are many others. I can’t take anti-inflammatories for my OA now that I’m taking other drugs for my heart. These may be stronger than paracetamol. if in doubt. talk to your pharmacist or doctor. etoricoxib (Arcoxia). but have been developed to be safer for the stomach – although they do have other side effects and Cox-2s still need to be considered carefully. This includes people aged 65 or over. cocodamol and codydramol are available on prescription. but are more likely to cause side effects. is relatively effective and very safe. but they alter the nature of the pain. your doctor may prescribe a course of non steroidal anti-inflammatory drugs (NSAIDs). making it more bearable. as is often the case with osteoarthritis.’ Jan Slaney 15 . They contain paracetamol and a second codeine-like drug. several times daily.

For example.’ Jan Slaney Occupational therapists (OTs) are the best people to get help from if you are having difficulty with day-to-day tasks like washing. They can also advise on your work environment. but you also need to avoid straining joints by doing things awkwardly or doing more than you are comfortably able. This probably means learning different ways of doing everyday jobs. They may also be able to supply some of the more expensive items on temporary loan. An occupational therapist can help with all of this. It is very difficult to predict the outcome in individual cases. osteoarthritis tends to reach a peak after a few years and then stays the same. cooking and cleaning. So it is possible to take an active role in your life with osteoarthritis. it does not necessarily mean that it will get worse. but there are many things that can be done to help alleviate the symptoms and prevent the disease from progressing. OTs are experts on what equipment is available to help you and where you can buy these items. active life by properly managing the condition and making small. and adapting your life in a number of ways. dressing. For many. common sense alterations to life. protecting the joints from further injury and maintaining an ideal weight through a healthy diet will all benefit you. Occupational therapists ‘Remember that OTs can provide you with equipment right up to bathrooms and stair lifts. you may have to give more thought to the clothes and shoes you wear. Regular exercise. to the way you lift. My OT managed to get me a walk-in shower room installed because I just couldn’t step into the bath. Other people may experience a worsening in one or more joints (especially in the hip or knee).LOOKING AFTER YOUR JOINTS Although there is no cure for osteoarthritis (at least. Inflamed or damaged joints need to be cared for and protected. Most people can lead a full. grip and carry things or to the way you arrange your home or place of work. not yet). Arthritis prevention and knowing how to take care of your own joints are the best ways to either avoid or control osteoarthritis. 16 . and it may become painful and disabling. Keeping healthy is part of this.

use your shoulder or hip.’ Meriel Blake ‘I try to do stretching and range of movement exercises every day. but I have lost a bit of confidence because I don’t want to fall and damage it. but it’s difficult. I’m piling on the weight because its almost impossible to do any aerobic exercise. ● Use larger. the benefits of exercise are enormous. But it is also good for pain and stress. 17 . for example. You should ask for an assessment of your needs under the NHS and Community Care Act 1990. Everyone benefits from exercise. ’Make sure that you tell the OT what you want and what you’d find most helpful. So. use a trolley to move things over longer distances. However. If you are having trouble getting a referral to an OT. exercise is good for us. This may be at your local hospital or they may visit you at home. but for people with arthritis. ● Change positions often – shifting position or stretching every half an hour will help you dodge joint stiffness.’ Anne Howard ‘I’m useless at doing my exercises. and take frequent breaks when writing. The wrong sort of exercise could put strain on your joints and damage them further. rather than pushing a door open with your hand and wrist. It keeps us supple and flexible. for example. ● Don't grip things too tightly – with pens. and reduces the risk of illness. Exercise protects joints by keeping the muscles strong and keeping you mobile. the weight of your body falls forward putting added strain on muscles and joints. Avoid handheld bags: use a shoulder strap.’ Meriel Blake Exercise and rest – a fine balance Exercise can be the furthest thing from people’s minds when they live with pain on a daily basis. ● Watch your posture – if you slouch. which is a scheme to encourage people to get out and about. even though I know they’re good for me – I find them boring. choose a fatter one. I know that it’s best not to be overweight with OA. The fact that I’m leading them with my new hip gives them all confidence too. hold it as loosely as possible or expand the grip with padding. I actually got the rails in my bathroom. the high loo and the railing up the stairway through social services. Ask your GP whether it is ■ Change the way you move ● Spread the load – use both hands to lift and hold.Your GP or hospital consultant can put you in touch with an occupational therapist. fatigue and pain. ● Use less effort and shift rather then lift – slide heavy pans along a kitchen top.’ Jan Slaney ‘I’m starting to ride my bike again after my hip replacement. stronger joints – use larger joints to protect the fragile joints in your fingers and wrists by using larger ones. then you can refer yourself by phoning your local social services department.’ Veronica Jones ‘I’m a “Walking for Health” leader. Exercise won't make your arthritis worse – as long as it is the right sort. satchel or rucksack instead. It can also help you lose any extra weight which puts strain on joints.

appropriate for you to be referred to a physiotherapist. gradually building up the repetitions. ROM exercises are done smoothly and gently so they can be done even when in pain. 18 . Strengthening Strengthening exercises are important for everyone. Always check with a doctor or physiotherapist before starting a regime. which includes these exercises. As the muscles get used to doing more. Aerobic Aerobic just means exercise that raises your heart rate. and are important for good posture and strength. then ease them a little further ● strengthening – these tighten and relax muscles around a joint to protect it ● aerobic – any exercise that raises your heart rate and gets you slightly out of breath. By developing strong muscles. Start slowly. This type of exercise burns off calories. joints become more stable and things such as walking and climbing stairs are easier. protect and support your joints. who will help you work out a programme combining different types of exercise: ● flexibility or range of movement – these exercises gently take your joints through their range of movement. because they help to strengthen the muscles which move. especially people with arthritis. Ask your GP or physiotherapist for examples of these exercises or call 020 7380 6540 for Arthritis Care's Fit for life booklet. Many people become less active when they develop arthritis because of the pain and fear of causing damage. The type of exercises you do will depend on which joints are affected and how severe your condition is. The exercises involve taking joints through their full range of movement and then easing them a little further. Everyone should do these as they help maintain flexibility. they adapt and become stronger. This can lead to muscle wastage and weaker joints. Range of movement Range of movement (ROM) exercises form the backbone of every exercise programme.

cycling and swimming. and increase your energy and vitality.’ Joyce Cox Warm water exercise Warm water exercise is popular with people who have osteoarthritis. You are at a good level if you start to sweat and can still carry on a conversation at the same time. contact the communications department at the Chartered Society of Physiotherapy. help with good posture. This involves exercising in a heated pool under the supervision of a physiotherapist. The first meeting will last about 45 minutes and 30 minutes thereafter. especially if you have moderate to severe arthritis. ‘I tried hydrotherapy. but found that it wasn’t effective enough at alleviating the pain for me. Check with a doctor before beginning any regime. Your doctor may possibly refer you for hydrotherapy. Hydrotherapy sessions may be held in your local hospital. the range of movement in your joints should increase and pain decrease. Gentle exercise can be carried out in jacuzzis or heated swimming pools that 19 . Most hydrotherapy pools range in depth and if you cannot lower yourself into the water. To get any benefit. Tel: 020 7306 6666. These exercises done correctly and consistently will provide some relief from the pain of arthritis. It allows people with arthritis to exercise their joints and muscles whilst being supported with warm water at body temperature. London. The best forms of aerobic exercise for people with arthritis are walking.speeds up the body's metabolism. It also helps control and reduce weight. strengthens bones. For more information on hydrotherapy. Because the water supports your weight. helps maintain a strong heart and helps muscles work more effectively. making it easier to relax. 14 Bedford Row. reduces depression and builds up stamina. Begin any exercise by stretching to warm up. aerobic exercise must be done for a prolonged period (20-30 minutes) two to three times a week. there will usually be a hoist. Build gradually each day until you reach your goal. improves sleep. You can improve muscle strength by pushing your arms and legs against the water. WC1R 4ED. a heart condition or high blood pressure. The warm water aids muscle relaxation and eases pain in joints. The good effects of it wore off pretty quickly.

The water enables gentle and lowimpact exercise. ● Range of movement exercises should be done every day in every joint. Resting painful joints will make them more comfortable. There is a lot of debate about whether what you eat affects arthritis. Try to also cut down on sugary and fatty foods. If you notice this. fish and white meat. Get advice if you are unsure. A healthy diet Not eating certain foods doesn’t make any difference to my arthritis. aubergines. Some people claim that certain foods seem to make their inflammation or pain worse. and promotes better blood circulation. Try to include more of these in your diet and consider taking a supplement. so make sure you eat a healthy.The warm water soothes the joints. Certain foods may help. pasta. Start slowly and make sure to avoid exercising in water that is too hot. as long as you don't miss out on essential nutrients. It is very important not to overdo things.will usually be heated to around 34 degrees centigrade. and also offers the resistance needed to keep muscles and joints in shape. and don't assume that 20 .’ Jan Slaney ‘I try to steer clear of citrus fruits because they seem to add to my pain. pulses (such as beans and lentils). vegetables. ● Regular exercise is one of the best ways to relieve the symptoms of osteoarthritis. green peppers and potatoes from my diet. it makes sense to avoid it in future.’ Joyce Cox ‘I have eliminated tomatoes. and can work out which food is the trigger. I find that I am in less pain when I don’t eat these. balanced diet and include lots of fruit. Eating well will also help you lose any extra pounds which can put extra strain on your joints. relieves stiffness.’ Mrs Lipman Your body needs a range of nutrients. Studies on essential fatty acids (found in oily fish) show that they can ease joint pain and stiffness. It has definitely helped me. consult your GP before you begin this type of exercise. ● Develop a moderate exercise programme – a strenuous programme may cause more pain and possibly accelerate damage. You need to strike a balance between rest and activity. Keeping active strengthens the muscles around the joints helping to prevent further degeneration. but too much may make them stiff. As with any exercise programme. Rest your joints – especially when they are inflamed or particularly painful.

though recent findings for omega-3 fatty acids and glucosamine are promising. and never begin a diet that involves stopping medication without discussing it with your doctor. Read Arthritis Care's Food for Thought booklet for further information on diet and arthritis.’ Veronica Jones Glucosamine Glucosamine is popular with people who have osteoarthritis. It doesn't 21 . Below are a few of the supplements most commonly taken by people with osteoarthritis. vitamins. Before you start taking supplements bear in mind the following: ● find out as much as you can about the supplement in which you are interested ● remember that supplements will not cure arthritis ● check with your doctor or pharmacist for interaction with prescription drugs ● tell your doctor if you are taking any supplements and report any side effects immediately ● keep a record of how you feel so you can see if they are having an effect ● buy brands from reputable manufacturers ● consider the cost.’ Meriel Blake ‘Cod liver oil capsules seem to have been useless for me. So far there is little evidence that dietary supplements improve arthritis or its symptoms.’ Meriel Blake Supplements People with arthritis take a huge range of supplements including herbal remedies. Call 020 7380 6540 for your copy. homeopathic medicines. While it does not cure arthritis. ‘Ginger in capsule form really seems to help my arthritis. lobster or prawn shells.what works for someone else will work for you.’ Mrs Lipman ‘I drink lots of semi-skimmed milk and take a homeopathic supplement to keep my bones strong and to encourage the bone to knit into my new hip replacement. oranges and hard cheese all make the pain of my arthritis worse so I try not to eat them. ‘I’ve found that orange juice. Taking supplements can be expensive. talk it over with your doctor or dietician first. It is a natural substance extracted from crab. although research in this area is complicated and much more needs to be done. Some doctors believe that special diets are worth trying. some people believe that it does help ease the pain and stiffness of their osteoarthritis. If you are considering one. There is not much scientific evidence to support this at this stage. minerals and dietary supplements. Beware of diets that claim to cure osteoarthritis.

swelling and stiffness in both osteoarthritis and rheumatoid arthritis. but minor ones include nausea and indigestion. which comes in capsule form. and they switch off another enzyme known to cause much of the pain and inflammation of arthritis. but lesser ones include nausea and indigestion.help everyone. Studies still need to be carried out on the possible long-term toxicity of taking fish oils. It doesn't help everyone – if you have severe cartilage loss you probably won't get any benefit. but some studies suggest that it helps stop joint degeneration. like cod liver oil. so if you haven't seen an improvement after two months. is often taken in combination with chondroitin. In supplement form it is derived from the trachea of cattle or sometimes shark cartilage. Care should be taken not to exceed safe levels of vitamin A and D when taking cod liver oil. Chondroitin is a slow-acting supplement so don't expect to see any improvement for at least two months. must be taken for at least three to six months. Glucosamine. often in capsule form. it probably won't help you. can produce a modest improvement in joint pain and stiffness and have a good record of easing the symptoms of osteoarthritis. New Zealand green-lipped mussels Researchers have found that both stabilised mussel powder and a lipid extract may be effective in reducing pain. 22 . A daily dose. and is often taken alongside glucosamine. Any benefit is lost when you stop taking it. It could increase the chances of bleeding if you are taking any blood-thinning drugs. There is no proof that it reverses cartilage loss. There do not seem to be any serious side effects. The long-term effects of this supplement are not known. There are no known major side effects. Fish oils Fish oils. Chondroitin Chondroitin sulphate exists naturally in our bodies and is thought to give cartilage elasticity and to slow its breakdown. Recent research has found that omega-3 fatty acids are effective because they reduce the activity of the enzymes responsible for cartilage damage.

Practitioners of these therapies may advise people to stop using conventional medications and they should be regarded with extreme caution. About 30 per cent of the UK population has used. Complementary therapies Many people with arthritis have tried a range of complementary therapies in addition to the conventional drugs prescribed by their doctor. help alleviate some of the symptoms such as pain and stiffness as well as dealing with some of the unwanted effects of taking drugs. The hydrotherapy sessions were wonderful and I met lots of other people in a similar position. New Zealand green-lipped mussel extract commonly comes in capsule form.However. However.’ Anne Howard 23 . the majority of people who visit complementary therapists each year in the UK pay for their own treatment and they can be costly. There are a multitude of different therapies. what works for one person may well not work for another. Some people find them helpful and others try them and choose not to continue. but nothing made a blind bit of difference to me. or is using. So. I only had it done when the pain was really bad. I undid all the good work. however. Some complementary therapies are available on the NHS and some private health insurance companies will pay for treatment. The more concentrated versions are more likely to be effective. Complementary therapies can play an important role in encouraging positive changes in lifestyle and outlook.’ Anne Howard ‘I’ve tried everything for my arthritis. Some of them are thoroughly reputable and are regulated by statutory bodies. Complementary therapies can generally be used alongside orthodox treatment. complementary therapies do not offer a cure for arthritis.’ Jan Slaney ‘I had laser acupuncture done on my lower back. it was just too much money. Like conventional medicine. At the other end of the scale are therapies making highly dubious claims with little or no evidence to back them up. Lifestyle changes like these may help to stabilise or improve your arthritis. They can. other studies have shown no benefit. some form of complementary medicine. This increases to nearly 60 per cent among people who have arthritis. However. but I had to drive 15 miles there and back so by the time I got home. but at £25 a time. a positive attitude. although doctors may vary in their attitudes to them. learning relaxation techniques and appropriate exercises. Some of the complementary therapies that are beneficial for osteoarthritis are listed over the page. such as increased self-reliance. ‘I managed to get on three 10week physiotherapy courses.

Tel: 01925 730727. By learning to stand and move correctly. By using needles at these special points. It teaches pupils new ways of using the body to improve balance. and you need regular practice to successfully change a lifetime of bad habits. co-ordination and awareness. Email: Admin@medical-acupuncture. but feels as though you are being lightly pinched. Some health insurance policies will cover the cost. The British Medical Acupuncture Society. It aims to restore the natural balance of health by inserting fine needles into specific acupoints in the body.org. feet and hands. thereby relieving pain. An initial consultation will cost around £40 with subsequent visits from £25. legs. Acupuncture needles will be inserted into chosen points on the arms. sit and talk.uk Alexander technique ‘I’ve practised the Alexander technique for years and find that it really helps my posture and relieves pain’ Judith Morris The Alexander technique concentrates on how we use our bodies in everyday life and how this can adversely affect their functioning. The first visit to an acupuncturist can take between 40 minutes and an hour. WA4 4QW. Lessons last between 30 and 45 minutes and most people need between 15 and 30 lessons to become proficient.Acupuncture Acupuncture is a traditional Chinese medicine that has been practised for thousands of years. between three and six sessions are required. Tel: 020 7284 3338. NW1 9AH. Generally. Email: stat@stat. The Society of Teachers of the Alexander Technique. London. This is not painful.uk 24 . your complexion and your tongue and look at how you walk. Cheshire. imbalances in the flow of energy can be corrected. The acupuncturist will ask about your lifestyle and medical history. 12 Marbury House. Higher Whitley. people can ease stresses on their body and alleviate conditions that are exacerbated by poor posture. 129 Camden Mews. Alexander technique is generally taught oneto-one.org. Some GPs will you refer you on the NHS. then examine you. Warrington. The theory is that health is determined by the flow of internal energy through the body. long standing complaints may need more.

Tel: 020 8251 7912 Chiropractic Chiropractic focuses on mechanical problems of the joints. Essential oils can be used in many ways – vaporised. some as antibiotics. If you have any other health conditions. inhaled. Chiropractors use their hands to adjust the joints of your spine and extremities where signs of restriction in movement are found. some relaxing. London SE25 6WF. for up to 10 minutes. For an inhalation. On your first visit. marjoram and juniper. some act as antiinflammatories. While they cannot reverse the degeneration of joints with arthritis. For an aromatherapy bath. the chiropractor will 25 .000 practitioners. improving mobility and relieving pain. used in baths or a burner – but one of the most common methods is as part of an aromatherapy massage. camomile. P O Box 19834. check if there are any oils you should avoid. especially the spine. The Aromatherapy Organisations Council represents 12 associations and 6. add six drops of oil to the water and lie back and relax for at least 10 minutes. A full body massage will last between one and two hours and cost about £30-£35 per hour. The oils then exert their effect both through the powerful aromas and by being absorbed through the skin. chiropractors claim that by regularly adjusting them they can keep them healthy and mobile.Aromatherapy Aromatherapy uses essential oils obtained from plants to promote health and well-being. add four drops of oil to a bowl of steaming water. To vaporise essential oils. AOC. Each oil has its own range of properties – some are invigorating. Lean over the bowl with a towel over your head. reducing pain and helping to slow further degeneration. chemists and by mail order. Aromatherapy massage combines the techniques of massage with the therapeutic properties of essential oils. Oils which are particularly good for muscular and joint aches and pains are rosemary. add two or three drops to water in the bowl of an oil burner and light the candle underneath. Pure essential oils can be bought at health food shops.

infection or sometimes if osteoporosis is suspected. 78 Medow Street. Some private practitioners will come to your home. Before starting treatment. On a psychological level. An initial assessment is similar to that carried 26 . Massage Massage is popular with many people with arthritis. ‘I find massage really relaxing. Osteopaths manually adjust the alignment of the body and apply pressure to the soft tissues of the body. They may also give advice on lifestyle changes and exercises to do at home. On a physical level. Tel: 01772 881 063. The British Federation of Massage Practitioners. This corrects structural and mechanical faults and allows the body to heal itself. Massage is poorly regulated and your GP may be able to recommend a therapist or your local sports centre or health club is likely to offer it.’ Judith Morris Osteopathy Osteopathy focuses on the importance of the spine and peripheral joints for the proper functioning of all parts of the body. Lancashire P1 1TS. A full massage can last between 60 and 90 minute and costs around £30 per hour. An initial assessment will take longer (about 30 minutes) and cost more (£35) than follow-up appointments (10-20 minutes. I know it’s not going to make any difference to my arthritis. Preston. increase the flow of blood and lymph and ease tension.probably take X-rays of your spine. Osteopathy was founded on the belief that disease is the result of a disturbance in the normal balance of the defence and repair mechanisms in the body. massage can loosen stiff muscles. Tel: 0118 950 5950. Enclose an SAE. Blagrace House. £20-£30). a good massage leaves you feeling relaxed and cared for. contact: The British Chiropractic Association. 17 Blagrave Street. improve the tone of slack muscles. Reading RG1 1QB. Treatment should not be given where there is inflammation. a professional masseur will ask you about particular problem areas and general preference (a gentle touch or firmer pressure). but being relaxed helps relieve the pain. To find out more about the general register of chiropractics.

Further examination is normally carried out in a variety of positions – lying on your back. ● Ask how much treatment will cost. and how many sessions you will need to feel a benefit. Ask if they have insurance in case something goes wrong. Follow-up appointments are usually around 20-30 minutes and cost approximately £20-£30. what kind of training they have had and how long have they been practising. or sitting with your legs over one side of the couch and your back towards the osteopath. The number of treatments required will depend on the nature of your problem. so it is worth asking your GP if he or she can recommend a therapist or a particular therapy. Surgery While some people with arthritis will never need to have surgery. improving mobility and reducing stiffness. An initial assessment may take up to an hour and cost £30. but X-rays are rarely used. 176 Tower Bridge Road. The Balanced Approach. There is more information about complementary therapies in Arthritis Care's booklet. For further information contact: The General Osteopath Council.out by a chiropractor. ● If possible. Ask them if they can recommend a therapist. ● Ask if the therapist is a member of a professional body. London SE1 3LU. ● Tell your therapist about any drugs you are taking. front or side. talk to other people with osteoarthritis who have used the therapy you are thinking of trying. Don't stop taking prescribed drugs without talking to your doctor first. ■ Finding a good therapist ● Although most people pay for their own treatment. some therapies are available on the NHS. ● The Institute for Complementary Medicines (see page 38 for contact details) can also help you find a qualified therapist. some people find it is very successful in relieving pain caused by arthritis. Tel: 020 7357 6655. Osteopathy House. but remember that what works for someone else may not suit you. and your doctor about the therapy. Surgery is a big decision to make and is usually only 27 .

including your orthopaedic surgeon. unfortunately. They now see real possibilities of understanding and controlling osteoarthritis in the future. many people decide that the positive effects on their lifestyle will outweigh any risks. There is a risk the operation won't work. However. or will lead to further physical complications. The worst bit was waiting for it to be done. but recent research is uncovering the mechanisms which lead to joint damage as well as factors that control the healing response. For a while I just couldn’t see a light at the end of the tunnel and I was a bit frightened of managing when I came out. still many people who have to live with their osteoarthritis and the daily pain it can cause. It does get better though. Call 020 7380 6540. Surgery can be minor – to assess damage done or smooth joints and repair cartilage (also known as an arthroscopy) or it can be more intrusive – to replace or to fuse a joint.’ Mr Viv Williams ‘I think a long stay in hospital does affect you. I could hardly leave the house before. They no longer see osteoarthritis as an inevitable part of ageing or a wear and tear disease. I chose to have a spinal block as I wanted to be awake. I still have a bit of pain. Surgery can also prevent joints deteriorating further and prevent disability. The new one is far superior – it’s great.’ Joyce Cox ‘Three months ago I broke my hip replacement when I fell over. You will find more information and advice in Arthritis Care’s Surgery booklet.’ Meriel Blake ‘My knee replacement failed due to an infection setting in. My recovery started straight away. but more as a major challenge and an important problem which they can one day solve. They gave me an epidural when I had the operation and I had no pain at all. You may still have to see the doctor from time to time to have your condition reassessed and your treatment plan discussed. I thought that if I could see what they were doing. Doctors and research workers have changed their attitude a great deal in recent years.’ Mr Viv Williams considered after all other suitable treatment options have been explored and when the joint is badly damaged by arthritis. Having surgery could bring about a dramatic improvement in your pain levels and quality of life. it would give me a sense of power and the confidence to get better.‘Having my hip replacement was the best decision I’ve ever made. I think I’ve just been unlucky and it certainly hasn’t put me off trying again. It is a good idea to weigh up the pros and cons of surgery with your healthcare team. We do not yet know the causes or the cure for osteoarthritis. 28 . For example. Recovery may take some time and a lot of effort on your part. as I live alone. we now know some of the chemicals which thin out the cartilage in osteoarthritis and drugs are being tested that inhibit the actions of these chemicals. but it doesn’t limit me like it used to. there are. New developments In spite of great progress with artificial joints.

There are lots of handy gadgets and useful adaptations that can help around the home. It’s far easier than trying to balance a tray. for instance. Local home improvement agencies and voluntary organisations also offer help or funding for equipment and adaptations. but there are plenty of sources of help.’ Anne Howard ‘I find a tea trolley is great for moving things around. ‘I’m very conscious of the heights of furniture. At home Most homes aren’t designed for people with arthritis. and the latches and knobs on doors. But there are many ways you can set things up at home to make sure that it is as streamlined and stress-free as possible.’ Jan Slaney ‘Reaching things high up and low down is difficult so I now arrange my things so that they are within easy reach.’ Jan Slaney ‘Use a small travel kettle rather than a large one if your wrists are weak. You are entitled to have your needs assessed – usually by an occupational therapist – to see whether you are eligible for help. It’s the same with the fridge. You may also have to wait a long time for an assessment or equipment. I make a list before I go of criteria that must be met. Some equipment may also be available on the NHS. When I need something new. Eligibility varies throughout the UK and you may have to contribute towards the cost.’ Meriel Blake ‘I find that ceramic hobs are far easier to keep clean and I only use the top oven to avoid bending down. such as chairs. they might include: ● rearranging cupboards and drawers so the things you use the most are nearby ● lightweight pans. mugs or a kettle ● equipment with easy-to-use buttons and switches ● an electric tin opener. The organisations listed on pages 38 and 39 of this booklet also have a wealth of practical advice and experience to share. In the kitchen. or knives and peelers with padded handles ● a stool to sit on while you are preparing food.PRACTICALITIES Living with osteoarthritis may not be easy. 29 . If your needs change. I find that wearing thermal shorts under my trousers really helps to keep my hip joint warm. or raising the oven and fridge. a cap gripper.’ Anne Howard Help with costs Your local social services department (social work department in Scotland.’ Anne Howard ‘When it’s really cold. health and social services board in Northern Ireland) may be able to help with equipment or adaptations to your home. I made sure that the fridge was at the top and the freezer at the bottom because I use the fridge more. It means that I don’t get something home and am then unable to use it. so they are at the right height for you and you can slide things around. cupboards and gadgets. or a trolley for moving heavy items across the room ● devices for turning taps more easily ● evening up your worktops. Men’s thermal boxer shorts are best because they are bigger and go almost down to my knees. contact social services so they can move you up the waiting list.

’ Jan Slaney ‘At my local supermarket there’s a service that provides electric carts if you find it hard to get around the store – I find it invaluable. If you are thinking of buying your own. get as much information as you can. ● Gas. but social services may be able to arrange for care workers to visit you for domestic care. You could also think about paying a cleaner. or getting a handyperson in for bigger tasks. If you have a specific carer. Help varies a lot from area to area. Ask yourself: will this solve the problem or create new ones? ● Your occupational therapist can help you find the right equipment or adaptations. tools and aids can add up. what about getting someone else to help? Friends and family may be able to lend a hand. Other people If you find you are doing a lot of work around the home. See page 38 for more details. ● Local disablement information and advice lines (DIALs – see page 38) can give you information about services and suppliers who loan or sell equipment near you. and maybe able to lend you some to try out.■ Care assessment You have the right to an assessment of your care needs at home – again. and try them out before buy them. I used to have to drape myself across a trolley. As well as being a Disabled Living Centre. or to give you support with personal tasks. Local 30 . such as cleaning and shopping. ● High street stores like chemists. then go for it. If a wheelchair or electric buggy makes life easier for you. the assessment must also take their needs into account. advice and the chance to try out a range of products. electricity and phone companies often offer disabled people help with advice. ● Arthritis Care’s helplines team can also help with suggestions (see back page). products or services. the Disabled Living Foundation (call 0870 603 9177) holds the most comprehensive database on equipment. ● Many national and local disability organisations – such as disabled living centres – offer information. The cost of purchasing ‘Don’t let your pride get in the way of using equipment that may really help you in the end.’ Anne Howard Gadgets. or look in the Yellow Pages under Disability. contact your local social services department. supermarkets and hardware shops often sell labour-saving devices and daily living equipment.

but I had to give it up due to my OA and fibromyalgia. I just couldn’t cope with getting in and out of the car. This could be by providing things such as a support worker. but had to give up in the end. I fought and fought. There’s lots more information about home life in Arthritis Care’s booklet. citizens advice bureau or library if they know of a local volunteers’ organisation which can help. equipment or adaptations to your workplace. taking regular breaks. and help people understand what osteoarthritis means for you. Smarter ways of working will help protect your joints and conserve energy. They can include: ● organising your work – rearranging work area. Contact your local Jobcentre for more information.’ Jan Slaney 31 . Access to Work advisers offer in-depth information on the Access to Work programme– a Government scheme that helps disabled people and their employers overcome work-related obstacles. Work and education Your arthritis may not significantly affect your work at all – other than time off for doctor’s appointments or surgery – but hiding it and struggling on if you have difficulties could make your arthritis worse. relaxing. Disability employment advisers are based at your local Jobcentre and offer support and advice to disabled people and employers.organisations may be able to put you in touch with volunteers to help you with jobs around the house. or making the move from benefits to work.’ Mr Viv Williams ‘I was an occupational therapist and the manager of a residential care home. and work-related expenses. The best policy is to be positive. such as car adaptations or taxi fares. I just thought: I can’t do this anymore. An occupational therapist can help you figure out what you need to do to make working life easier. handling application forms and interviews. honest and clear about your needs. Contact the organisations listed on page 38 for more details. Depending on how your arthritis affects you. It really kept me occupied. or being based at home some of the time if that fits in with your job. Ask your local council. using computer equipment correctly.’ Anne Howard ‘I had to give up working in a charity shop. Reaching Independence. I can now only drive about a 20 mile radius. ‘After I gave up work I went back to university and got a degree in behavioural sciences. pacing yourself and varying tasks ● flexibility – perhaps working a shorter day or different hours. as can a disability employment adviser. There is also financial and practical help on offer if you want support finding work.

Transport ‘I find trains very hard to get on and off. And there are often so many steps at stations.’ Judith Morris Getting around is very important. You don’t have to be a full-time student to get it. further education and voluntary work may all open new doors. which means that you will be allowed to park in a designated parking space closer to your destination. your life can become very restricted. There are some transport schemes and services run by local authorities. The DDA also covers recruitment. The badge belongs to the disabled person who qualifies for it (who may or may not be a car driver) and can be used in any vehicle they are 32 . moving your workspace to the ground floor. If it becomes difficult for you to use public transport or drive a car. you may be eligible for a disabled students’ allowance. It is important to discuss options before deciding to give up work. For more information. promotion and dismissal and only if you fit the definition. Information for people with arthritis looking for – or already in – work can be found in Arthritis Care’s booklet Working Horizons. or retraining you and reallocating your duties. These can include changing the working environment. service provision throughout the UK can be patchy. The allowance is intended to cover any extra costs or expenses students have because of a disability. The Disability Discrimination Act (DDA) says that companies with more than 15 employees must take reasonable measures to ensure they don’t discriminate against disabled people.the time may come when you need to consider changing jobs. ● You can apply for a blue badge. training. and voluntary and commercial organisations to allow you to maintain your mobility. contact Skill (see page 39). If you are going into higher education (post18). However. But you will only be protected by the DDA if your employer knows about your arthritis. Some people do have to stop working altogether – this is never an easy decision and it’s important to get professional advice about your rights and options. Remember that giving up work doesn’t mean that you are giving up your life: retraining.

You don’t even have to stand at the actual bus stop – they stop and pick you up just if they see you. A nice train conductor helped me off the train at Manchester once. ● Most international airports produce their own disability access guides.’ Meriel Blake 33 . and some run their own transport schemes.’ Judith Morris ‘People have been generally very kind to me when using public transport. train and minicab services in their area. again the Motability scheme can help. ● Your local disability organisation (in the phone book). If you prefer to drive then just a few minor adjustments – such as a padded steering wheel. a headrest. national and international travel. you can order two free leaflets from the Department of Transport which are a guide to transport for disabled people: Get Wheelchair-Wise and Wheels within Wheels. extra side-mirrors or a wide-angled mirror – may make driving easier. library or local newspaper may also be able to tell you about what’s on offer locally. help you plan and book your journey and arrange any assistance you need. If you get the higher rate of the mobility component of the disability living allowance. contact an accredited driving assessment centre. For further details visit the Department for Transport website at www. available from any train station. Ask the Mobility Advice and Information Service (MAVIS) for a list of centres. I have to rely on my car. ● Individual railway operating companies can give you information.’ Meriel Blake ‘I can’t use public transport – it’s too far from my house and buses don’t come often enough. The booklet also tells you how to get a disabled person’s railcard. you may be able to use it to hire or buy a car through the Motability scheme (see page 39).travelling in. An automatic gearbox and power steering can be essential for many people with osteoarthritis as they reduce strain on joints and muscles. If you need a specially adapted car. ● For more ideas. Don't forget to tell the Driver ‘Buses are great where I live. If you prefer to get around by wheelchair or scooter. Get their details from the National Railway Enquiries Line on 08457 484950 or the Rail Travel for Disabled Passengers booklet. ● Tripscope (see page 39) runs a free information service and can help you plan local.gov. Public transport isn’t all bad. and any other schemes run by voluntary or commercial organisations. carried my case and asked someone else to help me on to my connecting train when it came. See page 39 for details.uk ● Some local authorities (in the phone book) produce guides to accessible bus.dft.

If you are 65 or over you may be entitled to attendance allowance (AA) for help with personal care. The mobility component of the DLA allows me to be able to run a car – it’s a great asset and has opened up my life. it’s my responsibility. It is worth reapplying as many people go on to qualify on further attempts. If you are disabled or over 60.Vehicle Licensing Authority (DVLA) and your insurance company if your arthritis affects your ability to drive. DLA and AA are not means tested. However.’ Joyce Cox ‘I didn’t want to use the Motability scheme because I didn’t want to be locked into a three-year contract.’ Anne Howard ‘I’m lucky because I worked in the welfare department of the NHS so I knew how to fill out the benefit forms.’ Anne Howard 34 You may be entitled to state benefits to help with the extra costs of having arthritis or if you are unable to work. Benefits ‘I am eligible for the DLA low rate care component and the higher rate mobility component. My car has everything I need – fully adjustable seats and electric windows. like running a car. which aims to advise disabled people of their benefit entitlements and assists them in making a claim. it is worth getting expert help and advice from: ● a social worker or welfare rights officer at your social services department (social work department in Scotland. health and social services board in Northern Ireland) ● your citizens advice bureau or other advice centre ● your local social security office or Jobcentre Plus office (under Jobcentre Plus or social security in the phone book) ● Benefit Enquiry Line – an information line run by the government. They also mean you may qualify for other benefits or help. Benefits for Beginners. Claiming benefits can be complicated and time consuming so. your local council may run a scheme making you exempt from paying for public transport. It has allowed me to do and have the things which I would have had to give up. Contact your local council or social services for more details. if anything goes wrong with it.’ Anne Howard ‘The DLA has helped me. You may be eligible for free or discounted travel too. are tax free and are paid in full on top of other income and all other benefits you get. I was turned down to begin with. before you start. It took two and a half years to thrash it out. Call 0800 882200 ● Arthritis Care's booklet. but what a fight that was. so it is worth applying for them if you think you are eligible. but reapplied and was awarded it without quibbling. Don’t be put off if your claim is initially unsuccessful. you can claim disability living allowance (DLA) if you are under 65 and need help getting around or with personal care (such as washing and dressing). DLA and AA Whether you are working or not. .

0800 220674). whether you are in work or out of work even if your income is quite high. See Arthritis Care's Benefits for Beginners for more details on other benefits. there are several other benefits you can apply for such as income support. If you get turned down. Carers can apply for benefits too but should check first before claiming carer’s allowance that their claim will not affect the benefits of the person they care for. there is no upper limit on the amount of savings you can have. You usually need to have paid a certain amount of national insurance contributions to get it. but income from savings will be taken into account. in Northern Ireland. you are asked to explain how your condition affects you. working tax credit (WTC) can top up earnings if you are on a low income. thank goodness. so you don't underestimate how much help you need.When you apply for DLA or AA. ‘The Benefits for Beginners booklet is absolutely excellent for benefit information. you may be able to claim incapacity benefit. Unlike disabled person’s tax credit which WTC replaced.’ Jan Slaney Working tax credit and child tax credit If either you or your partner work 16 hours a week or more and you have a disability. then fight. Reflect the bad days as well as those when you can manage. I had to fight for DLA and got it in the end. listing any things you have trouble doing and the time it takes you to do them. pension credit (if you are over 60). Keep a diary over a couple of weeks. Tel: 0800 882200 (or. The Benefits Enquiry Line (BEL) is a free telephone information service. Child tax credit (CTC) is also available if you are responsible for children. Incapacity benefit If you can no longer work because of osteoarthritis or other health problems. Benefits for Beginners guides you through the forms and helps you think out things to mention. 35 . Other benefits If you are on a low income. It cannot deal with claims. housing benefit and council tax benefit. Any occupational pension or health insurance you receive may reduce the amount of incapacity benefit you are paid. but it can provide answers to any questions about benefits.

’ Mr Viv Williams 36 Everyone's experience of arthritis is different. but of course I couldn’t and this frustrated me. People you are close to may really want to help. Talk to your partner about how you feel. feeling positive one week and negative the next. Pain can usually be controlled. Some people become stronger and more determined as a result of having to adapt their lives to fit in with their arthritis – everyone is different. Explain how your arthritis affects you and be as clear as you can about how you are feeling. You may be worried about letting them down or about depending on them too much. that it is perfectly natural to feel out of sorts sometimes. there comes a time when you realise that you are making progress.’ Joyce Cox ‘When you want to go out socialising you end up making a deal with yourself and accept that you might feel a bit off colour the next day. The operation was such a challenge and I was on a high for quite a long time. You may not be the type of person who expresses their emotions freely. but it is good to let your emotions out. grip and mobility. Your relationship may come under a bit of strain too. Don't be surprised if you feel frustrated one day and perhaps angry the next. Some people find that their lives do not change that much and that they can more or less carry on as normal. The best thing is to be positive. You may find Arthritis Care’s booklet. level of pain or the same feelings. Nothing is more annoying than when someone says: “But you look so well”. Our Feelings. Well informed friends and family members will be in a much better position to help you should the need arise.’ Veronica Jones ‘I decided to have my hip replacements one at a time rather then both together as it knocks you a bit for six. Our Emotions. But when it comes to emotions. things get a bit more complicated. helpful. Remember though. I thought I could do anything.’ Meriel Blake ‘I had a gruelling time after my knee replacement.’ Veronica Jones ‘I think that self-management is a wonderful thing.’ Anne Howard ‘The invisibility of the pain of osteoarthritis is most frustrating for me. but not know how. just how does arthritis feel? Depending on how advanced your arthritis is. Bottling them up can make things worse.Your emotions ‘Since my hip replacement I do still have the odd black day. Your relationships Sharing information about your condition with family and friends can really help them to understand what you’re going through. both physically and emotionally and encourage them to ask questions If you are feeling stiff or having trouble moving . However. stiffness and inflammation relieved. the more powerful you feel. I was quite down. Not all people experience the same symptoms. we know that pain is high up on the list as well as fatigue and a whole host of other physical symptoms. So. I did get a bit depressed when I was recovering because of the weakness and painkillers. Talking and listening is key. Your own reactions to arthritis will differ from time to time. The more you know about your condition. and there are ways to overcome the loss of strength.

I often stubbornly keep going when common sense tells me I should stop and rest my joints. It will make you feel less worried about the future. I’ve been really hurt by what people have said. I will just go out and do it again because even if I’ve got OA. helpful. focuses on what you can do for yourself. handling pain. how to get the most from your health professionals. Our popular course. Several things may help. depression and fear are all very understandable and very common. ● Accept your limitations. A warm bath or shower beforehand will help to loosen your joints. For more on what Arthritis Care offers. frustration. your arthritis will get on top of you. ● Get out and about – keeping up with friends may become tricky if you are having problems with your osteoarthritis. fatigue and depression. though. There are ways round things – it’s a lot to do with your own attitude. However.around. If you like and trust them. ● Find out as much as you can about your arthritis. but try to make space for your social life. There will be times when you are just too tired or painful to get close to your other half. This could be someone close to you or someone else with arthritis. You could even try persuading your partner to give you a gentle foot or back massage. ‘When I feel achy and stiff I get bad tempered and depressed. I am like a bear with a sore head and my poor partner is the one who has to pick me up and put me back together again. It is a great chance to meet with others in the same position.’ Pennie Cumming ‘Friends mean well. see the back page. and remind yourself about what you can do and enjoy. rather than the things you can’t. Our Sexuality. I still grow tomatoes and have very good neighbours who help to pick them for me.Challenging Arthritis. help you to keep flexible and boost your mood. but there are alternatives. relaxing. Don’t be embarrassed to raise the issue with your healthcare team. 37 . My daughter has been excellent. it certainly hasn’t got me. and keeping active. Our Relationships. Try different positions. you will feel more positive and it will make it easier to approach them if you have a problem. The first time I used a wheelchair at the mall. we had a real laugh together – it took away the embarrassment.’ Pennie Cumming Living well From time to time. ● Include exercise in your day. ● Try to build a good relationship with your health professional.’ Mr Viv Williams ‘I love DIY and gardening and when I have a job to do I just have to finish it and get it right. supporting your body with pillows and cushions to make love-making more comfortable. ● Talk to somebody who understands how you are feeling. but they’re not necessarily tactful. You may find Arthritis Care’s booklet. It will build your strength. it is hard to be spontaneous. and even a hug can be difficult if you are in pain.’ Jan Slaney ‘I had to give up gardening – I used to have an allotment. Focus on the here and now. uncertainty. Despite this. Anger.

uk Information about health.uk Umbrella body. Pain Concern PO Box 13256.org.Tavern Quay London SE16 7QZ Tel: 020 7237 5165 www.30am to 6. local NHS facilities and waiting lists.uk Funds medical research into arthritis and produces information.uk Details on local practitioners.org.uk Provides information on disabled living centres (demonstration and resource centres for disabled people) around the UK. London SE1 1LB. Health services NHS Direct Tel: 0845 4647 www.org.30pm.disabilityalliance. DIAL UK St Catherine’s Tickhill Road Doncaster DN4 8QN Tel: 01302 310123 www. College of Occupational Therapists 106-114 Borough High Street Southwark. National Centre for Independent Living 250 Kennington Lane London SE1 5RD Tel: 020 7587 1663 www.org Provides a welfare rights service and information on benefits.org.uk Details on local practitioners.cot.org.radar.USEFUL ADDRESSES General arc (Arthritis Research Campaign) Copeman House St Mary’s Court St Mary’s Gate. Daily life Disabled Living Centres Council Redbank House. Pain management Pain Society 21 Portland Place London W1B 1PY Tel: 020 7631 8870 www.ricability.uk Details of your nearest disability advice and information service.painsociety. Benefit Enquiry Line for disabled people Tel: 0800 882200 Mon – Fri.nhs. 9am to 1pm. Chartered Society of Physiotherapists 14 Bedford Row London WC1R 4ED Tel: 020 7306 6666 www. Manchester M8 8QA Tel: 0161 834 1044 www. RADAR 12 City Forum 250 City Road London EC1V 8AF Tel: 020 7250 3222 www. Complementary therapies Institute for Complementary Medicine PO Box 194 . Sat.uk Advice and information on equipment.dialuk. 4 St Chad’s Street. Mon and Wed 2-4pm www. Disabled Living Foundation 380-384 Harrow Road London W9 2HU Tel: 020 7289 6111 Helpline: 0845 130 9177 www. 38 .dlcc.org. Ricability 30 Angel Gate City Road London EC1V 2PT Tel: 020 7427 2460 www.icmedicine.org. Send large sae and state the therapy.nhsdirect.org.csp.uk Promotes personal assistance and other aspects of independent living.arc.org Information about chronic pain and pain clinics. Chesterfield Derbyshire S41 7TD Tel: 01246 558033 www. Tel: 020 7357 6480 www.uk National campaigning organisation which also publishes a wide range of information on general disability issues. 8.uk Researches and publishes guides on services and equipment. Money and benefits Disability Alliance Universal House 88-94 Wentworth Street London E1 7SA Tel: 020 7247 8776 (voice and minicom) Rights advice line: 020 7247 8763.dlf.ncil.co.org. Haddington East Lothian EH41 4YD Tel: 01620 822572 Information and helpline. Can put you in touch with qualified practitioners locally.

39 . 118 Great Minister House.org.uk AbilityNet PO Box 94.uk Support for people with disabilities to use computer technology.bacp. 89-93 Fonthill Road London N4 3JH Tel: 0870 241 0450 www.org Works to eliminate discrimination against disabled people. training and employment for young people and adults with disabilities.nos.uk/ mavis/mavadv.gov.abilitynet.co. Station Approach.uk Information about further.uk Tripscope The Vassall Centre. Work and education Skill: National Bureau for Students with Disabilities Chapter House 18-20 Crucifix Lane London SE1 3JW Voice/text: 020 7450 0620 Information line: 0800 328 5050 www.skill.dft. Crowthorne Berks RG45 6XD Tel: 01344 661000 www. Harlow Essex CM20 2ET Tel: 01279 635666 www.htm Driving training.tripscope. Old Wokingham Road. information and assessments. Gill Avenue Bristol BS16 2QQ Tel: 08457 585641 www.org. Department for Transport Mobility and Inclusion Unit. Rights and discrimination Disability Rights Commission DRC Helpline Freepost MID 02164 Stratford-upon-Avon CV37 9BR Tel: 08457 622 633 www.uk Arranges travel for people with disabilities. National Osteoporosis Society Camerton.drc-gb. 89-93 Fonthill Road London N4 3JH Helpline: 0800 018 4730 www. Warwick Warwickshire CV34 5WS Helpline: 0800 269545 www. higher and continuing education.org.org. Pregnancy and parenting Disabled Parents Network Unit F9.uk Information and advice for disabled parents.uk Details of local counsellors.motability. Mobility Advice and Information Service (MAVIS) Macadam Avenue.org.co. Warwickshire CV21 2SG Tel: 01788 550899 Information line: 0870 443 5252 www.dppi.mobilityunit. Other British Association for Counselling and Psychotherapy BACP House 35-37 Albert Street Rugby.Getting around Motability Goodman House.uk Provides cars and powered wheelchairs through the Motability scheme. Disability Pregnancy and Parenthood International Unit F9. 76 Marsham Street London SW1P 4DR Tel: 020 7944 8300 Order your Get Wheelchairwise and Wheels within Wheels leaflets from here.disabledparentsnetwork .org. Bath BA3 3YB Tel: 01761 471771 Medical helpline: 0845 450 0230 www.

It is also available 10am-4pm charged at the national rate. a helpline service for young people with arthritis by telephone.org.uk ● offers The Source. It aims to empower people to take control of their arthritis.. Published by Arthritis Care. Edited by Kate Llewelyn.org. Printed by Manor Creative. Scotland and Northern Ireland. Production: Chris Hogg. November 2003 ACR124 ISBN 1 903419 31 X . Tel: 020 7380 6555. London NW1 2HD Tel: 020 7380 6500. Arthritis Care 18 Stephenson Way. Arthritis News ● campaigns for greater awareness of the needs of all people with arthritis ● has a local office in Wales. and 70.Arthritis Care is the largest UK-wide voluntary organisation working with and for all people with arthritis.000 supporters.uk ● offers a range of self-management and personal development training courses for people with arthritis of all ages to enable people to be in control of their arthritis ● runs four hotels in the UK ● produces a range of helpful publications including a bi-monthly magazine. 1st Edition.org. It has over 500 branches and groups.uk Written by Sarah Rastrick. and four regional offices in England.arthritiscare. Thanks to members of Arthritis Care’s readers’ panel and Arthritis Care’s medical advisory group for their guidance in producing this booklet. their lives and their organisation. Email: thesource@arthritiscare. weekdays 12 noon-4pm on a freephone helpline (0808 800 4050). ARTHRITIS CARE: ● provides a helplines service by telephone and letter. Freephone: 0808 808 2000 weekdays 10am2pm. letter and email. Design: Jon Heal. Fax: 020 7380 6505 www. Email: Helplines@arthritiscare. Phone 020 7380 6540 to find your nearest one. 206563. Registered Charity No.

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