GP, media doctor and writer, Rob Hicks offers key advice to Arthritis Digest readers

I have a 96 year old aunt who celebrated her birthday last weekend. I can always gauge how bad her osteoarthritis is by whether or not she’s been baking. Sunday was a good day for many reasons, one being that she’d been well enough to make a delicious three tier chocolate cake.

A couple of times a week my aunt emails me from her iPad, which she finds easier since I bought her a pen to type with. She’s proactive, in that if she can’t do something, she’ll try to find a way around it, be it an adapter for her tap or a hand rail to make getting up and down the stairs easier.

As a GP, I see people with osteoarthritis on a regular basis and feel sad when I hear “I guess it’s my age and I just have to live with it”. I’m quick to point out that there are plenty of ways to improve their pain, mobility and quality of life.

Often my first suggestion is that they should become more active if possible. Being active helps people with arthritis by strengthening the muscles that support the joints, which in turn helps them to work better. Activity also helps reduce weight when this is necessary, which means less pressure on the joints. And endorphins – the feel good hormones – are released, improving mood.

We talk about what the arthritis is stopping the person from doing that they want to continue with… be it gardening, walking the dog, going to the shop, volunteering within the community. And we use that as a goal to work towards.

For some a regular gentle walk may be all they can manage, but others might be up to a brisker walk. Swimming is a wonderful form of gentle exercise too. It’s important to make sure that the activity is manageable so together we find something they can do, will do and enjoy doing.

If their symptoms do not improve, I ask them to come back and see me again.

Finding equipment (such as living aids) to make life easier is another route – either from a local shop or online. In some cases I will involve an occupational therapist who offers practical advice and specialist equipment to help overcome everyday problems at home. At times I might refer someone with arthritis to a physiotherapist who can assess movement and address individual needs to improve function and manage pain.

Pain relief

I often hear people say that they are taking painkillers that aren’t working. When I delve deeper, it frequently turns out that the doses they are on are too small to make any difference. There seems to be a stoic belief that the pain has to get worse before painkillers are used to their best advantage. The reality is that if people use painkillers appropriately, the pain will ease so they can move around more freely, which in turn helps ease the pain and reduces the need for painkillers.

As for rheumatoid arthritis, we now know that the sooner it is diagnosed and treatment started, the better in terms of avoiding deformity and the need for joint replacement. The advent of biologic drugs has revolutionised the outcome and people who are diagnosed early today need be much less fearful of rheumatoid arthritis-related complications.

Complementary medicine

My personal view is that although the research isn’t strong when it comes to many complementary therapies, time and again I’ve spoken to people who swear by one approach or another that does not fall under the umbrella of mainstream medicine. I believe that as long as it does not harm them, mislead them or rip them off, there is nothing wrong in trying. Of course we must respect research, but if a form of complementary therapy is making a positive contribution to someone’s life, why challenge it?

But if complementary medicine is something that you’re considering, it’s a good idea to ask your GP first (or your hospital specialist if you have one) just in case it could be detrimental to your condition or any medication that you’re taking. Equally, they might know someone reputable who practises in the area.

Don’t be afraid of asking for advice from healthcare professionals, not just on complementary therapy but about other ways of managing your symptoms and improving your quality of life. Being proactive and having a positive attitude can help reduce pain and improve mood. Find out if there is anything you can do before deciding there is nothing to be done.

First published January 2015.

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