Managing the pain of arthritis

To highlight National Arthritis Week (which runs from the 12th-18th October 2015) we've asked Dr Tom Margham, Lead for Primary Care at Arthritis Research UK and a GP in East London to give us his top tips on how to manage joint pain with arthritis.

Talk to your doctor

If you've got joint pain or have been diagnosed with osteoarthritis and are still experiencing increasing pain, do talk to your doctor. Osteoarthritis doesn't inevitably just get worse over time and it may be that you are having a flare up of pain that can be helped. 

Drug and non-drug treatments may help. Examples are: supports and bracing of the joints, insoles for shoes, physiotherapy and devices such as tap-turners.

In the absence of 'magic bullets' when it comes to managing the symptoms osteoarthritis, I aim for a combination of treatments which, whilst on their own may only give a small benefit, when used together may have a bigger effect.

Keep moving

If arthritis is causing pain, you may not want to move. But this can increase stiffness and in the long term your muscles will weaken, making movement even more difficult. If you don't use it, you may lose it.

Exercise also has positive mental effects. Often you'll feel much better and more self-confident when you've done some exercise. This can affect the way you cope with a condition.

To start exercise and stay motivated, follow these tips: 

• Set realistic goals - start low and go slow. Build up the amount of exercise you do gradually
• Wear comfortable, supportive footwear
• Remember, it's normal to feel some more pain when you start exercising as your joints and muscles get used to the increased activity. This should improve over the first few weeks
• It will usually take around six weeks of regular exercise to start feeling the benefits of improved pain and generally feeling better
• Do exercise that you enjoy  
• Do it regularly - exercise is a perishable good. To keep getting the benefits it needs to be ongoing
• Find a friend or join a class - this can keep you motivated and help your wellbeing

Alternative therapies

In the UK, at least 60% of people with arthritis use complementary and alternative medicine each year. From aromatherapy to acupuncture, because there are so many types, it's impossible to generalise about whether they work or not.  Everyone responds differently to the treatments.  

However, if you find that complementary and alternative therapies work for you, then this may be a more important consideration than how or why the therapy works.

Do bear these tips in mind:

• Be realistic - there are no miracle cures for arthritis 
• Tell your doctor - most doctors will be interested to find out what has helped you.

Diet

Although there are no diets or dietary supplements that will cure your arthritis, some people do find that their symptoms improve as a result of changing what they eat. 

The two most important things to bear in mind are: 

• Your weight - every time we take a step a force of between three and six times your bodyweight goes through our knees. If you’re overweight, losing some weight will reduce the strain on your joints, so you may find you don’t need to take painkillers quite so often. 
• Whether your diet gives you the vitamins and minerals you need - a good diet can help to protect you against some possible side-effects of drugs and against heart disease (which can sometimes be a complication of certain types of arthritis)

If you have any type of arthritis you should try to eat: 

A balanced and varied diet to get all the vitamins, minerals, antioxidants and other nutrients you need

A more Mediterranean-style diet which includes fish, pulses, nuts, olive oil and plenty of fruit and vegetables 

More omega-3 fatty acids, for example, from oily fish

Tips on how to deal with daily pain

Pain is a protective mechanism that alerts the brain when damage has occurred. This is helpful when your body is protecting itself from immediate danger. But when we experience pain for long periods of time then there are changes in the way the brain processes those pain messages. The pain messages are not helping us avoid damage, they become a problem in themselves. 

Pain also has emotional effects and can make you feel upset or distressed. If it makes you feel down or unable to sleep well, it will be worth discussing treatment options with your GP.

There are a number of approaches available to help you manage your pain:

• Drugs
• Painkilling drugs range from paracetamol to codeine and up to stronger morphine based drugs
• Painkilling creams and gels that contain non-steroidal anti-inflammatory drugs such as diethylamine succinate or ibuprofen can be effective, especially for knees, hands and feet
• Non-steroidal anti-inflammatory drugs (NSAIDs) such as naproxen, ibuprofen or celecoxib, which are painkillers as well as having an anti-inflammatory action
• Corticosteroids, often called steroids for short, given as injections into painful joints

Simple measures that can help to relieve joint or muscle pain include:

• A heated wheat or rice pad or a hot-water bottle
• An ice pack or a cold-water compress
• Massage (with or without creams that create a sense of warmth)
• Adequate rest time

Many people find that following the simple advice can help them manage any flare ups of pain:

• Avoid certain activities - for example jumping or twisting exercises
• Ask for help to avoid straining the joints
• Try using gadgets and home adaptations
• A doctor, social worker, physiotherapist or occupational therapist can offer expert help and advice with these changes.

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Images: Arthritis Research UK and Shutterstock