Arthritis is a very common condition. It is seen more frequently with advancing age and expresses itself with varying degrees of severity.
It may be associated with swelling and/or deformity of the joints. The patient may complain that the joint is “stiff” from the slow and restricted movement. Abnormal cracking or crunching noises can be heard on movement of the joint. Some weakness of the muscles associated with the joint can occur. Quite often, (but not always!) The arthritic joint will be painful. It is often the pain from arthritic joint that causes a patient to seek advice.
Not all arthritic joints need treatment! For many, the pain is manageable and a slight
loss of function may have no noticeable effect on somebody’s day-
Splintage and support
Modification of activity
In the early stages of the disease, the symptoms can be held at bay by the use of
certain drugs. In general we tend to use the mildest drug that will control the symptoms.
Typically, paracetamol, non-
Typical side effects of anti-
Indigestion, reflux, gastrointestinal ulceration and bleeding, damage to the kidneys in susceptible patients.
Constipation, drowsiness, unsteadiness
Paracetamol has a very low incidence of side-
It makes sense therefore very carefully follow the instructions given to you by your doctor or on the medication label to make sure you reduce the chance of side effects.
It was once believed that physiotherapy had no beneficial effect on the progress of symptoms of arthritis. Clinical studies have shown however that some patients gain very real benefits from the attentions of a physiotherapist.
Exercises to improve your muscle strength and to improve your balance are often associated
with a significant reduction in symptoms. It is probably true that the arthritis
itself does not diminish but the positive effects of physiotherapy in terms of symptoms
can be achieved with virtually no side-
There is a vast array of commercially available braces, supports and orthotics which
seem to have some benefit in terms of pain relief. In order to be acceptable they
cannot be too cumbersome, and the mechanism by which they relieve pain may be somewhat
indirect. Again, these are treatments which have virtually no side-
In the knee, orthotics or specially moulded insoles placed in the shoes can have quite a significant effect on the pain of arthritis.
In general, it does no harm to try these non surgical treatments before considering surgical treatment.
Most patients come to complain that the pain of the arthritis prevents them from achieving certain activities. For example walking long distances, certain types of sport and other recreational activities can be made very difficult. Although most patients are looking for advice and treatment that will help restore their function, not all are willing to take tablets, undergo physiotherapy or be burdened by Splintage and walking aids. If the symptoms are particularly mild, changing your activity may be enough to keep symptoms at bay. For example planning to walk short distances, changing your sport to something less aggressive, getting help from friends and relatives to do certain activities on your behalf. Everyone is individual and you should discuss your own personal needs with your doctor.
Steroid in general has a bad press and is often associated with major side-
In fact steroids (short for corticosteroids) are an extremely effective and very
Of course, to get into the joint they have to be injected. The injections themselves are like any other injection and are painful for a short period of time. Some people cannot bear the idea of a needle being inserted into the joint, but those who are brave enough to undergo this get profound dramatic relief that can substantially change the quality of life and function.
The major side-
A steroid injection can provide relief for a few weeks to several months. Individual patients vary quite substantially in how they respond to these injections and sometimes the only way to find out is to try it.
“Measuring “ arthritis is not easy. X-
Measuring how arthritis affects an individual is even more problematic. One man’s pain is another man’s ache and even if we could agree how to measure pain, a person’s individual circumstances may lead them to suffer more disability than another given an agreed measure if similar pain!
However we can get an idea of severity from some simple information, such as “Does the pain wake you up at Night”, “How far can you walk before you have to stop”.
There are more sophisticated analytical tools which assess many parameters of pain and disability, such as the Oxford Knee score and the Oxford Hip score; They can help us to get a rough idea of disability, but again , they are not foolproof tools to say whether someone should have a surgical operation, but they can help when put together with other information to give a patient the best guide to making a decision. Modern surgeons are trained to use these tools and using input from patients, can help you to come to the correct decision.
If you and your surgeon have come to the conclusion that you need surgery, the pages on this website can help you understand what steps you can take to improve your problem, what to expect and how to achieve it.