Osteoarthritis
“wear and
tear arthritis”
As
we get past forty or so, we all start to suffer the odd twinge from “wear
and tear arthritis”. Past sixty, nearly everybody has aches and pains to
an extent, in the joints in their back, their neck, their knees, their hips
and the base of their thumb. Nearer eighty, it’s almost inevitable- to
some extent.
The
problem is the cartilage- the chewy gristle in a joint- which is meant to be
the shock absorber, and to
lubricate the joint. It gets thinned out and hardened with time. The joint
lining, the capsule, becomes stiff with many years of continuous stretching,
and the bones around the joint become hardened and less supple, and can’t
absorb the shocks they used to.
Result- inflammation and pain in the joint.
Sometimes
nerves can get trapped by the “wear and tear arthritis”. You feel pain
where the nerves are running to: perhaps sciatica in the back of the leg
from a lower back problem, or pain down the arm from the neck.
So
what can I do about it?
$For
weight bearing joints- hips,
knees, ankles, lower back
$keep
your weight as low as possible.
Say you’re 13 stones and your ideal weight is 10 stones- age doesn’t
enter into deciding ideal weight! Go into Tescos and pick up 3 (stones
overweight) x 14 (pounds per stone) x 2 (half pound packs) = 84 half pound
packs of lard. Pile them up. Imagine putting them into a ruck-sack, and
walking around with them on your back, all day, everyday- that’s just what
you’re doing! What athlete wouldn’t feel achy joints if he or she had
that 84 pound on their back all the time?
$Avoid
jarring your joints.
Use shock absorbing shoes as much as possible- decent training shoes are
built to absorb shock as you walk, rather than hard leather shoes. Get shock
absorbent insoles- Sorbothane is one leading brand.
$Keep
fit and mobile- the most
important.
$Joints
that aren’t moving become stiff and rigid and painful to move. Do everyday
tasks. Best, swim three or four times a week. Walking distances jars? Bike.
Go to low impact aerobics.
Keep your muscles around the
painful joints as fit as possible. They absorb shock, they take the jarring,
they stop the sliding and grinding of one raw joint surface against another.
Here’s some suggestions for different joints- but do them every day
Knees
Develop
your quads, the big thigh muscle above your knee cap.
$Walk.
Cycle. Swim,
several times a week.
$You’re
standing? Pull your knee-caps up as high as you can, using your quads. Count
slowly to ten. Relax. Do sets of ten of these each time you touch a tap-
that’s a useful trigger to remind you.
$Sitting
watching television? Reading the paper?
$Legs
straight out in front of you, both feet several inches off the floor. Hold
them there. Can do a minute? Do two. Do it again. And again. And again.
$Do
it comfortably? Get a plastic carrier bag, put a 2 lb. bag of sugar in it.
Hook your foot through the handles, and lift it up as long as you can, as
before.
Low
backs and sciatica.
Lots
of exercises here, too detailed to go into. Get a copy of “Treat Your Own
Back” by McKenzie. It’s usually in Wrays, some chemists, and the
library. It won’t cost more than a couple of packs of fags.
Necks
and pain down the arm
Lots
of exercises here as well, too detailed to go into. Get a copy of “Treat
Your Own Neck” also by McKenzie. Find it in the same places as above. Same
price.
What
about pills and rubs?
They
do help some people, but often at the cost of considerable side effects.
$Try
paracetamol first. It’s the safest,
and you can take 2 x 500mg. tablets, up to four times a day.
$Slightly
stronger pain-killers such
as co-proxamol and co-codamol
may offer a bit more relief, but beware of drowsiness and constipation- eat
lots of fibre. Avoid soluble and effervescent co-codamol- it contains lots
of sodium to put your blood pressure up.
$Non-steroidal
anti-inflammatory pills (NSAIDs)
do offer help to some people, in addition to the paracetamol they take
regularly. But only at the cost of some pretty serious side effects, such as
kidney problems, putting up your blood pressure, indigestion and stomach
ulcers, vomiting blood, etc. etc. Ibuprofen
is the most popular, and is recommended by the Committee on Safety of
Medicines as the safest- it’s available over the counter at the chemists.
Use NSAIDs intermittently, if possible, when symptoms are particularly bad.
Stop immediately if indigestion is a problem.
$NSAIDs
are also available in gels, to rub into joints. Few people get much benefit
from them. They are also available over the counter, if you wish to try
them, but don’t expect a lot.
$Sometimes,
low doses of non-addictive anti-depressant type of drugs, taken regularly, can slowly help the
brain to make the brain not feel the pain so much.
Will
Physiotherapy help me with Osteoarthritis?
A
very good question. For long-standing “wear and tear arthritis”, you can
do your own Physiotherapy at home just as effectively as any Physiotherapist
with all her machines. She
can’t turn back the clock and put fresh springy cartilage in worn out
joints and backs. Her role, where she can make a real difference, is
in sudden joint displacements, trapped nerves, sudden injuries, some times
nerves trapped by bulging discs, and the like. No
matter what the age. That’s where the NHS is prepared to pay for
Physiotherapy not in wear
and tear arthritis, where it really makes little difference.
Regardless of age.
Physiotherapy
is short for “Physical Therapy”. You
can do your own “Physical
Therapy” at home for arthritis.
$Joints
swollen and inflamed? Get a bag of crushed ice wrapped in a tea-towel, and
hold it around the joint for 20 minutes, three or four times a day, for a
week.
$Try
local soothing deep heat. Hold a hot water bottle around aching joints-
that’s all the Physio’s magic machines do, they heat up the joint.
$Try
rubbing an embrocation like Balmosa or Deep Heat from the chemist gently
around the joint. The gentle massage might help.
But
most importantly- do the exercises
we’ve told you, regularly, every day, without fail.
Physio
at the proper physio can sometimes
temporarily help Osteoarthritis a
bit. But only for a few days,
and not much more, if at all, than the physio and exercises you
can do yourself, at home. If you really want to try it, it’s available in
Filey from Mrs. P. Miller, above Wrays Booksellers in Belle Vue Street (Tel.
513778) for about the cost of twenty fags a day for week. There are other
Physiotherapists in Scarborough and Bridlington, if that is more convenient
with work, etc.
What
about an X-Ray?
X-Rays
show the shadows of the bones, not the damaged interior of the joint. Their
results don’t match very well with what is actually going on in the
damaged joint- severely damaged joints can look nearly normal on X-Rays, and
painless joints can look awful. Your doctor can tell far more from his
examination. But above all. They are radiation. Repeated X-Rays increase the
chance of cancer. Your doctor will not request one unless the result might
change what he will do.
What
other treatments are available?
Acupuncture-
can temporarily help, if given repeatedly. Mrs. Miller does this locally.
Same cost, details as above. Also available via Pain Clinic, rationed to six
weeks a couple of times a week.
Chiropractic
and Osteopathy-
some people find it helps, but generally it’s better for displaced joints.
Surgery-
joint replacements certainly an option, but the risks mean it’s best left
till arthritis is causing pain sufficient to stop you sleeping despite all
the above treatments. Some people do indeed get a new lease of life.
Pain
Clinic-
nerve blocks and the like can help a few people with significant problems.
Corsets
and Collars-
often of value for an acute flare up of neck Osteoarthritis or Low Back
Pain, respectively. Work by immobilising and supporting the inflamed joint,
but unfortunately the muscles tend to whither with prolonged use. Don’t
use all the time.
Summary
$Osteoarthritis
is a “wear and tear arthritis”.
$Graduated
exercise, and keeping below ideal weight is the mainstay of treatment
$Pills
can sometimes help, but have potential serious side effects. Paracetamol is
the safest.
$Physiotherapy
is of little value for “wear and tear arthritis”. Regular “do it
yourself” physio at home is just as good, and will save you money!!
