There are over a hundred different types of arthritis and related diseases, some of which can go entirely unnoticed while others are incredibly aggressive and debilitating. These conditions can affect people of all ages and have a wide variety of causes, from autoimmune disorders to sexually transmitted infections.
The two most common forms of arthritis can be classified into degenerative and inflammatory arthritis.
Rheumatoid arthritis is the most common form of inflammatory arthritis. It typically presents symmetrically (on both sides of the body) and commonly occurs in the small joints in the hands and wrists but can also affect the elbows, hips and knees. As it’s an inflammatory condition, the primary symptoms are pain, swelling and a feeling of hotness in the joints which can be worse in the morning. The pain can be constant and is not specifically aggravated by movements.
Rheumatoid arthritis is an autoimmune condition, which means that the immune system targets the body’s own tissues instead of fighting germs and viruses. The exact cause of this remains unknown and it is three times more common in women than in men.
Degenerative arthritis, also known as osteoarthritis and degenerative joint disease is the most common form of arthritis in the UK and is the type of arthritis that we most frequently encounter here at West London Physiotherapy. It results in a gradual reduction in the thickness and strength of the cartilage within the joints, most commonly presented in the weight bearing joints such as the knees, hips and lower back.
This reduction in cartilage is a natural result of the ageing process but will also be exacerbated by excessive body weight, muscle weakness, dysfunctional movement and previous injury/surgery. Typical symptoms of osteoarthritis are, again, pain and swelling in the affected joints and a reduction in range of movement. The pain is typically provoked by specific activities, a common example being climbing stairs in the morning.
However, I must reiterate that degenerative arthritis doesn’t always cause pain or even go noticed at all. Back in March, I wrote about why MRI scans can be trouble, leading people to worry about and pursue treatment for abnormalities revealed by the scan which aren’t even symptomatic. The example I used then was for spinal abnormalities, but the same problem arises in arthritis affecting the hips and knees. Many people will show signs on scans of degenerative arthritis as they age, especially in the knees, yet experience no symptoms whatsoever.
The example I always use is that you get wrinkles as you age, some of them are outside and visible to us, while others are on the inside and only seen by scans. Wrinkles do not give any pain, and I definitely wouldn’t say my grandmother has degenerative face disease!
Break the Pain Cycle
It’s easy for people with arthritis to get caught in a vicious cycle of pain and reduced activity, leading to weakness and deconditioning, followed by further pain and reduced activity – and so on. Our role as physiotherapists is to break this cycle and put you on a new one, of reduced pain and increased activity, leading to greater strength and further reduced pain and increased activity.
While there is no cure for arthritis, it can be managed successfully and it definitely doesn’t mean you have to say goodbye to activity and exercise. I have many clients who first saw me with severe stiffness and pain from arthritis who are now – and this is no exaggeration – stronger and more active than they’ve ever been.
The best way to manage arthritis is to strengthen the body. If your muscles and tendons are strong, they offload force away from your joints, relieving pain and stiffness and slowing the rate of degeneration. Strength training using machines and flexibility exercises are the standard treatment, combined with pain killers to provide a window in which you can comfortably exercise.
For severe arthritis, the exercises must be low-impact, to minimise the forces going through already painful joints. Exercises such as swimming, cycling and using a cross trainer are great ways of increasing strength without putting pressure on your joints. Eventually, when you’re conditioned enough, you may be able to return to higher impact activities such as running if we believe the risk of it worsening your condition is low.
There may also be a dietary component to the treatment if your arthritis is exacerbated by body weight. The heavier you are, the more pressure is put on your joints, so it’s very important to maintain a body weight that your joints can comfortably support. If this is a factor in your condition, we can refer you to a dietician/nutritionist as part of our treatment.
It’s unfortunate that it often takes painful arthritis or similarly debilitating conditions to push someone to take action about their strength, but it does mean that many of my clients experience a second wind with their body and totally shatter their preconceptions about what they are and are not capable of at their age.
If arthritis is stopping you from doing the things you love, give us a call on 020 7937 1628 or email info@westlondonphysio.co.uk and we’ll help you break the pain cycle and get your life back.
David Wynne BSc (Physio) MSc (Sports and Exercise Medicine) MCSP MHCP
Musculoskeletal and Sports Physiotherapist, Research Lead at West London Physiotherapy
For any other questions regarding this topic please do not hesitate to contact West London Physio on 0207 937 1628 or email David at david@westlondonphysio.co.uk
