Arthritis means sore joints – and often lots of painkillers to keep the aches at bay. But there could be alternatives to popping prescription pills every day, according to experts.
Exercise, weight loss and supplements, such as vitamin D and rosehip, could help manage the often agonising symptoms of joint health, it is claimed. Dr Alastair Dickson, a GP with an interest in arthritis, said joint problems are common.
“They can be caused by lots of things and can be short-term pain or more long term,” he said. “Acute pain is often caused by knocks, sprains and other injuries. Typically, this pain will get better over a number of days or weeks.
“Persistent joint pain often results from more chronic processes related to trauma and wear and tear, such as osteoarthritis, and inflammatory arthritis.”
Osteoarthritis, Dr Dickson explains, is the response of your body trying to heal your joints – and can have a significant impact on the lives of sufferers. The condition is most common in the over 40s, and in people who have suffered more trauma in their joints. It can affect any joint, but the most common are hips, knees, ankles, hands, fingers and neck.
“Joint pain is different for each patient,” Dr Dickson said.
“Commonly osteoarthritis in the large joints (such as your knees and hips) affects your mobility whilst osteoarthritis of your shoulders, hands and fingers can affect your ability to lift and open and close things making everyday tasks such as dressing difficult.
“Neck osteoarthritis can make movement such as looking up awkward and painful,” he said.
In Scotland it is estimated that 16.6% of people aged over 45 years suffer with knee osteoarthritis and 10.1% have hip osteoarthritis.
“The symptoms of osteoarthritis, especially pain, tend to develop slowly and build-up in severity over time, typically years,” Dr Dickson explained. “If you have pain from osteoarthritis the symptoms are individual to you. Treating everyone in the same way doesn’t work.”
When it comes to treatment, non-weight bearing exercise and weight loss are considered crucial. And painkillers are often prescribed – but Dr Dickson says alternatives, such as physiotherapy, cognitive behavioural therapy and evidence-based supplements, can help reduce this long-term reliance on pain relief. “Over recent years, evidence has been accumulating that overuse of painkillers is problematic and doesn’t necessarily cure the pain,” he said.
“Paracetamol is often insufficient for the pain on its own. To complicate matters further drugs that work for one person don’t necessarily work for someone else. There is currently a very large change in practice being suggested with the National Institute for Health and Care Excellence (NICE) draft guidance advising most painkillers for chronic pain should not be used long term as they are ineffective.”
The answer, Dr Dickson says, could be to look at the causes of pain and consider supplements where there is good evidence that they are safe and clinically effective. Unfortunately many supplements, such as glucosamine or chondroitin products, rubefacient creams (deep heat creams) are currently not considered to be either clinically or cost-effective following reviews by the NHS.
However, increasing vitamin D has been shown to reduce muscular pain – and evidence suggests rosehip may be effective in relieving some symptoms. Dr Dickson, who advises a company who supports GOPO, a rosehip-containing medication, explained: “A summary analysis of three clinical trials found that rosehip-containing medications are clinically effective in reducing pain. Studies have found that some rosehip compounds appear to have anti-inflammatory properties and potential benefits to cartilage but there have been no clinical trials to confirm this in patients.
“Some patients use rosehip as an alternative to paracetamol. It’s not available on the NHS but can be bought over the counter from a chemist. NICE is currently reviewing its osteoarthritis guidance and there should be updated guidance next year. Hopefully NICE will include rosehip compounds in its updated analysis.”
He added: “I use painkillers but over recent years the evidence has changed for why and how we should be using them: I now increasingly advise that they are to help you to start to mobilise by reducing – not curing – your pain.
“We use the lowest dose possible for the shortest time.
“This doesn’t mean never taking them but rather educating the patient so they become the expert and, armed with the information, they can become more in charge of how best to manage their pain and when to use painkillers.”
Many over-the-counter supplements are thought to be helpful for arthritis sufferers. Here are some you could try:
Helps keep the cartilage in joints healthy and may have an anti-inflammatory effect. Natural glucosamine levels drop as people age.
Often used with glucosamine as an osteoarthritis treatment, researchers found that chondroitin appeared to reduce pain, increase joint mobility, and decrease the need for painkillers.
Omega 3 fatty acids
Found in fish oil, Omega 3 fatty acids encourage the body to produce chemicals that help control inflammation. May help ease stiffness for rheumatoid arthritis patients.
Active ingredient of turmeric, it has anti-inflammatory properties and provides relief for people with osteoarthritis of the knee.
Packed with polyphenols, antioxidants believed to reduce inflammation and slow cartilage destruction.
Important for keeping bones strong and preventing injuries from falls. Research shows that people with low levels of vitamin D may have more joint pain.
May be beneficial in managing the inflammation and pain of arthritis, due to anti-inflammatory effects.
Contains polyphenols and anthocyanins, which are believed to ease joint inflammation and prevent damage.
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