Osteoarthritis

 

Osteoarthritis is a common condition of the joints. It is a process of 'wear and repair' within the joint. The joint surface (cartilage) becomes worn or damaged. Tissues within the joint, such as bone, ligaments and joint lining, then change as the body tries to repair the damage.

There are no known medicines which can influence this process, but lifestyle change can help provide relief from the symptoms of pain and stiffness.

More on what we do

Osteoarthritis is usually managed by your GP. You might be referred to an orthopaedic surgeon if your GP thinks you might benefit from surgery, such as a joint replacement.

A rheumatologist may be involved if your GP or hospital specialist is not certain about the cause of your pain.

We do not routinely see patients to help manage established osteoarthritis. Before that stage there are other important approaches to self-management described below.

Treatments

Exercise: Exercise can help improve the movement of a joint and strengthen the muscles that move and support them. General physical activity which raises the heart and breathing rate is called aerobic exercise. This type of exercise burns off calories, helps improve sleep and can reduce pain. There is good evidence that exercise does not harm arthritic joints.

Weight: Being overweight can affect the joints in two main ways: firstly, the excess load on the joints can cause pain and discomfort. Secondly, a number of chemical messengers produced in fat can affect joint tissues and increase sensitivity to pain. Weight loss can improve the function of joints and reduce pain, as well as reduce your risk of developing other conditions, such as diabetes and heart disease.

Well-being: In the short term, pain is a warning sign. Your natural reaction might be to protect the affected area. However, long-term rest, reduced activity and support of a joint or body area is often not helpful. Sometimes people get into a frame of mind which encourages them to avoid tasks or things they normally enjoy because they tend to increase pain levels.

After a time, lack of use leads to weakening of the muscles, stiffening of joints and our nerves to those areas become more sensitive. Also, as we become less fit, we tire more easily and become more prone to strains and sprains, resulting in further pain. This can easily become a vicious circle – leading to frustration, worry and low moods.

Strategies to deal with the challenges of long term pain:

  • maintain your social contacts with friends and family
  • remain as active as possible
  • try setting some goals and pacing yourself
  • relaxation techniques can reduce your pain and encourage a sense of well-being. Try mindfulness exercises. 

Complementary and alternative remedies: Several complementary medicines and nutritional supplements might help osteoarthritis symptoms, such as pain and stiffness. There is some evidence of benefit but many questions remain unanswered regarding whether to take some, all, for how long and for what type of osteoarthritis.

Supplements often tried include glucosamine sulphate and chondroitin, Methylsulfonylmethane (MSM), turmeric, extracts of Boswellia Serrata and avocado-soya bean unsaponifiables (ASU).

Footwear, insoles and splints: Footwear may need to be adapted to accommodate arthritis in the ankles, midfoot or toes. For example, you may need a different size or width fitting. Some people need insoles to correct foot deformities and advice from a chiropodist or podiatrist could be useful. Splints can be used to support the work done by hand joints, such as the wrist and base of the thumb.

Our team

Our rheumatology team includes six consultants and a Staff Grade:

  • Dr Earl
  • Dr Haigh
  • Dr Brown
  • Dr Mascarenhas
  • Dr Abusalameh
  • Dr Cates
  • Dr Murphy

 

We have five nurse specialists:

  • Jill Moran
  • Tracey Morey
  • Gillian Hawkins
  • Sharon Mulcahy
  • Rachael Shaw

 

All consultants see patients with osteoarthritis.

Where to find us

RD&E Wonford, Barrack Rd, Exeter EX2 5DW

Helpful websites

Information for healthcare professionals

Further information about management and referral pathways for osteoarthritis can be found on the Devon formulary website.

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