Weekly Roundup - Feb 15th

Somatic Symptom Disorder: Will you be victim of a mental illness diagnosis error? - A very informative post with a focus on Fibromyalgia/Chronic Fatigue Syndrome. The article explores the possibility that, with the recent changes to DSM-5 (a book of medical and diagnostic guidelines) people suffering from various illnesses may be misdiagnosed with a mental health issue instead.

 From Tacklegout.org: a useful post on recognising the triggers of gout, and how to treat attacks when they occur.

Not related to arthritis, but a worry nonetheless: a call to ban gluten free foods being prescribed on the NHS. As anyone who's ever gone gluten-free will attest, specialist foods are still quite expensive in supermarkets, and the choice is limited - perhaps supermarkets need to set their prices a little lower to relieve the financial pressure on both the NHS and coeliac sufferers?

Sunnier climates may reduce the risk of rheumatoid arthritis, a BBC article suggests. Vitamin D deficiency has been linked with increased risk of developing certain conditions, including MS. For those of us who suffer in the sunshine, fortifying foods with Vitamin D (as North America does with cow's milk) should be considered as another option.

A study in the Clinical Journal of Sports Medicine suggests that treatment with Platelet-Rich Plasma may be a viable treatment for knee osteoarthritis. Up to 73% of patients reported an improvement in their symptoms following the treatment.

And finally,  three researchers studying rheumatoid arthritis have won the Crafoord Prize, awarded by the Royal Swedish Academy of Sciences. Their discoveries will hopefully lead to a better understanding of the cause of this illness, and to ways of preventing and treating it.

Weekly Roundup

A BBC article this week questioned the effectiveness of many alternative therapies recommended for arthritis patients. Among the more effective alternative therapies were acupuncture, tai chi, massage, yoga and the Alexander technique.

A young patient with Ehlers-Danlos syndrome is receiving specialist treatment for her condition. Ehlers-Danlos is a connective tissue disorder which can cause hypermobility of the limbs and frequent dislocation. The Welsh government will be funding Phoebe Bruce's care, as her specialist is based in London.

A new centre for patients with Juvenile Idiopathic Arthritis, funded in part by the Great Ormond Street Hospital Children's Charity, has opened in London.

The new Arthritis Research UK Centre for Adolescent Rheumatology, funded by ARUK in collaboration with University College London, University College Hospital and Great Ormond Street Hospital Children’s Charity, aims to understand why young people like Michelle are affected by rheumatic diseases and how they can improve their treatment.

What is arthritis? A brief overview.

It might sound like a silly question - after all, almost all of us know someone with arthritis. We're all familiar with creaky knees and gnarled fingers, particularly in the elderly. But there's a lot more to arthritis than this. It's thought that there are well over 100 different kinds of arthritis, ranging from the common to the extremely rare, and the vast majority don't discriminate in who is affected.

I'll be delving into some of the more common types of arthritis in later posts, but here is a brief overview of the three main subtypes.

1) Inflammatory Arthritis. An umbrella term describing a group of conditions in which a person's immune system starts attacking their own tissues - a process called 'autoimmune disease'. The resulting damage to the joints causes pain and stiffness, and can lead to irreversable changes within the joint itself. The most common forms of inflammatory arthritis include Rheumatoid Arthritis, Psoriatic Arthritis and Ankylosing Spondylitis. In some cases, other parts of the body may be also affected by the inflammation.

2) Non-Inflammatory Arthritis. The most common form of non-inflammatory arthritis is osteoarthritis, which is the condition most people tend to think of when talking about arthritis. Unlike inflammatory arthritis, there is no autoimmune response, and the pain is usually caused by 'wear and tear', or mechanical problems in the joint. Other non-inflammatory forms of arthritis include fibromyalgia and scoliosis. Contrary to popular thinking, osteoarthritis can affect people of any age.

3) Connective Tissue Disease. There's an overlap here with inflammatory arthritis, as most connective tissue diseases are autoimmune in nature, and tend to cause inflammation in the joint. Typically, connective tissue diseases are systemic, meaning they affect multiple systems within the body. Examples include SLE (Lupus), Sjogren's syndrome, Ehlers-Danlos syndrome and Scleroderma.

Just to complicate matters further, there's also Septic Arthritis to consider - usually a temporary condition, it's caused by a bacterial infection within the joint. Most patients suffer no long-term damage.

Arthritis affects around 10 million people in the UK, and may be a secondary complaint to a diverse range of conditions including Ulcerative Colitis, Hepatitis and Haemochromatosis. Around 27,000 arthritis sufferers are under the age of 25. A report by Arthritis Care revealed that up to 34% of people they surveyed would not consider visiting a doctor, and that a further 50% would need frequent, unbearable pain before seeing a healthcare professional. As you can see, it's important to challenge the oft-repeated myths that arthritis only affects the elderly and that it is an inevitable part of ageing - there's still so much that can be done!

weekly roundup of useful links

some useful articles, opinion pieces and facts from around the web.

Firstly: a study supported by the World Health Organisation has found that rheumatic and musculoskeletal conditions are the second biggest cause of disability in the world. The study showed that lower back pain is the leading cause of disability, and that osteoarthritis is one of the fastest growing conditions. From the article:

Neil Betteridge, Vice President of EULAR representing People with Arthritis and Rheumatism in Europe (PARE) said “The finding that musculoskeletal conditions are the second greatest cause of disability globally should drive policy changes for the millions of people living with these painful and disabling problems. Despite the huge personal, social and economic impact of rheumatic and musculoskeletal conditions, policymakers have not prioritised them but this is now set to change."

A UK study suggests that emailing and text messaging may have a place in treating people with rheumatic disorders. A survey of 112 rheumatology patients in Hertfordshire revealed that, up to age 65, a high proportion of the clinical population is well-versed in the use of mobile phones and the internet.

“It has been assumed that the disability that these patients face because of their illness would be a barrier to using technology,” Dr. Hughes says. “However, although a small number of patients reported experiencing problems using a computer mouse and pressing the small buttons on a mobile phone, they managed to overcome these barriers and continue to use the technology.”

This BBC article tells the stories of two women suffering from Juvenile Idiopathic Arthritis. To an extent, most of us are guilty of considering arthritis primarily a disease of adulthood - the article discusses the challenges inherent in growing up with arthritis, and the effect it has on adolescence - one of the most difficult periods in a young person's life.

Researchers from the Arthritis Research UK Centre for Adolescent Rheumatology, set up in collaboration with University College London, University College Hospital and Great Ormond Street Hospital (GOSH), want to understand why young people like Emily and Michelle are affected by rheumatic diseases and how they can improve their treatment.

Prof Lucy Wedderburn, director of the new centre and a consultant at GOSH, says this will require large-scale studies and clinical trials specifically involving young people with arthritis - and not adults, who have been the focus of most research in the past.
"I feel strongly that teenagers and adolescents have different needs, but there's a real gap in our knowledge," she says.

A study published in the Journal of Clinic Nursing suggests that complementary and alternative therapies may be beneficial in helping arthritis patients manage their condition. 250 rheumatoid and osteoarthritis patients, aged between 20 and 90 years old, were interviewed. Almost 25 percent had tried CAT in conjunction with prescribed medication, and of that percentage, 64 percent reported an improvement in pain intensity, sleeping patterns and activity levels.

"Our study underlines the importance of healthcare professionals being knowledgeable about the potential use of CAT when providing medical care to patients with arthritis," lead author Prof. Nada Alaaeddine, chief of the Regenerative and Inflammation Lab in the Faculty of Medicine, University of St. Joseph, Beirut, Lebanon, said.

"Although CAT might have beneficial effects in rheumatoid arthritis and osteoarthritis, patients should be cautious about their use and should tell their healthcare providers that they are using them to make sure they don't conflict with their existing treatment," Alaaeddine added.

Researchers at Rush University Medical Centre have discovered a molecular mechanism which may explain what causes pain in osteoarthritis patients. Possible good news for osteoarthritis sufferers!

"This is an important contribution to the field of osteoarthritis research. Rather than looking at the cartilage breakdown pathway in osteoarthritis, Dr. Malfait and her colleagues are looking at the pain pathway, and this can take OA research in to a novel direction that can lead to new pain remedies in the future," said Dr. Joshua Jacobs, professor and chairman of orthopedic surgery at Rush University Medical Center.

And finally, a study by the Mayo Clinic shows that men with fibromyalgia are often going undiagnosed, and reveals the need for more research in this area.

Based on the study's findings, the researchers estimate that 6.4 percent of people 21 and older in Olmsted County have fibromyalgia - far more than have been officially diagnosed with it.

Fibromyalgia is more common in women, but men can get it too. The discrepancy between the number of people reporting fibromyalgia symptoms and the number actually diagnosed with the condition was greatest among men, the study found. Twenty times more men appeared to have fibromyalgia based on their survey response than had been diagnosed, while three times more women reported fibromyalgia symptoms than were diagnosed.

Welcome to Bones, Moans & Groans

Welcome to the Bones, Moans and Groans blog, a new project set up in support of the Arthritis Self-Help Network - a London-based charity which aims to empower arthritis patients with knowledge and support, and to help them better understand their condition in order to help themselves.

I first got involved with the charity during a fortuitous meeting at the Loxford Polyclinic in Ilford, where I met the charity's founder whilst waiting for my rheumatology appointment. I agreed to write a blog, and my New Year's Resolution is to do just that.

First, a little background. I have suffered with joint pain since I was nineteen. It was several years before any one doctor took my complaints seriously enough to try tests of any kind (more about that in a future post.) During routine blood tests, it was discovered that I had a positive ANA and I was referred to a rheumatologist. The rest, as they say, is history.

I have been under the care of that same rheumatologist for a little over three years, and while the exact reason for my pain remains something of a mystery, I have had the good fortune to find myself surrounded by people offering support, advice and a sympathetic ear. It's something I wish every arthritis sufferer had access to, as I've found this support invaluable, particularly when I find myself in a rut of self-pity. Hence my support of ASnet, whose work for the local community and efforts to educate, support and reach out to arthritis sufferers ensures that people don't have to deal with their illness alone.

Welcome to the blog!