Arthritis Diagnosis

If arthritis is suspected, there are a variety of examinations you may undergo in order to confirm a diagnosis.

During your appointment, your doctor should examine you for signs of swelling and a reduced range of joint movement. It’s not always easy for the doctor to be sure whether arthritis is present because no single test can confirm the disease. Doctors usually have to piece together their diagnosis from the separate items of information they obtain from their examination, tests, and most importantly what you tell them.

If there’s a possibility of arthritis, you’ll be referred for two types of test:

Arthritis Test

• X-rays – these can reveal any damage to the joints caused by arthritis and are most useful when confirming osteoarthritis. In the early stages of rheumatoid arthritis, an x-ray might reveal no changes or damage.
• Blood tests – there are many types, all measuring the levels of different blood cells and chemicals. They can indicate anaemia and how much inflammation there is in the body.

If your doctor works at a large health centre, you may have these tests done there. But it’s more likely that you’ll be referred to a hospital.

Different Types of Arthritis

Osteoarthritis

This is the most common kind of arthritis. It’s sometimes called ‘wear and tear’ arthritis and becomes more likely as a person gets older. However, younger people can be affected too.

Osteoarthritis Causes

It’s estimated that about eight million people in the UK have osteoarthritis and that about one million of these request treatment. There is no single cause, but several factors seem to increase the likelihood of getting the disease:

• Age – osteoarthritis becomes more likely with increasing age and is uncommon before the age of 40
• Gender – osteoarthritis is more common in women
• Weight – being overweight increases the risk of osteoarthritis, particularly of the knee
• Injury – an injury, operation, earlier disease or repeated strain at a joint may lead to osteoarthritis later in life

Side Effects of Osteoarthritis

In osteoarthritis, the smooth cartilage that takes the strain in a normal joint becomes rough, brittle and weak. To compensate, the bone beneath thickens and spreads out, forming knobbly outgrowths (osteophytes). The synovial membrane surrounding the joint thickens and the fluid-filled space within it becomes smaller. There is often inflammation.

As osteoarthritis gets worse, bits of cartilage may break away from the bone, causing the bone ends to rub together and the ligaments to become strained. This causes a lot of pain and changes the shape of the joint.

Osteoarthritis is most common in the hands, knees, hips and feet. Some people also develop it in the back and neck.

Osteoarthritis Symptoms

Osteoarthritis develops differently from person to person. The condition typically causes joints to become stiff and painful to move, but it doesn’t usually cause symptoms outside the area of the joint.

It usually develops slowly and the changes can be so gradual that people hardly notice them. The condition usually settles down after a number of years and, although the joints may have a knobbly appearance, they may become less painful.

Rheumatoid Arthritis

This is the most common type of inflammatory arthritis, affecting about one in 100 people.

Rheumatoid Arthritis Causes

Rheumatoid arthritis is an autoimmune disease in which the body’s defence mechanisms go into action when there’s no threat. In this case, the immune system attacks the joints and sometimes other parts of the body. It’s not yet known why the immune system acts in this way in some people.

Rheumatoid arthritis is a common disease affecting about one in 100 people. People of all ages have the condition, but it most commonly starts between the ages of 30 and 50. Three times as many women are affected as men.

Rheumatoid Arthritis Symptoms

The joints become inflamed, particularly:

• The synovial membrane
• The tendon sheaths
• The bags of fluid that allow muscles and tendons to move smoothly over one another (bursae)

Inflammation sometimes becomes far worse – known as a ‘flare-up’ – when the joints become warm and red as blood flow to the area increases. The synovial membrane produces extra fluid, causing swelling and a stretching of the ligaments around the joint. The result is a stiff, swollen and painful joint.

In one in five cases, rheumatoid arthritis develops very rapidly but more often the symptoms develop over several months. For about one in 20 people with the disease the cycles of inflammation cause severe damage in many joints, but others have little or no damage. Treating inflammation as quickly as possible is vital because once joint damage has occurred it can’t be reversed.

In a few cases, symptoms typical of rheumatoid arthritis come and go. These patients may have a different, but probably related, condition called palindromic rheumatism, which may be mistaken for rheumatoid arthritis. (There may also be other symptoms, such as certain skin rashes, which are not seen in rheumatoid arthritis.) Most importantly, the damage to bones or joints that occurs in rheumatoid arthritis is not seen in this condition. However, over time, as many as 50 per cent of patients will go on to develop rheumatoid arthritis.

Most people get fluctuating pain and stiffness that gets worse during flare-ups. Whereas in osteoarthritis morning stiffness wears off quickly, in rheumatoid and other forms of inflammatory arthritis it usually lasts more than 45 minutes. Many people find that the condition gives them flu-like symptoms and makes them tired, irritable or depressed.

Rheumatoid Arthritis and Genetics

There is no single gene to blame for rheumatoid arthritis, and when one family member develops the disease the risk to others in the family is small. However, although about 0.5 to one per cent of people in most populations will develop rheumatoid arthritis, it is much more common among the Pima Indians (5.3 per cent) and the Chippewa Indians (6.8 per cent) and far less common in China and Japan.

This shows that genetics do play some part in predisposing to rheumatoid arthritis.

The main risk comes from a group of genes known as HLA-DRB1 alleles, but several genes appear to be involved, each of which exerts only small effects to different degrees in different people.

In 2007, researchers in Manchester identified a genetic variant in part of chromosome 6 that is associated with rheumatoid arthritis. It’s thought that this variant, although not a gene itself, may affect the behaviour of a nearby gene called tumour necrosis factor associated protein gene (TNFAIP3), which is known to be involved in the process of inflammation.

Other Types of Arthritis

After osteoarthritis and rheumatoid arthritis, these are the most common type of arthritis that you may be tested for:

• Ankylosing spondylitis – inflammation occurs in the spine and pelvis, causing the joints to stiffen and sometimes become immobile. The neck, shoulders, knees and eyes can also be involved. It affects more men than women.
• Systemic lupus erythematosus (SLE) – an uncommon disease, sometimes known as lupus, which affects nine times as many women as men. It causes inflammation of the joints and skin and frequently other organs such as the kidneys and lungs. It is potentially very serious but can usually be controlled with medication.
• Gout – caused by uric acid crystals forming in the joints – particularly the big toe, ankles, hands and wrists. It can be very painful, but is easily controlled by medication and a change in diet.
• Polymyalgia rheumatica – an inflammatory condition affecting the muscles and soft tissues in the shoulder and upper arm, buttocks and thighs. It causes tiredness, stiffness, loss of weight and occasionally circulation problems.
• Reactive arthritis – a temporary inflammation of one or more joints as a reaction to an infection elsewhere in the body – for example, in the bowel. There may be a delay before the arthritis occurs, which then usually clears up by itself.

Juvenile Arthritis

What is juvenile idiopathic arthritis?

Arthritis is an inflammation of the joints, with pain or stiffness. It may be acute or chronic.

Acute arthritis is also called septic arthritis and may affect one or more joints.

Chronic arthritis is also known as juvenile idiopathic arthritis (JIA). There are three types of JIA, which are diagnosed according to symptoms and blood tests.

Oligoarticular JIA – the most common kind of childhood arthritis, which often starts at the age of two or three. The problem is limited to four joints or fewer, which become swollen and painful. Sometimes the eyes are affected, too. It is also known as pauciarticular arthritis.

Polyarticular JIA – affects five or more joints. It can start at any age, from a few months onwards, and usually spreads quite quickly from one joint to another. Children often feel generally unwell, sometimes with a fever.

Systemic onset JIA – affects the whole body, and causes fever and rashes as well as inflamed and painful joints. It usually starts in children under five but can affect children of any age. It used to be called Still’s disease.
About one in 1,000 children has arthritis. In many cases, the inflammation stops in late childhood, but about one-third of children affected have problems that last into their adult life.

Juvenile Idiopathic Arthritis Causes

Infection is an important but treatable cause of JIA, especially in the under-twos. Infections include bacteria and viruses, such as mumps, rubella, herpes and Lyme disease.

Polyarticular JIA may be caused by many different things including inflammatory bowel disease, such as Crohn’s disease, inflammatory blood vessel disease or vasculitis, blood disorders such as sickle cell anaemia or haemophilia, malignancy, cystic fibrosis and connective tissue disorders often because of problems linked to the immune system, such as lupus and ankylosing spondylitis.

The cause of systemic juvenile idiopathic arthritis is unknown. Genetic factors may play a part and disease may be triggered by a viral infection (although none has been identified), which causes overactivity of the immune system.

Juvenile Idiopathic Arthritis Symptoms

Symptoms depend on the type of arthritis and joints affected but include painful, swollen, stiff and tender joints, an acute illness with fever and lethargy, loss of appetite, weight loss and refusal to use the affected joint or limb.

In systemic arthritis there may be high fever, rash, swollen glands and muscle pain lasting for at least two weeks, associated with anaemia and inflammation of other organs, including the heart or eye. Joints may develop deformities over time.

Juvenile Idiopathic Arthritis Diagnosis

Diagnosis is made on the basis of a combination of clinical examination, x-rays, bone scans and blood tests. It may be necessary to take a sample of fluid from the joint to test for infectious organisms.

Juvenile Arthritis Treatment

Septic arthritis needs urgent treatment with antibiotics to reduce the risk of damage to the joint.

Treatments include drugs to control pain and inflammation, steroids (in more severe cases, which may include injections into the joint) and powerful medicines that alter the immune system (such as methotrexate, salazopyrin, cyclosporine and etanercept).

Physiotherapy to keep the joints mobile and build muscle strength is also important. Splinting or surgery is sometimes needed.

In most cases, children recover from juvenile arthritis with few long-term problems. However, some do experience considerable difficulties from ongoing disease or damaged joints throughout adolescence and into adulthood.

Other Arthritis Doctors and Specialist You May See

At the same time as sending you for tests, your doctor may refer you to an arthritis specialist at a hospital – usually a consultant rheumatologist. Or you may be referred after your test results have come through. This doesn’t mean your condition is serious, but you’ll have the opinion of an expert in the field.

After Arthritis Diagnosis

Once your doctors are sure you have arthritis, you’ll agree with them a suitable treatment plan. This may involve returning to your health centre or hospital at regular intervals for check-ups and treatment.

It’s possible that you’ll be referred to other health professionals with a special understanding of one aspect of your condition: nurses, orthopaedic surgeons, counsellors, physiotherapists, occupational therapists and social workers. These people should work together as a team to provide you with a package of care tailored to your needs. It’s up to you and your doctors to discuss your best options.

As well as medication and exercise, there are things you can do every day to improve your arthritis condition.

Reduce stress on arthritic joints

• Keep to your ideal weight
• Pace your activities throughout the day – don’t tackle hard physical jobs all at once
• Think about your movements – what makes things worse?
• Wear shoes with thick soft soles, which act as shock absorbers
• Consider using equipment or modifying your home and workplace to help you avoid stressful movements

Dealing With Arthritis Pain

As well as medication, there are simple ways in which you can treat your painful joints.

Warmth applied to the affected area can relieve pain and stiffness. Some people buy special heat lamps or creams that produce localised heat, but a hot water bottle can be just as effective. Make sure it’s wrapped in something so it doesn’t burn you.

An ice pack can bring relief to hot and inflamed joints, but you should seek advice from a physiotherapist first. Never apply ice directly to the skin – it can burn.

Stress and muscle tension can make arthritis seem much worse. Many people find that taking a long bath, listening to soothing music or using a relaxation tape can help. Your physiotherapist will be able to advise you on relaxation techniques.

Some people try and break the pain cycle by putting together a pain management plan. This might include:

• Notes on the best times to take medication
• Notes on when heat, cold and rest seem to help
• Plans on when to take different types of exercise
• Reminders of what helps you feel relaxed

Arthritis Diet

Your body needs a variety of nutrients to stay healthy, so make sure you get lots of fruit and vegetables, meat and/or fish, dairy foods, and bread, rice or pasta. This is what is meant by a balanced diet.

There are many theories about whether what you eat affects your arthritis. As yet there’s little scientific evidence to suggest that it does, but some doctors feel special diets are worth trying as long as they don’t mean missing out on vital nutrients.

If you’re considering going on a special diet for your arthritis, it’s important to discuss it with your doctor first.

Some people with arthritis find their condition improves when they give up certain foods. One theory is that this is because of a food allergy or food intolerance.

There are many tests for determining allergies or intolerances, but the only reliable way of identifying foods that could be making your arthritis worse is by systematically excluding them from your diet. This should be done with the knowledge of your doctor and the help of a qualified dietitian.

Foods Good for Arthritis

There are theories that certain foods and dietary supplements may help arthritis. Some have been tested more than others. For example, there’s evidence that the essential fatty acids found in fish oil and plant seed oils, such as sunflower oil and evening primrose oil, may help some people with rheumatoid arthritis, taken at a dose of 3.5g daily for fish oils and up to 6g daily for EPO. Glucosamine sulphate (but not glucosamine hydrochloride), Chondroitin, and cod liver oil can help those with osteoarthritis.

Other supplements you may hear about include green-lipped mussels, selenium and garlic. However, there’s little scientific evidence of these having positive effects for rheumatoid arthritis and only slightly for osteoarthritis.

You should discuss taking such supplements with your doctor, for example, glucosamine may interfere with medications for diabetes, fish oils can affect blood clotting so should not be taken with aspirin or warfarin, evening primrose oil may interact with anti-inflammatory medications and also anticoagulants.

Some people with arthritis find they help them relax and deal with their pain, although none of them cure arthritis.

Arthritis Medication

Discover more about the different kinds of medication available to people with arthritis.

If you have arthritis, your family doctor or hospital doctor is likely to prescribe medication to help relieve the pain and discomfort and reduce future damage. Always follow the doctor’s or pharmacist’s instructions, as written on the medicine label.

There are four main types of medicine used to treat arthritis.

Arthritis Medicine: Pain-Relieving

The best-known pain-relieving medicines (analgesics) are:

• Aspirin
• Paracetemol
• Ibuprofen

Strictly speaking, aspirin and ibuprofen are anti-inflammatory medicines (see below), but in small doses they have painkilling qualities. Analgesic tablets and gels are available over the counter at chemists without a prescription. You should talk to your doctor before using them for your arthritis. You may be prescribed stronger versions of these medicines or medicines such as codeine or diamorphine that block pain signals to the brain.

Arthritis Medicine: Anti-Inflammatory

These can reduce inflammation as well as pain and so lessen the damage done to joints. There are two types:

Non-steroidal anti-inflammatory drugs (NSAIDs) – the most commonly prescribed arthritis medicines. They usually need to be taken over a long period to have any effect, but continued use can also cause stomach problems. Common NSAIDs include ibuprofen, indomethacin, naproxen, fenbufen, piroxicam and diclofenac. A new type of NSAIDs, cox-2 inhibitors, are recommended to treat some types of arthritis, for example, osteoarthritis.

Steroids – steroids such as cortisone are manufactured versions of the body’s natural hormones. They can be very effective in reducing inflammation, but can cause side effects if taken long term, so they’re usually used to bring severe arthritis under control before using other treatments.

Arthritis Medicine: Disease-Modifying Medicines

These medicines (known as disease-modifying antirheumatic drugs or DMARDs) are used for types of arthritis that involve problems with the immune system, such as rheumatoid arthritis and juvenile idiopathic arthritis. They act on the immune system itself rather than the symptoms of the disease. Some are taken by mouth, some by injection.

Types of disease-modifying medicines include: methotrexate, sulfasalazine, gold (sodium aurothiomalate), penicillamine and azathioprine.

Biologic Response Modifiers

Biologic response modifiers (or BRMS) are a new class of drug once reserved for only very severe rheumatoid arthritis but now increasingly used in early disease because they can be so effective in preventing the long term damage to the joints. Many people find their rheumatoid arthritis responds very well to biologicals, as they are known, but they don’t suit everyone.

BRMs inhibit proteins called cytokines which are the chemical messengers of inflammation in the body. Different BRMs target different messengers. For example etanercept, infliximab and adalimumab block an important chemical called tumor necrosis factor-alpha (TNF-α) while anakinra blocks interleukin-1.

Unfortunately these drugs are expensive and must be given as an injection or infusion.

Using Arthritis Medicines Carefully

Some of the worries can be taken out of using new medicines if you know exactly what they are and how they should be used. When your doctor prescribes you a medicine, you should be absolutely clear about:

• What it is and how it should help.
• How much to take, how often and when.
• Whether there are special circumstances for taking it – for example, after meals.
• Whether it will act immediately or only after some time.
• If there are any side-effects and what to do if they occur.
• Whether it’s all right to take it with other medication you have been prescribed.
• Whether you should avoid alcohol or activities such as driving when taking it.

Side Effects of Arthritis Medicine

All medicines produce side-effects. Reactions vary hugely from person to person and medicine to medicine. Many people taking arthritis medicines do report side-effects, but they are usually minor – the odd stomach pain, for example. On the other hand, arthritis medicines are usually powerful, and some can produce unpleasant and damaging effects.

When making decisions on medicines you should remember the following:

• The likelihood of side-effects is far less if medicines are taken exactly according to instructions – for example with food, if that is specified.
• Your doctor should be regularly supervising your treatment – mainly to check whether the medicines you’re taking are effective and agree with you. If not, they can be changed.
• The risk of taking medicines needs to be weighed against the adverse effects of not taking them. Without treatment, arthritis can become increasingly painful and disabling.
• If you do find that a medicine is causing unwanted effects, such as a rash, headaches, indigestion, stomach upsets or pains, consult your doctor immediately.

Arthritis and Pregnancy

Women who are on medication for their arthritis must talk to their doctor if they’re thinking of starting a family. Some medicines can be harmful in pregnancy and it may be necessary to adjust medication.

Physiotherapy for Arthritis

Physiotherapists and occupational therapists should be part of the team caring for you if you have arthritis. The two professions often work closely together to help people become independent. They can help prevent deformities in children and adults with arthritis.

Chartered physiotherapists are specialists in human movement who aim to help people keep active and free of pain. They’re often based in hospital departments, but some work from family health centres.

Physiotherapists Provide a Number of Services Including:

• Advice on how you can minimise the impact of arthritis on your lifestyle and work
• Pain-relieving treatments such as electrotherapy, massage and sometimes acupuncture
• Hydrotherapy – exercise sessions in heated water can improve mobility and lessen pain

In addition, physiotherapists can also teach arthritis sufferers:

• Specially designed exercise programmes to mobilise your joints and strengthen your supporting muscles
• Relaxation techniques to reduce the stress and muscle tension that can make arthritis seem worse

Physiotherapists sometimes run group sessions, where you can learn exercises and meet people with similar problems.

Occupational Therapy and Arthritis

Occupational therapists (OTs) find ways to keep people independent despite their physical difficulties and give practical advice on how to cope with everyday tasks such as washing, dressing and cooking. They can provide special equipment to help you or tell you where to get it. They also make splints to support and protect joints that are severely affected by arthritis.

They can advise you on:

• How to look after vulnerable joints
• How your home might be made more accessible
• Cars, wheelchairs and the best ways to get around
• Leisure activities
• Employment and benefits
• Your hospital doctor may refer you to the OT department at your local hospital. An OT may need to visit you at home to assess if your house can be altered to make it better suited to you. In this case, you’ll probably be referred to a community OT based at your local social services department.

Arthritis Surgery

If damage to a joint is severe enough to make life very difficult and other treatment isn’t helping, your doctors may recommend surgery.

Surgical options for arthritis

Here are some of the different types of surgery options for severe arthritis:

• Removal of the inflamed lining of the joint
• Removal of the painful covering of tendons
• Release or repair of tendons
• Removal of bone to relieve pain
• Release of trapped nerves
• Fusing joints to make them more stable and pain free
• Replacement of a damaged joint with an artificial joint

Arthritis Joint Replacement

Joint replacement is the most common form of surgery for arthritis, Ankles, shoulders, elbows, wrists and fingers can all be replaced too. Artificial joints don’t work as well as natural joints, but they do enable about 95 per cent of people who have the operation to be free of pain for the lifetime of the joint – around 15 years, sometimes longer.

Joint replacement also helps to regain a significant amount of joint movement, around 75 per cent of the range of movement of a normal joint.

One in 20 joint operations fails and complications can set in. The operation is major, so the decision to have a joint replacement shouldn’t be taken lightly. If your doctor suggests it, discuss what’s being offered and why. The decision will ultimately be yours.

If you want to go ahead, you’ll be referred to an orthopaedic surgeon. You can ask your rheumatologist about the performance and experience of the person to whom you are being referred.

Complementary and Natural Treatment for Arthritis

Some complementary approaches such as homeopathy and acupuncture are available, in some areas, but they’re not universally accepted.

There is a limited body of evidence for certain therapies such as chiropractice, whilst for many other therapies, such as homeopathy, there is no accepted clinical evidence at all for its efficacy and yet complementary therapies still remain a popular choice for many people. The role of homeopathy remains debatable but many doctors acknowledge that complementary approaches may have some benefit for some conditions, as part of a holistic care plan which includes conventional medicine.

Checklist for Natural Treatment for Arthritis

Do:

• Tell your doctor, physiotherapist or occupational therapist that you’re considering seeing a complementary practitioner
• Find a reliable practitioner – it’s worth checking whether there’s an organisation that sets standards in their field, and that they belong and are clinically current in terms of training and education
• Try to find someone who has worked with people with arthritis
• Check the cost
• Check the number of sessions they tell you are needed before benefits are felt
• Choose someone you feel comfortable with

Don’t be:

• Afraid to ask for credentials and references
• Led to believe there are miracle cures
• Taken in by people who say you should follow their method and abandon other treatments

Types of Complementary Natural Therapies for Arthritis

Acupuncture for Arthritis

Works on the theory that inserting needles along energy lines of the body can stimulate energy flow and reduce pain

Alexander Technique for Arthritis

A way of teaching improved posture to help people stand and move more efficiently

Aromatherapy for Arthritis

The use of essential oils from flowers, plants and trees, sometimes combined with massage

Chiropractic for Arthritis

Manipulation to improve mobility and relieve pain by adjusting the joints of the spine and limbs where there are signs of restricted movement (not usually recommended for those with osteoporosis or inflamed joints)

Herbalism for Arthritis

Use of plants and herbal remedies to treat illness

Homeopathy for Arthritis

A system of remedies based on giving people very dilute amounts of a substance that in larger amounts might produce symptoms similar to the condition being treated

Osteopathy for Arthritis

manipulation to restore normal action to the body and reduce pain (not usually recommended for those with osteoporosis or inflamed joints)

Reflexology for Arthritis

massage using pressure to the feet to improve the health of various parts of the body

Yoga for Arthritis

A combination of relaxation, breathing techniques and exercise to combat stress and help circulation and movement of the joints

Exercise for Arthritis

Exercise is a key part of treating arthritis, but it’s important to get it right. People with arthritis should seek professional advice from a physiotherapist about the sort of exercise that will suit them.

Rest and Exercise for Arthritis

People with arthritis often have to balance carefully how and when to exercise and when to rest.

In adults, if the joints are particularly inflamed or swollen it may be necessary to rest more than usual. But generally, people with arthritis should exercise every day to prevent joints from becoming stiff and painful and to keep muscles strong.

For children with arthritis, it’s particularly important to exercise even when the disease is very active because contractures and deformities can develop very quickly.

People with arthritis need three forms of exercise:

General Exercise for Health

Any exercise that leaves you feeling a little breathless and your muscles slightly tired is good for you. As well as keeping you mobile it can help you relax, make you feel better about yourself and give you more energy.

When exercising, it’s best to use as much of the body as possible – swimming, walking and cycling are all good options. Swimming has the added advantage that the water supports the weight of your body rather than your joints. Some strokes may not suit you, though, so try to get professional advice.

If you go to exercise classes, check they’re run by a qualified teacher and that the teacher knows about your condition.

Mobilising Exercises for Arthritis

People with arthritis need to keep their joints moving. Bending and straightening exercises, gentle pedalling or swimming can help a lot. Your physiotherapist may recommend hydrotherapy at your local hospital: many people find they move more freely in water and the warmth of the water loosens their joints.

Special Arthritis Exercises to Strengthen Muscles

If your muscles are strong and healthy, they protect your joints better and you may feel less pain. Your physiotherapist will be able to give you a series of muscle-strengthening exercises to perform at home. Swimming and hydrotherapy are also effective ways of strengthening as well as mobilising.

Arthritis Exercise Checklist

Exercise for Arthritis Do:

• Choose exercises suitable to your level – if you’re a beginner, work up gradually
• Do gentle warm-up stretches before and after the exercise
• Wear good footwear and appropriate clothing
• Enjoy yourself

Exercise for Arthritis Don’t:

• Binge on exercise – little and often is better
• Continue with an activity if it makes your pain worse
• Do fitness or aerobic exercises on a stone or concrete floor
• Exercise if you feel ill

Living With Arthritis

Whatever your age, arthritis presents problems that can significantly affect your life.

Getting around

If arthritis means you have increasing difficulty using public transport, or driving a car, there are many ways of maintaining your mobility.

Some driving instructors are trained to teach people with disabilities to drive. The organisation Motability may be able to help with some of the costs of driving lessons and obtaining a properly adapted car if you’re eligible. You must advise both the Driver Vehicle Licensing Authority (DVLA) and your insurance company if your arthritis affects your ability to drive in any way.

Coping With Arthritis at Home

Arthritis can mean that previously simple tasks become difficult. But there’s help and equipment available. A wide range of devices are available to help you to turn taps on and off, open tins, bottles and jars, cut vegetables, pour tea, pick things up off the floor, write, bathe, dress, garden, brush your hair – and much more.

Stress, Depression, and Arthritis

People with arthritis can feel disheartened, angry, frustrated, lonely and depressed. You may have worries about whether you’ll become disabled and dependent, or about the pressures you’re causing for families and friends.

It can be demoralizing to be told to be positive. It isn’t that simple. But people do come to terms with their condition and find things to be very positive about.

Talking about feelings and fears can help relieve anxiety. But you need to talk to someone who can understand the way you feel. That might be a friend or family member, your doctor or physiotherapist, or someone else with arthritis.

If you don’t want to talk to anyone close to you, or you’ve been depressed for a long time, you may find it useful to talk to someone whose job it is to listen. Your family doctor, social worker or seek counseling services.

Arthritis can present special problems for young people. Worries about future job prospects, family, relationships and disability can be especially intense. It’s not unusual to react angrily to being different and even to refuse to follow the treatment doctors prescribe. Young Arthritis Care runs support groups where young people and their families can discuss feelings and problems.

It’s worth talking to your family doctor about how you feel – they may have other options to help you.

Work and Arthritis

If your arthritis causes difficulties at work, you may be able to overcome them by adjusting your working patterns or using special equipment. Your employer should be happy to discuss such changes with you, to help you continue working.

Sex and Arthritis

Like everyone else, people with arthritis can encounter problems in their sex lives. These can often be connected with the physical and psychological symptoms of arthritis. Talking to your partner is a vital first step. But if the problems continue, your family doctor may be able to help, or refer you to other people who can, such as a trained sex therapist.

Coping as a Carer

Those who live with or look after someone with arthritis has to get the right balance between being supportive and over-protective. It’s easier to judge what to do if you try and learn as much as possible about the condition, and communicate well with the person who has arthritis. Having a child with arthritis poses special problems and can put enormous pressure on parents.